Sunburns are readily noticeable by their visible signs [7]. These signs include erythema which usually occurs within two to six hours after overexposure. The pain is often so intense that even a thin layer of clothing touching the skin can cause pain. It may also seem like the skin is stiff and can make moving painful or difficult.

A sunburn can also cause a fever, chills, general malaise, and even nausea, vomiting and syncope if the case is more severe. Severe cases may also create blisters which may become infected in rare cases. 

The erythema usually resolves within a few days after exposure, but scaling and desquamation may occur.

• Fever

  A sunburn can cause a mild fever and a headache. Lie down in a cool, quiet room to relieve the headache. A headache may be caused by dehydration, so drinking fluids may help. For more information, see the topic Dehydration. [web.archive.org]

  […] with aspirin, acetaminophen, or ibuprofen to relieve pain and headache and reduce fever. [cdc.gov]

  With a moderate fever: You feel warm or hot. You know you have a fever. With a mild fever: You may feel a little warm. You think you might have a fever, but you're not sure. [uofmhealth.org]

• Chills

  You may even feel like you have the flu -- feverish, with chills, nausea, headache, and weakness. A few days later, your skin will start peeling and itching as your body tries to rid itself of sun-damaged cells. [webmd.com]

  It will add moisture back into your skin and prevent peeling. * If you have a fever or chills, you might have sun poisoning. [youtube.com]

  Weakness and fatigue Chills. Treatment Inflammation and swelling from sunburn is at it’s worst after a couple of days and you can reduce the severity of the burn. Apply a cold compress to your skin to soothe the burn. [capitalchemist.com.au]

  Signs and Symptoms Mild: skin redness and warmth pain itchiness Severe: skin redness and blistering pain and tingling swelling headache nausea fever and chills dizziness What to Do Have your child get out of the sun right away. [kidshealth.org]

• Malaise

  A sunburn can also cause a fever, chills, general malaise, and even nausea, vomiting and syncope if the case is more severe. Severe cases may also create blisters which may become infected in rare cases. [symptoma.com]

  Systemic symptoms can accompany severe sunburn: there may be headache, chills, malaise, nausea and vomiting. Assessment [ 2 ] As for any burn - assess the severity and area covered (see box below). [patient.info]

  Severe sunburn Severe cases of sunburn can cause: blistering swelling of the skin (oedema) chills a high temperature (fever) of 38ºC (100.4ºF) or above a general feeling of discomfort (malaise) You may also have symptoms of heatstroke, such as: dizziness [hse.ie]

• Rigor

  This study examines whether RTR have sufficiently rigorous sun protection behaviour compared with the general population. [ncbi.nlm.nih.gov]

  Therefore, they are not always the same as official national estimates produced using alternate, potentially equally rigorous methods, nor necessarily endorsed by specific Member States. [who.int]

• Hand Pain

  Despite an additional 1-week delay (total of 5 weeks from the prior liposomal doxorubicin), and complete visual recovery from the effects of the sunburn, the patient developed severe (grade 3) PPE involving both hands (pain, pronounced erythema, blistering [ncbi.nlm.nih.gov]

• Pertussis

  Abstract Three children had striking localization of varicella lesions to skin overlying a diphtheria-pertussis-tetanus toxoid (DPT) immunization injection site, a facial abrasion, and a sunburn of the trunk, respectively. [ncbi.nlm.nih.gov]

• Overeating

  Multivariate analyses adjusted for key demographics, temperature, cloud, wind and ultraviolet radiation (UVR) to assess change in outcomes over time. [ncbi.nlm.nih.gov]

• Blister

  If your skin blisters, allow the blisters to heal. Blistering skin means you have a second-degree sunburn. You should not pop the blisters, as blisters form to help your skin heal and protect you from infection. [aad.org]

  Care of blisters Home treatment may help decrease pain, prevent infection, and help the skin heal. Small, unbroken blisters [less than 1 in. (2.5 cm) across] usually heal on their own. Do not try to break the blisters. Just leave them alone. [web.archive.org]

  Unfortunately, several days before her next scheduled cycle, she developed significant sunburn (intense erythema without blistering). [ncbi.nlm.nih.gov]

  There may be blisters. Capillary refill is absent. Full thickness: dry and white, brown, or black in colour, with no blisters, no pain and no capillary refill. [patient.info]

  Sometimes these blisters lead to skin infections that can cause more pain, swelling and a fever. Sunburn blisters often can be treated with some simple and easy home remedies. [top10homeremedies.com]

