Sunburn and Children

What is sunburn? 

Sunburn is a red, painful skin reaction after exposure to ultraviolet (UV) light. The skin absorbs UV light from sunlight as well as artificial sources of light such as tanning beds. UV rays can also cause invisible damage to the skin. Excessive or multiple sunburns cause wrinkling and premature aging of the skin. Sun exposure is also the leading cause of skin cancer. 

Children often spend a good part of their day playing outdoors in the sun, especially during the summer. Children are more likely to develop skin cancer in later years if they have:

• Fair skin, moles, or freckles

• Multiple blistering sunburns

• A family history of skin cancer

Exposure to the sun during daily activities and play causes the most sun damage. Overexposure to sunlight before age 18 is most damaging to the skin.

UV rays are strongest during summer months when the sun is directly overhead. This is normally between 10 a.m. and 4 p.m.

What are the symptoms of sunburn?

These are the most common symptoms of sunburn:

• Redness

• Swelling of the skin

• Pain

• Blisters

• Dry, itching, and peeling skin 3 to 8 days after the burn

More severe cases may cause:

• Fever

• Nausea

• Chills

• Weakness, confusion, or faintness

The symptoms of sunburn may look like other skin conditions. Always see your child's healthcare provider for a diagnosis if you are unsure.

First aid for sunburn

If your child gets a sunburn, these tips can help make your child more comfortable:

• Have your child take a cool bath or use cool compresses on the sunburned area.

• Give your child acetaminophen or ibuprofen for discomfort and fever. Be sure to follow the directions on the container. Never give aspirin to children.

• If your child's healthcare provider tells you to, put a moisturizer, aloe gel, hydrocortisone cream, or a topical pain reliever on the sunburned skin.

• If your child's skin has blisters, don't break them open. They can get infected.

• Keep your child out of the sun until the burn is healed.

• Give your child extra fluid for several days to prevent dehydration. 

When should I call my child's healthcare provider?

Specific treatment for sunburn depends on the severity of the sunburn and age of the child. In general, call your child's healthcare provider right away if:

• The sunburn is severe or forms blisters

• Your child has symptoms of heat stress such as fever (see Fever and children, below), chills, nausea, vomiting, dehydration, or feeling faint

• Your baby is younger than 1 year and gets a sunburn.

Fever and children

Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:

• Rectal. For children younger than 3 years, a rectal temperature is the most accurate.

• Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.

• Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.

• Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.

• Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.

Use a rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.

Below is when to call the healthcare provider if your child has a fever. Your child’s healthcare provider may give you different numbers. Follow their instructions.

When to call a healthcare provider about your child’s fever

For a baby under 3 months old:

• First, ask your child’s healthcare provider how you should take the temperature.

• Rectal or forehead: 100.4°F (38°C) or higher

• Armpit: 99°F (37.2°C) or higher

• A fever of ___________as advised by the provider

For a child age 3 months to 36 months (3 years):

• Rectal or forehead: 102°F (38.9°C) or higher

• Ear (only for use over age 6 months): 102°F (38.9°C) or higher

• A fever of ___________ as advised by the provider

In these cases:

• Armpit temperature of 103°F (39.4°C) or higher in a child of any age

• Temperature of 104°F (40°C) or higher in a child of any age

• A fever of ___________ as advised by the provider

Preventing sunburn

Protect your child from the sun starting at birth and continuing throughout your child's life.

To prevent sunburn in children older than 6 months, follow these ABCs of sun safety:

Away	Stay away from the sun in the middle of the day. This is when the sun's rays are the most damaging.
Block	Block the sun's rays using a sun protection factor (SPF) 30 or higher sunscreen. Apply the lotion 30 minutes before going outside and reapply it often during the day. Use broad-spectrum sunscreens that block the greatest amount of UVA and UVB rays.
Cover up	Cover up using protective clothing, such as a hat and long-sleeve shirt when in the sun. Use clothing with a tight weave to keep out as much sunlight as possible. Sunglasses and hats with brims are important. Clothing rated with UPF (UV protection factor) can also be worn.

Note: Keep babies younger than 6 months old out of direct sunlight at all times. The American Academy of Pediatrics recommends using sunscreen on small areas of the infant's body only, such as the face and backs of the hands, if protective clothing and shade are not available. 

What is sunscreen and sunblock?

Sunscreens protect the skin against sunburn and play an important role in blocking the penetration of UV radiation.

Terms used on sunscreen labels can be confusing. The protection provided by a sunscreen is indicated by the SPF listed on the product label. No sunscreen blocks UV radiation 100%. A product with SPF 15 blocks about 93% of UVB radiation.

A product that physically blocks the sun (such as zinc oxide or titanium dioxide) is sometimes called a sunblock. The terms sunscreen and sunblock are often used interchangeably.

How to use sunscreen and sunblock

A sunscreen or sunblock protects the skin from sunburn and minimizes suntan by absorbing or reflecting UV rays. Using sunscreen correctly is important to protect the skin. To protect your child:

• Choose a sunscreen that's labeled for children. Test it on your child's wrist before using it. If your child has skin irritation, choose another brand. Apply the sunscreen very carefully on the face to avoid the area around the eyes.

• Choose a broad-spectrum sunscreen that filters out both ultraviolet A (UVA) and ultraviolet B (UVB) rays. More expensive sunscreen does not always mean it is better.

• Apply sunscreens to all exposed areas of skin, including easily overlooked areas. These include the rims of the ears, the lips, the back of the neck, and tops of the feet.  

• Use sunscreens for all children older than 6 months. It doesn’t matter what type of skin or complexion your child has. All skin types need protection from UV rays. Even dark-skinned children can have painful sunburns.  

• Watch for ingredients that may irritate your child's skin or give them an allergic reaction. 

• Apply sunscreen 30 minutes before going out into the sun to give it time to work. Put on a thick layer and reapply it every 2 hours after being in the water or after exercising or sweating. Sunscreens are not just for the beach. Use them when your child is playing outdoors in the yard or playing sports.

• Use a waterproof or water-resistant sunscreen.

• Use an SPF of 15 or 30. The American Academy of Dermatology recommends using sunscreen with SPF of 30 or higher while the American Academy of Pediatrics recommends an SPF of at least 15 up to SPF 50. High SPF sunscreens provide more protection than sunscreens with a lower SPF. Talk with your child or teen about why using sunscreen is important. Set a good example by using sunscreen yourself.

• Teach your teen to avoid tanning beds and salons. Most tanning beds and salons use UVA bulbs. Research has shown that UVA rays may contribute to premature aging of the skin and skin cancer.

• Keep children younger than 6 months out of the sun if possible. Dress your child in lightweight clothing that covers most surface areas of skin. 

Always ask your child's healthcare provider for more information.