Sunburn

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Sunburn
Sunburn Treatment Practices.jpg
A sunburned neck
Specialty Dermatology
Complications Skin cancer
Risk factors Working outdoors, skin unprotected by clothes or sunscreen, skin type, age
PreventionUse of sunscreen, sun protective clothing
TreatmentAvoiding further exposure to the sun. Cool, frequent baths or showers for pain relief. Anti-inflammatory medications such as ibuprofen or aspirin can also help with pain. Drinking water to stay hydrated.

Sunburn is a form of radiation burn that affects living tissue, such as skin, that results from an overexposure to ultraviolet (UV) radiation, usually from the Sun. Common symptoms in humans and other animals include red or reddish skin that is hot to the touch or painful, general fatigue, and mild dizziness. Other symptoms include blistering, peeling skin, swelling, itching, and nausea. Excessive UV radiation is the leading cause of (primarily) non-malignant skin tumors, [1] [2] which in extreme cases can be life-threatening. Sunburn is an inflammatory response in the tissue triggered by direct DNA damage by UV radiation. When the cells' DNA is overly damaged by UV radiation, type I cell-death is triggered and the tissue is replaced. [3]

Contents

Sun protective measures like sunscreen and sun protective clothing are widely accepted to prevent sunburn and some types of skin cancer. [4] Special populations, including children, are especially susceptible to sunburn and protective measures should be used to prevent damage. [5]

Signs and symptoms

Blisters on a sunburned shoulder Sunburn blisters.jpg
Blisters on a sunburned shoulder

Typically, there is initial redness, followed by varying degrees of pain, the severity of which is proportional to the duration and intensity of sun exposure.[ citation needed ]

Other symptoms can include blistering, swelling (edema), itching (pruritus), peeling skin, rash, nausea, fever, chills, and fainting (syncope). Also, heat is produced from capillaries close to the skin surface, therefore the affected area feels warm to touch. Sunburns may be classified as superficial or partial-thickness burns. Blistering is a sign of second-degree sunburn. [6]

Variations

Minor sunburns typically cause nothing more than slight redness and tenderness to the affected areas. In more serious cases, blistering can occur. Extreme sunburns can be painful to the point of debilitation and may require hospital care. [7]

Duration

Sunburn can occur in less than 15 minutes in response to sun exposure and in seconds when exposed to non-shielded welding arcs or other sources of intense ultraviolet light. Nevertheless, the inflicted harm is often not immediately obvious.[ citation needed ]

After sun exposure, the skin may turn red in as little as 30 minutes, but sunburn usually takes 2 to 6 hours. Pain is usually strongest 6 to 48 hours after exposure. The burn continues to develop for 1 to 3 days, occasionally followed by peeling skin after 3 to 8 days. Some peeling and itching may continue for several weeks.[ citation needed ]

Skin cancer

Ultraviolet radiation causes sunburns and increases the risk of three types of skin cancer: melanoma, basal-cell carcinoma and squamous-cell carcinoma. [1] [2] [8] Of greatest concern is that the melanoma risk increases dose-dependently proportional to the number of a person's lifetime cumulative episodes of sunburn. [9] An estimated 1/3 of melanomas in the United States and Australia could be prevented with regular sunscreen use. [10]

Causes

The cause of sunburn is the direct damage that a UVB photon can induce in DNA (left). One of the possible reactions from the excited state is the formation of a thymine-thymine cyclobutane dimer (right). Direct DNA damage.png
The cause of sunburn is the direct damage that a UVB photon can induce in DNA (left). One of the possible reactions from the excited state is the formation of a thymine-thymine cyclobutane dimer (right).

Sunburn is caused by UV radiation from the Sun but may also result from artificial sources, such as tanning lamps, welding arcs, or ultraviolet germicidal irradiation. It is the body's reaction to direct DNA damage from UVB light. This damage is mainly the formation of a thymine dimer. The damage is recognized by the body, which then triggers several defense mechanisms, including DNA repair to revert the damage, apoptosis and peeling to remove irreparably damaged skin cells, and increased melanin production to prevent future damage. [3]

Melanin readily absorbs UV wavelength light, acting as a photoprotectant. By preventing UV photons from disrupting chemical bonds, melanin inhibits both the direct alteration of DNA, as well as the generation of free radicals, to prevent them from indirectly damaging DNA. However, human melanocytes contain over 2,000 genomic sites that are highly sensitive to UV, and such sites can be up to 170-fold more sensitive to UV induction of cyclobutane pyrimidine dimers than the average site [11] These sensitive sites often occur at biologically significant locations near genes.

