First degree sunburn damages the skin’s outer layer and will heal by itself. Second degree sunburn may penetrate the skin’s outer layer and damage the layer beneath. It may also require specialist treatment.

Sunburn refers to flushed, damaged skin caused by overexposure to UV rays from the sun or an artificial heat source. Sunburn varies from mild to severe.

In the United States, sunburn is common. A 2015 National Health Interview Survey showed that 50% of 18–29-year-old adults reported cases of sunburn in the previous year.

Sunburn is usually first degree or second degree, depending on the depth and size of the affected area of skin.

This article looks at the signs and symptoms of first and second degree sunburn, as well as some treatment options. It also looks at how people can lower their risk of sunburn.

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First degree sunburn damages the skin’s outer layer and will heal by itself, usually within a few days.

A person with first degree sunburn may notice the following skin symptoms, usually about 4 hours after exposure to sunlight:

  • redness, which is more apparent on light skin
  • a warm or tight feeling
  • swelling or blistering
  • soreness

A person may also experience peeling skin around 3–8 days after exposure.

Other symptoms may also accompany first degree sunburn. These include headaches, raised temperature, fatigue, and nausea.

First degree sunburn may take up to a week to heal. In the meantime, people with sunburn can try the following to help ease the symptoms:

  • Take paracetamol, ibuprofen, or acetaminophen to relieve any pain, headaches, or fever.
  • Stay hydrated by drinking plenty of water.
  • Take a cool bath or shower.
  • Apply cool compresses to the affected area.
  • Avoid sun exposure until the sunburn has healed.
  • Apply moisturizing cream, aloe vera, or over-the-counter hydrocortisone cream to the affected area.
  • Lightly bandage any blistered areas to prevent infection, and apply antiseptic ointment or hydrocortisone cream to the affected area.

Second degree sunburn may penetrate the skin’s outer layer and damage the layer beneath, which is called the dermis.

It may take weeks to heal and may need specialist treatment. A person with second degree sunburn may notice the following symptoms:

  • skin that is deep red, especially on light skin
  • swelling and blistering over a large area
  • wet-looking, shiny skin
  • pain
  • white discoloration within the burned area of skin

People with second degree sunburn can follow the same steps to ease their symptoms as those with first degree sunburn. However, they may need further advice and treatment from a healthcare professional.

People with second degree sunburn should contact a doctor if they have skin that is badly blistered and swollen or have symptoms of heatstroke or heat exhaustion. These symptoms include:

  • having a raised temperature
  • feeling hot and shivery
  • exhaustion
  • dizziness
  • nausea
  • headache
  • muscle cramps
  • confusion
  • seizures
  • slurred speech
  • fast breathing or a rapid pulse

Second degree sunburn may take several weeks to heal. Treatment may require specialist burn cream and burn dressings.

Occasionally, people with severe sunburn may need hospital treatment, particularly if they also have heatstroke.

Treatment may include:

  • ice packs, cool baths, or cool compresses to bring down body temperature
  • cold water flushes into the stomach or rectum
  • anti-seizure or muscle-relaxing medications to control shivering and convulsions
  • diverting blood from the heart and lungs, cooling it in a special machine, then returning it to the body

Children and babies with severe sunburn should always visit a healthcare professional for further advice and treatment.

Certain factors increase the risk of sunburn. These include:

  • being outdoors when the UV index is highest, between the hours of 10 a.m. and 4 p.m.
  • having fair skin, blue eyes, freckles, or red or blonde hair
  • being outdoors at higher altitudes, such as when skiing or hiking
  • working or playing sports outdoors
  • being closer to the equator

Younger people are at high risk. One 2017 survey found that around 50% of high school boys and 60% of high school girls had experienced sunburn in the previous 12 months.

Although people with dark skin are at relatively lower risk of burning, they should still take adequate measures to stay safe from sunburn.

People with sunburn should visit a healthcare professional if:

  • Blistered skin covers much of the body.
  • Blisters develop on the face, hands, or genitals.
  • There are symptoms of infection, such as foul-smelling pus, bleeding, pain, or swelling.
  • The symptoms do not improve within a few days.

A person needs emergency treatment if they experience:

  • fever
  • confusion or fainting
  • symptoms of dehydration, heatstroke, or heat exhaustion

Sunburn in childhood can significantly increase the risk of developing skin cancer in later life.

People who have frequent sunburns should contact a dermatologist, as this can also increase the risk of skin cancer.

Sunburn can also age the skin prematurely.

The following tips can help reduce exposure to the sun’s harmful rays and protect the skin when outdoors:

  • Apply adequate protective cream with an SPF of 30 or above to protect against UVB rays.
  • Reapply sunscreen every 2 hours and after swimming.
  • Wear a wide-brimmed hat when outdoors.
  • Wear dark, close-weaved fabrics that block sunlight. Wearing UV protection factor clothing also helps.
  • Look for shaded spots to sit in when outdoors.
  • Avoid going outdoors between 10 a.m. and 4 p.m., when the UV index is at its highest.

People with fair skin, blue eyes, and light hair are at highest risk of sunburn.

Symptoms of sunburn include flushed skin, swelling, blisters, and nausea. People who have any symptoms of dehydration, heatstroke, or heat exhaustion should seek advice from a healthcare professional.

People can usually treat sunburn at home. However, severe sunburn may occasionally need urgent specialist treatment.

If people take suitable precautions when outdoors, they will decrease their risk of sunburn.