Angela J. Lamb, MD
Angela J. Lamb, MD, board-certified dermatologist and associate professor of dermatology at Icahn School of Medicine at Mount Sinai in New York City. Icahn.MSSM.edu
Who doesn’t love that first glorious spring day when the sun warms our forearms and our face? On such days, it’s easy to feel like those solar rays are nourishing your body and soul after a long fast. But as most of us now know, exposing your skin directly to the sun for too long increases long-term risk for skin cancer and short-term risk for sunburn and sun poisoning.
But exactly what is sun poisoning? Bottom Line Personal asked board-certified dermatologist Angela Lamb, MD, from Icahn School of Medicine at Mount Sinai.
Sun damage varies in severity from a mild sunburn that hurts a bit to the other extreme…sun poisoning. Symptoms of a sunburn, even a severe one, will be limited to the skin—it will turn red…be warm to the touch…tender and sore…and even might blister and peel.
Symptoms of sun poisoning, on the other hand, are systemic, meaning that in addition to the pain and damage to your skin, you may experience nausea, weakness, vomiting, faintness, dehydration, headache, fever and flulike symptoms.
When direct sunlight hits our skin, a few different processes begin. With prolonged exposure, the sun’s heat starts damaging the DNA in your skin cells. That is why sunburns early in life are associated with greater risk for skin cancer later on. Your body’s immune system responds to this assault by releasing cytokines that kick off a healing cascade of inflammation. The body is trying to wall off the damage and clean up the dead and disfigured cells. That inflammatory response is what causes your skin to redden and become tender and, in the case of severe sunburn, to form blisters.
With sun poisoning, the assault on the skin cells is so severe that it prompts an exuberant inflammatory response so intense that it feels like your entire body, not just your skin, is fighting off something. That’s when you get headache, nausea and other flu-like symptoms.
If you’ve ever wondered why your sunburn changes from red to tan, it’s because two things are happening at once. The fading of the redness is the inflammation receding. The emergence of the tan is the body releasing melanin, a natural pigment that rises toward the skin’s surface to shield it from more DNA damage. People with less natural melanin—and therefore fairer skin—are more prone to sunburn, sun poisoning and skin cancer.
Depending on how serious the case is, the most severe symptoms typically resolve within 24 and 48 hours.
The main dangers associated with sun poisoning are dehydration and infection of sun-ravaged skin. Most cases can be treated at home, although severe sun poisoning may require hospitalization.
Treatment for sun poisoning at home should consist of rest, drinking plenty of fluids and keeping the damaged skin clean. Don’t pop your blisters. Use soothing lotions, aloe and cool compresses to relieve the burning.
When to seek medical attention: If the person has a change in mental status and/or is unarousable, fainting or vomiting, seek medical care. Hospitalized patients are put on intravenous fluids to rehydrate. Depending on the symptoms, sometimes antihistamines are prescribed to decrease the inflammation…and patients receive wound care in the form of steroids and topical creams.
If you’ve ever had sun poisoning: We don’t know the extent to which a single bad sunburn contributes to skin-cancer risk, but some experts estimate that the increased risk is around 50%. There’s certainly reason to be cautious, especially if your episode of sun poisoning occurred when you were a child or teen. More solid research shows that having five blistering sunburns during childhood increases your melanoma risk by 80%.
You can’t undo the effects of a sunburn that you got decades ago—but you can be vigilant now. Get screened for skin cancer every year. If your doctor isn’t doing it as part of your annual wellness exam, insist upon it. Although treatments are improving, melanoma is still killing Americans at a rate of more than 8,000 per year—20 per day.
What sun poisoning isn’t: After their first significant sun exposure of the season, some people develop an itchy rash consisting of small bumps. This condition, called polymorphous light eruption, is sometimes mistakenly referred to as sun poisoning or sun poisoning rash, but it actually is an autoimmune disorder so it is more accurately labeled “sun allergy.” Polymorphous light eruption most often appears for the first time during your 40s, although sometimes you can get it in your teens or 20s. The rash can be treated with topical steroids or oral prescription prednisone, although most cases resolve within a few days and fewer rashes appear as the season progresses.