Sunburn causes an inflammation process that includes the production of prostanoids and bradykinin. These chemical compounds increase sensitivity to heat by reducing the threshold of heat receptor (TRPV1) activation from 109 °F (43 °C) to 85 °F (29 °C). [12] The pain may be caused by the overproduction of a protein called CXCL5, which activates nerve fibers. [13]

Skin type determines the ease of sunburn. People with lighter skin tones and limited capacity to develop a tan after UV radiation exposure have a greater risk of sunburn. Fitzpatrick's Skin phototypes classification describes the normal variations of skin responses to UV radiation. Persons with type I skin have the greatest capacity to sunburn, and type VI have the least capacity to burn. However, all skin types can develop sunburn. [14]

Fitzpatrick's skin phototypes:

Age also affects how skin reacts to the sun. Children younger than six and adults older than sixty are more sensitive to sunlight. [16]

Certain genetic conditions, for example, xeroderma pigmentosum, increase a person's susceptibility to sunburn and subsequent skin cancers. These conditions involve defects in DNA repair mechanisms which decrease the ability to repair DNA damaged by UV radiation. [17]

Medications

The risk of sunburn can be increased by pharmaceutical products that sensitize users to UV radiation. Certain antibiotics, oral contraceptives, antidepressants, acne medications, and tranquillizers have this effect. [18]

UV intensity

The UV Index indicates the risk of sunburn at a given time and location. Contributing factors include: [16]

  1. The time of day. In most locations, the sun's rays are strongest between approximately 10 am and 4 pm daylight saving time. [19]
  2. Cloud cover. Clouds partially block UV, but even on an overcast day, a significant percentage of the sun's damaging UV radiation can pass through clouds. [20] [21]
  3. Proximity to reflective surfaces, such as water, sand, concrete, snow, and ice. All of these reflect the sun's rays and can cause sunburns.
  4. The season of the year. The Sun's position in late spring and early summer can cause a more-severe sunburn.
  5. Altitude. At a higher altitude, it is easier to become burnt, because there is less of the Earth's atmosphere to block the sunlight. UV exposure increases about 4% for every 1000 ft (305 m) gain in elevation.
  6. Proximity to the equator (latitude). Between the polar and tropical regions, the closer to the equator, the more direct sunlight passes through the atmosphere over a year. For example, the southern United States gets fifty percent more sunlight than the northern United States.
Erythemal dose rate at three Northern latitudes. (Divide by 25 to obtain the UV Index.) Source: NOAA. UV Diurnal Erythemal Dose Rate Per Latitude graph.png
Erythemal dose rate at three Northern latitudes. (Divide by 25 to obtain the UV Index.) Source: NOAA.

Because of variations in the intensity of UV radiation passing through the atmosphere, the risk of sunburn increases with proximity to the tropic latitudes, located between 23.5° north and south latitude. All else being equal (e.g., cloud cover, ozone layer, terrain, etc.), each location within the tropic or polar regions receives approximately the same amount of UV radiation over a year. In the temperate zones between 23.5° and 66.5°, UV radiation varies substantially by latitude and season. The higher the latitude, the lower the intensity of the UV rays. Sun intensity in the northern hemisphere is greatest during May, June and Julyand in the southern hemisphere, November, December and January. On a minute-by-minute basis, the amount of UV radiation depends on the Sun's angle. Ultraviolet radiation is easily determined by the height ratio of any object to the size of its shadow. Height is measured parallel to the Earth's gravitational field and the projected shadow is measured on a flat, level surface. For objects wider than skulls or poles, the height and length are best measured relative to the same occluding edge. The most significant risk is at solar noon when shadows are at their minimum, and the Sun's radiation passes most directly through the atmosphere. Regardless of one's latitude (assuming no other variables), equal shadow lengths mean equal amounts of UV radiation.[ citation needed ]

The skin and eyes are most sensitive to damage by UV at 265–275 nm wavelength, which is in the lower UVC band that is rarely encountered except from artificial sources like welding arcs. Longer wavelengths of UV radiation cause most sunburn because those wavelengths are more prevalent in ground-level sunlight.[ citation needed ]

Ozone depletion

In recent decades, the incidence and severity of sunburn have increased worldwide, partly because of chemical damage to the atmosphere's ozone layer. Between the 1970s and the 2000s, average stratospheric ozone decreased by approximately 4%, contributing an approximate 4% increase to the average UV intensity at the Earth's surface. Ozone depletion and the seasonal "ozone hole" have led to much larger changes in some locations, especially in the southern hemisphere. [22]

Tanning

Suntans, which naturally develop in some individuals as a protective mechanism against the sun, are viewed by most in the Western world as desirable. [23] Tanning has led to an increased exposure to UV radiation from both the natural sun and tanning lamps. Suntans can provide a modest sun protection factor (SPF) of 3, meaning that tanned skin would tolerate up to three times the UV exposure as pale skin. [24]

Sunburns associated with indoor tanning can be severe. [25]

The World Health Organization, American Academy of Dermatology, and the Skin Cancer Foundation have recommended avoiding artificial UV sources such as tanning beds. Suntans are not recommended as a form of sun protection. [26] [27] [28]

Diagnosis

A sunburned leg below the shorts line Sunburned knee.png
A sunburned leg below the shorts line

Differential diagnosis

The differential diagnosis of sunburn includes other skin pathology induced by UV radiation, including photoallergic reactions, phototoxic reactions to topical or systemic medications, and other dermatologic disorders that are aggravated by exposure to sunlight. Considerations for diagnosis include duration and intensity of UV exposure, topical or systemic medication use, history of dermatologic disease, and nutritional status.