• Photosensitivity

  This reaction is distinct from true photosensitivity. Photosensitivity is listed in the drug brochure for methotrexate. However, a review of the literature does not support true photosensitivity associated with methotrexate. [ncbi.nlm.nih.gov]

  (NOS), Photosensitivity toxic reaction, Photosensitized, Dermatitis, Phototoxic [Disease/Finding], photosensitivity reaction, photosensitizing, phototoxic dermatitis, phototoxicity, photosensitivity reactions, phototoxic reaction, photosensitivity rash [fpnotebook.com]

  Photosensitivity - for example, systemic lupus erythematosus, porphyria; drugs such as tetracyclines and many others. [patient.info]

  photosensitivity (sun) 692.72 plants NEC 692.6 plasters, medicated (any) 692.3 plastic 692.4 poison preservatives 692.89 primrose (primula) 692.6 primula 692.6 radiation 692.82 radioactive substance 692.82 radium 692.82 ragweed (Senecio jacobae) 692.6 [icd9data.com]

• Dry Skin

  Groups more at risk of developing heatstroke are: children under two very elderly people people with kidney, heart or circulation problems people with diabetes Signs of heatstroke include dry skin, vertigo, confusion, headache, thirst, nausea, rapid shallow [sheffieldccg.nhs.uk]

  As well, the FDA says it lacks data to prove that sprays provide the necessary thick, even skin coverage on dry skin, let alone a wet kid." Until there is more research on the matter, EWG recommends using sunscreen lotion for optimal protection. [cbsnews.com]

  Down the line, sunburns can lead to dry skin and pronounced lines and wrinkles. [nypost.com]

  When you are sunburnt, it practically means that your skin is dehydrated which ultimately results in dry skin. Be sure to apply lotion to your skin to help keep it moisturized. [sunburntreatmenthq.com]

  Apply it to clean, dry skin at least 20 minutes before you go outside, and then reapply every 2 hours. You may need to reapply it more often if you are swimming, sweating a lot or rubbing yourself dry with a towel. [healthdirect.gov.au]

• Fair Complexion

  Other risk factors include a fair complexion, found commonly in people with blueor green eyes, freckles, and light-colored hair (The Skin Cancer Foundation, 2008). [ncbi.nlm.nih.gov]

  Her fair complexion now has dark marks on her face from just a few hours without sun protection. She wrote about her experience on MarieClaire.com, writing: "It was a very typical sunburn. [6abc.com]

• Pruritus

  […] without skin lesions (Pruritus sine materia). [worldcat.org]

• Red Nose

  The key to covering an awkward red nose is colour correction. Apply a green colour corrector on any redness before applying concealer. It'll neutralise any warm tones and create a better base for your concealer. [elle.com]

• Impaired Judgement

  Altered behaviour - irritability, agitation, impaired judgement, confusion, disorientation, hallucinations. In children (as with any burn) consider whether neglect or non-accidental injury could be a cause. Presence of co-existing injuries. [patient.info]

• Hyperalgesia

  The time course of hyperalgesia over 96 h was studied in a subgroup of 12 subjects. Within the sunburn area, cold hyperesthesia (P .01), profound generalized hyperalgesia to heat (P Copyright 2013 International Association for the Study of Pain. [ncbi.nlm.nih.gov]

• Hyperesthesia

  Within the sunburn area, cold hyperesthesia (P .01), profound generalized hyperalgesia to heat (P Copyright 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved. [ncbi.nlm.nih.gov]

For uncomplicated cases, laboratory studies and imagine studies are not needed as symptoms are visible to the eyes [8].
When diagnosis is in doubt though, skin biopsy may be useful in order to exclude other diseases in the differential diagnosis.

Sunburn treatment doesn’t heal the skin or prevent damage to the skin rather it is focused on the reduction of pain, discomfort and swelling [9]. When the condition doesn’t resolve on its own, the following may be prescribed:

• • Over the counter prescription pain relievers help control pain and swelling associated with sunburn especially when taken immediately after exposure to sun. The most common types are ibuprofen or naproxen. Some types of pain relievers may also be applied to the skin as gels. 
• • Corticosteroids may be prescribed as control for itching. They are often used in combination with pain relievers.

Normal cases of sunburn rarely develop beyond short-term cause for concern. This is because most of the cases will resolve spontaneously without any further complications [6]. In extremely rare cases however, dehydration, infection and second degree burns may arise. 

The main cause of sunburn is too much exposure to ultraviolet light which can occur when the individual stays for too long under sunlamps, tanning beds or direct sunlight [2]. 

In the United States, thousands of adults and children develop sunburns each year [3].

