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—normally between 10:00 a.m. and 2:00 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 use aspirin in children.

• Apply a topical moisturizer, aloe gel, hydrocortisone cream, or a topical pain reliever to sunburned skin.

• If blisters are present, don't break them open, as infection can occur.

• 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 will be determined by your child's healthcare provider and may depend on the severity of the sunburn. In general, call your child's healthcare provider 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

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer.

For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature.

Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

• Ask your child’s healthcare provider how you should take the temperature.

• Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher, or as directed by the provider

• Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider

Child age 3 to 36 months:

• Rectal, forehead (temporal artery), or ear temperature of 102°F (38.9°C) or higher, or as directed by the provider

• Armpit temperature of 101°F (38.3°C) or higher, or as directed by the provider

Child of any age:

• Repeated temperature of 104°F (40°C) or higher, or as directed by the provider

• Fever that lasts more than 24 hours in a child under 2 years old. Or a fever that lasts for 3 days in a child 2 years or older.

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 A, B, Cs of sun safety:

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, if protective clothing and shade are not available. 

What are sunscreens?

Sunscreens protect the skin against sunburns and play an important role in blocking the penetration of ultraviolet (UV) radiation. No sunscreen blocks UV radiation 100%.

Terms used on sunscreen labels can be confusing. The protection provided by a sunscreen is indicated by the sun protection factor (SPF) listed on the product label. Products with chemicals that absorb and filter the sunlight are sunscreens. A product that physically blocks the sun (such as zinc oxide or titanium dioxide) is called a sunblock. A product with SPF 15 blocks about 93% of UVB radiation.

How to use sunscreens

A sunscreen protects the skin from sunburn and minimizes suntan by absorbing or reflecting UV rays. Using sunscreens correctly is important to protect the skin. Consider the following:

• Choose a sunscreen for children. Test it on your child's wrist before using. If your child has skin or eye 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 him or her an allergic reaction. 

• Apply sunscreens 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 protect from burning for longer periods of time than do sunscreens with lower a SPF. Talk with your older 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.