Additionally, since sunburn is a type of radiation burn, [30] [31] it can initially hide a severe exposure to radioactivity. Excess radiation exposure may result in acute radiation syndrome or other radiation-induced illnesses, especially in sunny conditions. For instance, the difference between the erythema caused by sunburn and other radiation burns is not immediately obvious. Symptoms common to heat illness and the prodromic stage of acute radiation syndrome like nausea, vomiting, fever, weakness/fatigue, dizziness or seizure can add to further diagnostic confusion. [32]

Prevention

Sunburn effect (as measured by the UV Index) is the product of the sunlight spectrum at the Earth's surface (radiation intensity) and the erythemal action spectrum (skin sensitivity). Long-wavelength UV is more prevalent, but each milliwatt at 295 nm produces almost 100 times more sunburn than at 315 nm. Erythemal action spectrum.svg
Sunburn effect (as measured by the UV Index) is the product of the sunlight spectrum at the Earth's surface (radiation intensity) and the erythemal action spectrum (skin sensitivity). Long-wavelength UV is more prevalent, but each milliwatt at 295 nm produces almost 100 times more sunburn than at 315 nm.
Skin peeling on the upper arm as a result of sunburn - the destruction of lower layers of the epidermis causes rapid loss of the top layers Sun burn.JPG
Skin peeling on the upper arm as a result of sunburn – the destruction of lower layers of the epidermis causes rapid loss of the top layers
Tanning of the forearm (visible darkening of the skin) after extended sun exposure Sunburn - (20190727170341).jpg
Tanning of the forearm (visible darkening of the skin) after extended sun exposure

The most effective way to prevent sunburn is to reduce the amount of UV radiation reaching the skin. The World Health Organization, American Academy of Dermatology, and Skin Cancer Foundation recommend the following measures to prevent excessive UV exposure and skin cancer: [33] [34] [35]

UV intensity

The strength of sunlight is published in many locations as a UV Index. Sunlight is generally strongest when the Sun is close to the highest point in the sky. Due to time zones and daylight saving time, this is not necessarily at 12 pm, but often one to two hours later. Seeking shade using umbrellas and canopies can reduce UV exposure, but does not block all UV rays. The WHO recommends following the shadow rule: "Watch your shadow – Short shadow, seek shade!" [33]

Sunscreen

Commercial preparations that block UV light are known as sunscreens or sunblocks. They have a sun protection factor (SPF) rating based on the sunblock's ability to suppress sunburn: The higher the SPF rating, the lower the amount of direct DNA damage. The stated protection factors are correct only if 2 mg of sunscreen is applied per square cm of exposed skin translates into about 28 mL (1 oz) to cover the whole body of an adult male. The recommended dose is much more than many people use in practice. [36] Sunscreens function as chemicals such as oxybenzone and dioxybenzone (organic sunscreens) or opaque materials such as zinc oxide or titanium oxide (inorganic sunscreens) that mainly absorb UV radiation. Chemical and mineral sunscreens vary in the wavelengths of UV radiation blocked. Broad-spectrum sunscreens contain filters that protect against UVA radiation as well as UVB. Although UVA radiation does not primarily cause sunburn, it contributes to skin aging and increases skin cancer risk.[ citation needed ]

Sunscreen is effective and thus recommended for preventing melanoma [37] and squamous cell carcinoma. [38] There is little evidence that it is effective in preventing basal cell carcinoma. [39] Typical use of sunscreen does not usually result in vitamin D deficiency, but extensive usage may. [40]

Recommendations

Research has shown that the best sunscreen protection is achieved by application 15 to 30 minutes before exposure, followed by one reapplication 15 to 30 minutes after exposure begins. Further reapplication is necessary after activities such as swimming, sweating, and rubbing. [41] Recommendations are product dependent varying from 80 minutes in water to hours based on the indications and protection shown on the label. The American Academy of Dermatology recommends the following criteria in selecting a sunscreen: [42]

  • Broad spectrum: protects against both UVA and UVB rays
  • SPF 30 or higher
  • Water resistant: sunscreens are classified as water resistant based on time, either 40 minutes, 80 minutes, or not water resistant

Eyes

The eyes are also sensitive to sun exposure at about the same UV wavelengths as skin; snow blindness is sunburn of the cornea. Wrap-around sunglasses or the use by spectacle-wearers of glasses that block UV light reduce harmful radiation. UV light has been implicated in the development of age-related macular degeneration, [43] pterygium [44] and cataracts. [45] Concentrated clusters of melanin, commonly known as freckles, are often found within the iris.

The tender skin of the eyelids can also become sunburned and can be especially irritating.[ citation needed ]

Lips

The lips can become chapped (cheilitis) by sun exposure. Sunscreen on the lips does not have a pleasant taste and might be removed by saliva. Some lip balms (ChapSticks) have SPF ratings and contain sunscreens.[ citation needed ]

Feet

The skin of the feet is often tender and protected, so sudden prolonged exposure to UV radiation can be particularly painful and damaging to the top of the foot. Protective measures include sunscreen, socks, or swimwear that covers the foot.