People living in close to the equator and in higher altitude regions are the people most at risk of sunburn.

When the skin is exposed to the sun long enough, the individual not only enjoys radiant warmth but also vitamin D is synthesised. However, when the skin is left open to sunlight and other sources of ultraviolet rays for far too long, sunburn arises. Another common problem that sets in following excessive exposure is solar erythema.

Injury that arises as a result of excessive exposure to ultraviolet rays happen because the DNA gets damaged by ultraviolet light. When the DNA gets damaged, inflammation and apoptosis of the skin cell sets in. 

The characteristic erythema that is seen with sunburn is because the inflammation that follows sunburn often leads to a vasodilation of the cutaneous blood vessels. 

It only takes 2 hours for damage to the epidernal skin cells to be seen following excessive UV exposure. 

Below are some measures to prevent sunburn at any point in time. However, it is very important to be careful around bodies that reflect the sun’s rays such as water, snow, ice and sand. Additionally, UV light is often more intense when around high altitudes [10].

• • Avoid extensive exposure to the sun during peak hours by seeking shade when possible.
• • Tightly woven clothing that covers the arm and legs are good at providing sun protection.
• • Hats with broad brims are important as they protect the scalp and face. 
• • Broad spectrum sunscreen of 15 or more should be used frequently and generously irrespective of skin type. 
• • Sunscreen must be reapplied every 2 hours and must be used first before using any insect repellents.
• • Sunscreen can only be used on babies 6 months old and above. For younger babies, it is advisable to use other forms of sun protection like seeking shade. 
• • Glasses must be worn when outdoors. 
• • Base tan doesn’t prevent sunburn. No research supports this so it must not be used as method of prevention against sunburn. 

Sunburn is the condition that arises when the skin is exposed too much to the sun or other sources of ultraviolet radiations such as arc lamps, tanning beds, etc. Sunburn is an inflammatory reaction and clinically, it is regarded as superficial or first degreee burns [1].

Sunburn happens when your skin becomes red, painful and hot when touched as a result of staying too long under ultraviolet light from the sun, sunlamps or tan beds. Sunburn often clears off on its own but may take several days.

Consistent sunburn increases the risk of your skin getting damaged and becoming vulnerable to a lot of skin diseases such as wrinkled skin, dark spots, rough spots and some type of skin cancers like melanoma.

Sunburn can however, be prevented by adequate protection of the skin when outdoors. Sunburn treatments are often easy and straightforward, not requiring much intervention from medical personnel.

1. Kochevar IE, Taylor CR. Photophysics, photochemistry and photobiology. In: Freedberg IM, ed. Fitzpatrick's Dermatology in General Medicine. 6th ed. New York, NY: McGraw-Hill; 2003:1267-1275.
2. Walker SL, Hawk JL, Young AR. Acute effects of ultraviolet radiation on the skin. In: Freedberg IM, ed. Fitzpatrick's Dermatology in General Medicine. 6th ed. New York, NY: McGraw-Hill; 2003:1275-1282.
3. Matsumura Y, Ananthaswamy HN. Toxic effects of ultraviolet radiation on the skin. Toxicol Appl Pharmacol. Mar 15 2004;195(3):298-308.
4. Walsh LJ. Ultraviolet B irradiation of skin induces mast cell degranulation and release of tumour necrosis factor-alpha. Immunol Cell Biol. Jun 1995;73(3):226-33. 
5. Terui T, Takahashi K, Funayama M, Terunuma A, Ozawa M, Sasai S, et al. Occurrence of neutrophils and activated Th1 cells in UVB-induced erythema. Acta Derm Venereol. Jan-Feb 2001;81(1):8-13. 
6. Young AR. Acute effects of UVR on human eyes and skin. Prog Biophys Mol Biol 2006; 92:80.
7. Young AR, Chadwick CA, Harrison GI, et al. The similarity of action spectra for thymine dimers in human epidermis and erythema suggests that DNA is the chromophore for erythema. J Invest Dermatol 1998; 111:982.
8. Chang YM, Barrett JH, Bishop DT, et al. Sun exposure and melanoma risk at different latitudes: a pooled analysis of 5700 cases and 7216 controls. Int J Epidemiol 2009; 38:814.
9. Dennis LK, Vanbeek MJ, Beane Freeman LE, et al. Sunburns and risk of cutaneous melanoma: does age matter? A comprehensive meta-analysis. Ann Epidemiol 2008; 18:614.
10. Warthan MM, Sewell DS, Marlow RA, et al. The economic impact of acute sunburn. Arch Dermatol 2003; 139:1003.