How to Treat a Severe Sunburn—and When You Should Go to the Doctor

We all know how to treat mild- to moderate sunburns—plenty of water, a cold shower, and consistent application of topical ointments and aloe vera. These practices are so well-known in our sunny climate that you’d be hard-pressed to find a Coloradan who doesn’t have a preferred method of sunburn treatment. A few things to avoid doing include popping blisters, aggressively peeling skin, exfoliating, and using alcohol-based creams. And know that it’s never too early to start treating a sunburn. Symptoms may not appear until several hours after returning indoors. Drink water, take anti-inflammatories, and use topical treatments as soon as you suspect you’ve gotten too much sun.

Unfortunately, in the worst cases, these tried-and-true remedies aren’t always enough. Maybe your cold showers aren’t decreasing the pain you’re experiencing, or perhaps that over-the-counter topical medication isn’t doing anything to shrink or calm your blisters. What happens when your sunburn is severe enough to withstand your favorite treatments? While rarely life-threatening, severe sunburns can be dangerous and not just because they increase your chances of getting skin cancer in the future.

How to Define “Severe”

Understanding what having a “severe” sunburn entails is the first step toward knowing whether home remedies are going to cut it. A severe sunburn is not just large, painful red patches with occasional blistering—though this may feel severe enough to suffering person. Instead, truly dangerous sunburns typically include one or more of the following symptoms:

  • Widespread blistering
  • Burn accompanied by high fever
  • Extreme, almost unbearable pain
  • Burn accompanied by headache, confusion, and vision problems
  • Nausea and chills
  • Severe dehydration (fluid loss)

If your burn has not responded to treatment within two days of exposure, it should be treated as severe. When you develop any of the above symptoms to go along with a severe sunburn, it’s time to see a medical professional. These symptoms could lead to additional heat-related illness or indicate infection.

Take an anti-inflammatory, such as ibuprofen or aspirin, as soon as you get out of the sun. This should work to decrease milder symptoms, such as inflammation and pain, allowing you to clearly observe and assess the severity of the burn. Sunburns can take between four and six hours to develop, so keep a close eye on the burn in the hours following sun exposure.

The Connection between Sunburn and Heat-Related Illness

Sunburn is a common—even anticipated—outcome of spending time in the sun. Heat-related illness is a more unexpected and dangerous risk that comes with prolonged exposure to very hot and humid weather. Heat stroke, in particular, is a life-threatening emergency that occurs when your core body temperature rises to 104 degrees Fahrenheit or higher. Symptoms of heatstroke are similar to those of a severe sunburn, but they are often more intense.

  • High body temperature
  • Muscle cramps and weakness
  • Nausea and vomiting
  • Racing heart rate
  • Rapid, shallow breathing
  • Extreme headache
  • Confusion, seizures, hallucinations, or difficulty speaking
  • Lack of sweating despite hot external temperatures

The other important thing to know is that a bad sunburn increases your risk of heat exhaustion and heat stroke because damaged skin isn’t as efficient as sweating and cooling the body down. A big part of treating a sunburn is not going back out into the sun or heat until you’ve had a chance to heal.

The Connection between Severe Sunburns and Geography

It can seem like severe sunburn would be most problematic the farther south you live, but the statistics suggest otherwise. As with heat-related illness, the unfamiliarity with direct UV rays can make people living in northern states just as susceptible, if not more so, to severe sunburn. In discussing this issue with a >board-certified dermatologist, we learned that “even on the cloudiest days, eighty percent of the sun’s UV rays can pass through the clouds.” For Coloradoans, it’s also worth knowing that snow can also reflect 80 percent of these UV rays.

According to the CDC, in terms of the percentage of white adults who experience a sunburn severe enough to report it to a medical provider, the worst states for severe sunburn are Utah, Minnesota, Wisconsin, Idaho, and Wyoming. (Colorado was ranked #13.) What’s more, for a huge range of pre-existing skin conditions, a severe sunburn will exacerbate the problems associated with the condition.

The same is true for skin cancer. More than consistent but moderate exposure to UV rays, multiple and severe sunburns over the course of one’s life can be especially problematic. Thus, the worst states for skin cancer risk are also dominated by more northernly states. 

Choosing a Medical Service

If your severe sunburn is accompanied by headache, fainting, vomiting, or a very high fever, you should visit the ER. These symptoms may indicate a more serious condition, such as heatstroke or sun poisoning, which can be extremely dangerous. In the worst cases of severe sunburn, patients may be admitted to the hospital burn unit.

Often, a severe sunburn can be treated by a doctor’s office or walk-in clinic. If your sunburn is severe for primarily topical reasons—widespread blistering and puss excretion—an urgent care facility can address the condition. Moderate fevers, pain management, dehydration, and other symptoms that aren’t life-threatening can be handled by a walk-in clinic like Rocky Mountain Urgent Care.

To determine the type of medical service you need, reflect on the timeline of your burn. If you begin to feel sick shortly after reducing or eliminating your sun exposure, it’s more likely that the symptoms could become life-threatening. If your severe symptoms begin to develop after twelve hours, a doctor’s office or urgent care visit is probably the best answer.

What Services to Expect from a Health Provider

In most cases, you will be instructed to consume plenty of fluids, apply cool compresses, or soak in cool water. You may be provided intravenous therapy (IV) if dehydration persists, and the medical professional will likely give you a cream to prevent infection. The most severe sunburns are often treated with pain medication, oral steroids, and the aforementioned fluids. If you do sustain a severe sunburn, Rocky Mountain Urgent Care can assess your condition and recommend a course of action. If you have any questions regarding prevention or long-term dermatological health, our family practice can guide you to the answer. If you need immediate help after hours, our Aurora urgent care location has the longest hours from 8am—9pm every day of the week. Or find the clinic closest to you.

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