Diet

Dietary factors influence susceptibility to sunburn, recovery from sunburn, and risk of secondary complications. Several dietary antioxidants, including essential vitamins, are effective in protecting against sunburn and skin damage associated with ultraviolet radiation, in both human and animal studies. Supplementation with Vitamin C and Vitamin E was shown in one study to reduce the amount of sunburn after a controlled amount of UV exposure. [46] A review of scientific literature through 2007 found that beta carotene (Vitamin A) supplementation had a protective effect against sunburn. The effects of beta carotene were only evident in the long-term, with studies of supplementation for periods less than ten weeks in duration failing to show any effects. [47] There is also evidence that common foods may have some protective ability against sunburn if taken for a period before exposure. [48] [49]

Protecting children

Babies and children are particularly susceptible to UV damage which increases their risk of both melanoma and non-melanoma skin cancers later in life. Children should not sunburn at any age, and protective measures can reduce their future risk of skin cancer. [50]

Artificial UV exposure

The WHO recommends that artificial UV exposure, including tanning beds, should be avoided as no safe dose has been established. [51] Special protective clothing (for example, welding helmets/shields) should be worn when exposed to any artificial source of occupational UV. Such sources can produce UVC, an extremely carcinogenic wavelength of UV, which ordinarily is not present in normal sunlight, having been filtered out by the atmosphere.[ citation needed ]

Treatment

The primary measure of treatment is avoiding further exposure to the sun. The best treatment for most sunburns is time; most sunburns heal completely within a few weeks.

The American Academy of Dermatology recommends the following for the treatment of sunburn: [52]

Non-steroidal anti-inflammatory drugs (NSAIDs; such as ibuprofen or naproxen), and aspirin may decrease redness and pain. [53] [54] Local anesthetics such as benzocaine, however, are contraindicated. [55] Schwellnus et al. state that topical steroids (such as hydrocortisone cream) do not help with sunburns, [54] although the American Academy of Dermatology says they can be used on especially sore areas. [55] While lidocaine cream (a local anesthetic) is often used as a sunburn treatment, there is little evidence for the effectiveness of such use. [56]

A home treatment that may help the discomfort is using cool and wet cloths on the sunburned areas. [54] Applying soothing lotions that contain aloe vera to sunburned areas was supported by multiple studies. [57] [58] However, others have found aloe vera to have no effect. [54] Note that aloe vera cannot protect people from new or further sunburn. [59] Another home treatment is using a moisturizer that contains soy. [55] Furthermore, sunburn draws fluid to the skin's surface and away from the rest of the body. Drinking extra water is recommended to help prevent dehydration. [55]

See also

Related Research Articles

<span class="mw-page-title-main">Ultraviolet</span> Energetic, invisible light energy range

Ultraviolet (UV) light is electromagnetic radiation of wavelength shorter than that of visible light, but longer than X-rays. UV radiation is present in sunlight, and constitutes about 10% of the total electromagnetic radiation output from the Sun. It is also produced by electric arcs; Cherenkov radiation; and specialized lights, such as mercury-vapor lamps, tanning lamps, and black lights.

<span class="mw-page-title-main">Electromagnetic radiation and health</span> Aspect of public health

Electromagnetic radiation can be classified into two types: ionizing radiation and non-ionizing radiation, based on the capability of a single photon with more than 10 eV energy to ionize atoms or break chemical bonds. Extreme ultraviolet and higher frequencies, such as X-rays or gamma rays are ionizing, and these pose their own special hazards: see radiation poisoning.

<span class="mw-page-title-main">Skin cancer</span> Medical condition involving uncontrolled growth of skin cells

Skin cancers are cancers that arise from the skin. They are due to the development of abnormal cells that have the ability to invade or spread to other parts of the body. Skin cancer is the most commonly diagnosed form of cancer in humans. There are three main types of skin cancers: basal-cell skin cancer (BCC), squamous-cell skin cancer (SCC) and melanoma. The first two, along with a number of less common skin cancers, are known as nonmelanoma skin cancer (NMSC). Basal-cell cancer grows slowly and can damage the tissue around it but is unlikely to spread to distant areas or result in death. It often appears as a painless raised area of skin that may be shiny with small blood vessels running over it or may present as a raised area with an ulcer. Squamous-cell skin cancer is more likely to spread. It usually presents as a hard lump with a scaly top but may also form an ulcer. Melanomas are the most aggressive. Signs include a mole that has changed in size, shape, color, has irregular edges, has more than one color, is itchy or bleeds.

<span class="mw-page-title-main">Sunscreen</span> Topical skin product that helps protect against sunburn

Sunscreen, also known as sunblock or sun cream, is a photoprotective topical product for the skin that helps protect against sunburn and most importantly prevent skin cancer. Sunscreens come as lotions, sprays, gels, foams, sticks, powders and other topical products. Sunscreens are common supplements to clothing, particularly sunglasses, sunhats and special sun protective clothing, and other forms of photoprotection.

<span class="mw-page-title-main">Sun tanning</span> Darkening of skin in response to ultraviolet light

Sun tanning or tanning is the process whereby skin color is darkened or tanned. It is most often a result of exposure to ultraviolet (UV) radiation from sunlight or from artificial sources, such as a tanning lamp found in indoor tanning beds. People who deliberately tan their skin by exposure to the sun engage in a passive recreational activity of sun bathing. Some people use chemical products which can produce a tanning effect without exposure to ultraviolet radiation, known as sunless tanning.

<span class="mw-page-title-main">Indoor tanning</span> Tanning using an artificial source of ultraviolet light

Indoor tanning involves using a device that emits ultraviolet radiation to produce a cosmetic tan. Typically found in tanning salons, gyms, spas, hotels, and sporting facilities, and less often in private residences, the most common device is a horizontal tanning bed, also known as a sunbed or solarium. Vertical devices are known as tanning booths or stand-up sunbeds.

<span class="mw-page-title-main">Melanoma</span> Cancer originating in melanocytes

Melanoma is the most dangerous type of skin cancer; it develops from the melanin-producing cells known as melanocytes. It typically occurs in the skin, but may rarely occur in the mouth, intestines, or eye. In women, melanomas most commonly occur on the legs; while in men, on the back. Melanoma is frequently referred to as malignant melanoma. However, the medical community stresses that there is no such thing as a 'benign melanoma' and recommends that the term 'malignant melanoma' should be avoided as redundant.

<span class="mw-page-title-main">Actinic keratosis</span> Skin disorder

Actinic keratosis (AK), sometimes called solar keratosis or senile keratosis, is a pre-cancerous area of thick, scaly, or crusty skin. Actinic keratosis is a disorder of epidermal keratinocytes that is induced by ultraviolet (UV) light exposure. These growths are more common in fair-skinned people and those who are frequently in the sun. They are believed to form when skin gets damaged by UV radiation from the sun or indoor tanning beds, usually over the course of decades. Given their pre-cancerous nature, if left untreated, they may turn into a type of skin cancer called squamous cell carcinoma. Untreated lesions have up to a 20% risk of progression to squamous cell carcinoma, so treatment by a dermatologist is recommended.

<span class="mw-page-title-main">Sunless tanning</span> Indoor tanning lotion

Sunless tanning, also known as UV filled tanning, self tanning, spray tanning, or fake tanning, refers to the effect of a suntan without exposure to the Sun. Sunless tanning involves the use of oral agents (carotenids), or creams, lotions or sprays applied to the skin. Skin-applied products may be skin-reactive agents or temporary bronzers (colorants).

<span class="mw-page-title-main">Ultraviolet index</span> Measurement of strength of sunburn-producing ultraviolet (UV) radiation

The ultraviolet index, or UV index, is an international standard measurement of the strength of the sunburn-producing ultraviolet (UV) radiation at a particular place and time. It is primarily used in daily and hourly forecasts aimed at the general public. The UV index is designed as an open-ended linear scale, directly proportional to the intensity of UV radiation, and adjusting for wavelength based on what causes human skin to sunburn. The purpose of the UV index is to help people effectively protect themselves from UV radiation, which has health benefits in moderation but in excess causes sunburn, skin aging, DNA damage, skin cancer, immunosuppression, and eye damage, such as cataracts.

<span class="mw-page-title-main">Skin care</span> Range of practices that support skin integrity

Skin care or skincare is a range of practices that support skin integrity, enhance its appearance, and relieve skin conditions. They can include nutrition, avoidance of excessive sun exposure, and appropriate use of emollients. Practices that enhance appearance include the use of cosmetics, botulinum, exfoliation, fillers, laser resurfacing, microdermabrasion, peels, retinol therapy, and ultrasonic skin treatment. Skin care is a routine daily procedure in many settings, such as skin that is either too dry or too moist, and prevention of dermatitis and prevention of skin injuries.

<span class="mw-page-title-main">Sun protective clothing</span> Clothing which blocks light

Sun protective clothing is clothing specifically designed for sun protection and is produced from a fabric rated for its level of ultraviolet (UV) protection. A novel weave structure and denier may produce sun protective properties. In addition, some textiles and fabrics employed in the use of sun protective clothing may be pre-treated with UV-inhibiting ingredients during manufacture to enhance their effectiveness.

<span class="mw-page-title-main">Pyrimidine dimer</span> Type of damage to DNA

Pyrimidine dimers represent molecular lesions originating from thymine or cytosine bases within DNA, resulting from photochemical reactions. These lesions, commonly linked to direct DNA damage, are induced by ultraviolet light (UV), particularly UVC, result in the formation of covalent bonds between adjacent nitrogenous bases along the nucleotide chain near their carbon–carbon double bonds, the photo-coupled dimers are fluorescent. Such dimerization, which can also occur in double-stranded RNA (dsRNA) involving uracil or cytosine, leads to the creation of cyclobutane pyrimidine dimers (CPDs) and 6–4 photoproducts. These pre-mutagenic lesions modify the DNA helix structure, resulting in abnormal non-canonical base pairing and, consequently, adjacent thymines or cytosines in DNA will form a cyclobutane ring when joined together and cause a distortion in the DNA. This distortion prevents DNA replication and transcription mechanisms beyond the dimerization site.

UV-B lamps are lamps that emit a spectrum of ultraviolet light with wavelengths ranging from 290–320 nanometers. This spectrum is also commonly called the biological spectrum due to the human body's sensitivity to light of such a wavelength. UV-B light does not tan the skin very much, compared to the UV-A lamps that are used in tanning beds.

Tanning activators are chemicals that increase the effect of UV-radiation on the human skin.

<span class="mw-page-title-main">Photoaging</span> Ultraviolet light-induced biological development over time

Photoaging or photoageing is a term used for the characteristic changes to skin induced by chronic UVA and UVB exposure. Tretinoin is the best studied retinoid in the treatment of photoaging.

<span class="mw-page-title-main">Health effects of sunlight exposure</span>

Exposing skin to the ultraviolet radiation in sunlight has both positive and negative health effects. On the positive side, exposure allows for the synthesis of vitamin D3. Vitamin D has been suggested as having a wide range of positive health effects, which include strengthening bones and possibly inhibiting the growth of some cancers. A dietary supplement can also supply vitamin D, but there are also benefits to exposure not obtainable through Vitamin D supplementation. Long-term sun exposure is associated with reduced all-cause mortality and reduced mortality risk from cardiovascular disease (CVD), some forms of cancer, and non-CVD/noncancer related disease, with indications in these studies that Vitamin D is not the mediator. Supplementation offers limited bioavailability and no synthesis of subdermal nitric oxide. UV exposure also has positive effects for endorphin levels, and possibly for protection against multiple sclerosis. Abundant visible light to the eyes gives health benefits through its association with the timing of melatonin synthesis, maintenance of normal and robust circadian rhythms, and reduced risk of seasonal affective disorder.

Solumbra is a line of sun protection clothing and a patented fabric that was introduced in 1992.

<span class="mw-page-title-main">Sunscreen Innovation Act</span> US legislative piece

The Sunscreen Innovation Act is a 2014 law that amended the Federal Food, Drug, and Cosmetic Act to establish an expedited process for the review and approval of over-the-counter (OTC) sunscreens. The US Food and Drug Administration (FDA) had not approved a new active ingredient in sunscreen since 1999, despite some sunscreens having been approved and used overseas for a decade. The new law gave the FDA one year to respond to the existing backlog of sunscreen ingredient approval requests, and then 18 months to reply to any future applications.

<span class="mw-page-title-main">Skin cancer in Australia</span>

Skin cancer in Australia kills over 2,000 each year, with more than 750,000 diagnosed and treated. Tanning became embedded in Australian culture and proved to be a controversial issue because of its popularity among teens and solarium users, despite correlations between tanning and an increased risk of developing melanoma. Australia experienced relative success through skin cancer prevention campaigns started in the 1980s and continued to invest and promote awareness through government-funded mass media strategies. Although Australia has one of the highest national rates of skin cancer, mortality trends in melanoma stabilized.

References

  1. 1 2 World Health Organization, International Agency for Research on Cancer "Do sunscreens prevent skin cancer" Archived 26 November 2006 at the Wayback Machine Press release No. 132, 5 June 2000
  2. 1 2 World Health Organization, International Agency for Research on Cancer "Solar and ultraviolet radiation" Archived 29 July 2013 at the Wayback Machine IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, Volume 55, November 1997
  3. 1 2 Sunburn at eMedicine
  4. Maslin, Douglas L. (November 2014). "Do suncreens protect us?". International Journal of Dermatology. 53 (11): 1319–1323. doi: 10.1111/ijd.12606 . PMID   25208462. S2CID   205188894.
  5. Dusza, Stephen W.; Halpern, Allan C.; Satagopan, Jaya M.; Oliveria, Susan A.; Weinstock, Martin A.; Scope, Alon; Berwick, Marianne; Geller, Alan C. (February 2012). "Prospective Study of Sunburn and Sun Behavior Patterns During Adolescence". Pediatrics. 129 (2): 309–317. doi:10.1542/peds.2011-0104. ISSN   0031-4005. PMC   3269110 . PMID   22271688.
  6. "How to treat sunburn | American Academy of Dermatology". www.aad.org. Archived from the original on 20 March 2018. Retrieved 29 March 2018.
  7. Guy, Gery P.; Berkowitz, Zahava; Watson, Meg (1 January 2017). "Estimated Cost of Sunburn-Associated Visits to US Hospital Emergency Departments". JAMA Dermatology. 153 (1): 90–92. doi:10.1001/jamadermatol.2016.4231. ISSN   2168-6068. PMC   6057474 . PMID   27902809. S2CID   8254557.
  8. "Facts About Sunburn and Skin Cancer" Archived 2 June 2013 at the Wayback Machine , Skin Cancer Foundation
  9. Dennis LK, Vanbeek MJ, Beane Freeman LE, Smith BJ, Dawson DV, Coughlin JA (August 2008). "Sunburns and risk of cutaneous melanoma: does age matter? A comprehensive meta-analysis". Annals of Epidemiology. 18 (8): 614–27. doi:10.1016/j.annepidem.2008.04.006. PMC   2873840 . PMID   18652979.
  10. Olsen CM, Wilson LF, Green AC, Biswas N, Loyalka J, Whiteman DC (January 2018). "How many melanomas might be prevented if more people applied sunscreen regularly?". The British Journal of Dermatology. 178 (1): 140–147. doi:10.1111/bjd.16079. PMID   29239489. S2CID   10914195. Archived from the original on 7 August 2020. Retrieved 13 December 2019.
  11. Premi, Sanjay; Han, Lynn; Mehta, Sameet; Knight, James; Zhao, Dejian; Palmatier, Meg A.; Kornacker, Karl; Brash, Douglas E. (2019). "Genomic sites hypersensitive to ultraviolet radiation". Proceedings of the National Academy of Sciences. 116 (48): 24196–24205. Bibcode:2019PNAS..11624196P. doi: 10.1073/pnas.1907860116 . PMC   6883822 . PMID   31723047.
  12. Linden DJ (2015). Touch: The Science of Hand, Heart and Mind. Viking. Archived from the original on 15 October 2021. Retrieved 1 March 2015.
  13. Dawes JM, Calvo M, Perkins JR, Paterson KJ, Kiesewetter H, Hobbs C, Kaan TK, Orengo C, Bennett DL, McMahon SB (July 2011). "CXCL5 mediates UVB irradiation-induced pain". Science Translational Medicine. 3 (90): 90ra60. doi:10.1126/scitranslmed.3002193. PMC   3232447 . PMID   21734176.
  14. 1 2 3 4 5 Wolff K, Johnson R, Saavedra A (2013). Fitzpatrick's color atlas and synopsis of clinical dermatology (7th ed.). New York: McGraw-Hill Medical. ISBN   978-0-07-179302-5. OCLC   813301093.
  15. Wolff, K, ed. (2017). "PHOTOSENSITIVITY, PHOTO-INDUCED DISORDERS, AND DISORDERS BY IONIZING RADIATION". Fitzpatrick's Color Atlas and Synopsis of Clinical Dermatology (8th ed.). New York, NY: McGraw Hill. Archived from the original on 21 March 2018. Retrieved 20 March 2018.
  16. 1 2 "Sunburn – Topic Overview". Healthwise. 15 November 2013. Archived from the original on 30 September 2017. Retrieved 29 November 2014.
  17. Kraemer KH, DiGiovanna JJ (1993). "Xeroderma Pigmentosum". In Adam MP, Ardinger HH, Pagon RA, Wallace SE, Bean LJ, Stephens K, Amemiya A (eds.). GeneReviews®. Seattle (WA): University of Washington, Seattle. PMID   20301571. Archived from the original on 17 April 2021. Retrieved 23 March 2018.
  18. "Avoiding Sun-Related Skin Damage". Fact-Sheets.com. 2004. Retrieved 3 January 2015.
  19. "Tanning – Ultraviolet (UV) Radiation". Health Center for Devices and Radiological. United States Food and Drug Administration. Archived from the original on 23 May 2017. Retrieved 19 May 2017.
  20. "Global Solar UV Index: A Practical Guide" (PDF). World Health Organization. 2002. Archived (PDF) from the original on 27 November 2014. Retrieved 2 January 2015. Up to 80% of solar UV radiation can penetrate light cloud cover.
  21. "How UV Index Is Calculated". EPA. 2012. Archived from the original on 16 February 2015. Retrieved 2 January 2015. Clear skies allow virtually 100% of UV to pass through, scattered clouds transmit 89%, broken clouds transmit 73%, and overcast skies transmit 31%.
  22. "Twenty Questions and Answers About the Ozone Layer" (PDF). Scientific Assessment of Ozone Depletion: 2010. World Meteorological Organization. 2011. Archived (PDF) from the original on 1 April 2014. Retrieved 13 March 2015.
  23. "Suntan". Healthwise. 27 March 2005. Retrieved 26 August 2006.
  24. "The Surgeon General's Call to Action to Prevent Skin Cancer" (PDF). U.S. Department of Health and Human Services. 2014. p. 20. Archived (PDF) from the original on 26 November 2014. Retrieved 17 August 2016. A UVB-induced tan provides minimal sun protection, equivalent to an SPF of about 3.
  25. Guy GP, Watson M, Haileyesus T, Annest JL (February 2015). "Indoor tanning-related injuries treated in a national sample of US hospital emergency departments". JAMA Internal Medicine. 175 (2): 309–11. doi:10.1001/jamainternmed.2014.6697. PMC   4593495 . PMID   25506731.
  26. "Prevention - SkinCancer.org". skincancer.org. Archived from the original on 30 March 2018. Retrieved 30 March 2018.
  27. "Dangers of indoor tanning | American Academy of Dermatology". www.aad.org. Archived from the original on 30 March 2018. Retrieved 30 March 2018.
  28. "WHO | Artificial tanning devices: public health interventions to manage sunbeds". WHO. Archived from the original on 29 June 2017. Retrieved 30 March 2018.
  29. 1 2 Kasper DL, Fauci AS, Hauser SL, Longo DL, Jameson JL, Loscalzo J (8 April 2015). Harrison's principles of internal medicine (19th ed.). New York: McGraw Hill. ISBN   978-0-07-180215-4. OCLC   893557976.
  30. "What Are the Types and Degrees of Burns?". Archived from the original on 7 June 2019. Retrieved 7 June 2019.
  31. "Sunburn – Health Encyclopedia – University of Rochester Medical Center". Archived from the original on 8 June 2019. Retrieved 7 June 2019.
  32. "Acute Radiation Syndrome | CDC". 23 October 2020. Archived from the original on 8 June 2019. Retrieved 7 June 2019.
  33. 1 2 "Sun protection". World Health Organization. Archived from the original on 22 March 2018. Retrieved 28 March 2018.
  34. "Prevention Guidelines - SkinCancer.org". skincancer.org. Archived from the original on 29 March 2018. Retrieved 28 March 2018.
  35. "Prevent skin cancer | American Academy of Dermatology". www.aad.org. Archived from the original on 14 May 2018. Retrieved 28 March 2018.
  36. Faurschou A, Wulf HC (April 2007). "The relation between sun protection factor and amount of suncreen applied in vivo". The British Journal of Dermatology. 156 (4): 716–9. doi:10.1111/j.1365-2133.2006.07684.x. PMID   17493070. S2CID   22599824.
  37. Kanavy HE, Gerstenblith MR (December 2011). "Ultraviolet radiation and melanoma". Seminars in Cutaneous Medicine and Surgery. 30 (4): 222–8. doi:10.1016/j.sder.2011.08.003. PMID   22123420.
  38. Burnett ME, Wang SQ (April 2011). "Current sunscreen controversies: a critical review". Photodermatology, Photoimmunology & Photomedicine. 27 (2): 58–67. doi: 10.1111/j.1600-0781.2011.00557.x . PMID   21392107.
  39. Kütting B, Drexler H (December 2010). "UV-induced skin cancer at workplace and evidence-based prevention". International Archives of Occupational and Environmental Health. 83 (8): 843–54. doi:10.1007/s00420-010-0532-4. PMID   20414668. S2CID   40870536.
  40. Norval M, Wulf HC (October 2009). "Does chronic sunscreen use reduce vitamin D production to insufficient levels?". The British Journal of Dermatology. 161 (4): 732–6. doi:10.1111/j.1365-2133.2009.09332.x. PMID   19663879. S2CID   12276606.
  41. Diffey BL (December 2001). "When should sunscreen be reapplied?". Journal of the American Academy of Dermatology. 45 (6): 882–5. doi:10.1067/mjd.2001.117385. PMID   11712033.
  42. "How to select a sunscreen | American Academy of Dermatology". www.aad.org. Archived from the original on 29 March 2018. Retrieved 28 March 2018.
  43. Glazer-Hockstein C, Dunaief JL (January 2006). "Could blue light-blocking lenses decrease the risk of age-related macular degeneration?". Retina. 26 (1): 1–4. doi:10.1097/00006982-200601000-00001. PMID   16395131.
  44. Solomon AS (June 2006). "Pterygium". The British Journal of Ophthalmology. 90 (6): 665–6. doi:10.1136/bjo.2006.091413. PMC   1860212 . PMID   16714259.
  45. Neale RE, Purdie JL, Hirst LW, Green AC (November 2003). "Sun exposure as a risk factor for nuclear cataract". Epidemiology. 14 (6): 707–12. doi: 10.1097/01.ede.0000086881.84657.98 . PMID   14569187. S2CID   40041207.
  46. Eberlein-König B, Placzek M, Przybilla B (January 1998). "Protective effect against sunburn of combined systemic ascorbic acid (vitamin C) and d-alpha-tocopherol (vitamin E)". Journal of the American Academy of Dermatology. 38 (1): 45–8. doi:10.1016/S0190-9622(98)70537-7. PMID   9448204.
  47. Köpcke W, Krutmann J (2008). "Protection from sunburn with beta-Carotene—a meta-analysis". Photochemistry and Photobiology. 84 (2): 284–8. doi: 10.1111/j.1751-1097.2007.00253.x . PMID   18086246. S2CID   86776862.
  48. Stahl W, Sies H (September 2007). "Carotenoids and flavonoids contribute to nutritional protection against skin damage from sunlight". Molecular Biotechnology. 37 (1): 26–30. doi:10.1007/s12033-007-0051-z. PMID   17914160. S2CID   22417600.
  49. Schagen, S. K.; Zampeli, V. A.; Makrantonaki, E.; Zouboulis, C. C. (2012). "Discovering the link between nutrition and skin aging". Dermato-Endocrinology. 4 (3): 298–307. doi:10.4161/derm.22876. PMC   3583891 . PMID   23467449.
  50. "Children - SkinCancer.org". skincancer.org. 13 September 2016. Archived from the original on 29 March 2018. Retrieved 28 March 2018.
  51. "WHO | Artificial tanning devices: public health interventions to manage sunbeds". WHO. Archived from the original on 29 June 2017. Retrieved 28 March 2018.
  52. "How to treat sunburn | American Academy of Dermatology". www.aad.org. Archived from the original on 20 March 2018. Retrieved 28 March 2018.
  53. "Sunburn – Home Treatment". Healthwise. 15 November 2013. Archived from the original on 12 July 2012. Retrieved 29 November 2014.
  54. 1 2 3 4 Schwellnus MP (2008). The Olympic textbook of medicine in sport. Oxford, UK: Wiley-Blackwell. p. 337. ISBN   978-1-4443-0064-2. Archived from the original on 14 January 2023. Retrieved 20 September 2020.
  55. 1 2 3 4 "How to treat sunburn". American Academy of Dermatology. Archived from the original on 20 March 2018. Retrieved 26 June 2016.
  56. Arndt KA, Hsu JT (2007). Manual of Dermatologic Therapeutics. Lippincott Williams & Wilkins. p. 215. ISBN   978-0-7817-6058-4. Archived from the original on 14 January 2023. Retrieved 20 September 2020.
  57. Maenthaisong R, Chaiyakunapruk N, Niruntraporn S, Kongkaew C (September 2007). "The efficacy of aloe vera used for burn wound healing: a systematic review". Burns. 33 (6): 713–8. doi:10.1016/j.burns.2006.10.384. PMID   17499928.
  58. Luo, X.; Zhang, H.; Wei, X.; Shi, M.; Fan, P.; Xie, W.; Zhang, Y.; Xu, N. (2018). "Aloin Suppresses Lipopolysaccharide-Induced Inflammatory Response and Apoptosis by Inhibiting the Activation of NF-κB". Molecules (Basel, Switzerland). 23 (3): 517. doi: 10.3390/molecules23030517 . PMC   6017010 . PMID   29495390.
  59. Feily A, Namazi MR (February 2009). "Aloe vera in dermatology: a brief review". Giornale Italiano di Dermatologia e Venereologia. 144 (1): 85–91. PMID   19218914.