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Re: [at-l] Medical Sunburn Treatment
Thanks for one of the best "technical" posts I've seen in a long
while. This one goes into the Keeper file.
______________________________ Reply Separator _________________________________
Subject: [at-l] Medical Sunburn Treatment
Author: "Gary Buffington" <gbuffmd@bigfoot.com> at ima
Date: 4/28/99 10:23 PM
In my ER I see sunburned Yankees (mostly from Birmingham and Montgomery and
Atlanta!!) who come to Pensacola Beach. The best treatment is as follows:
1. Vinegar (or Aloe Green Jelly) will help cool the skin and feels good.
Probably cures nothing, but might reduce infection rates.
2. Soap and water wash two or three times a day reduces the staphylococcal
count and probably the skin infection rate.
3. Caladryl (Calamine lotion and Benadryl mixture) applied to the burn area
feels good as the Benadryl is a local anesthetic (yes, it's also an
antihistamine but that's not the effect of benefit in sunburn).
4. The major pain is from skin and subcutaneous tissue swelling. That is, the
sunburn is an inflammatory process. Therefore, anti-inflammatory medication
does a great job. You can progress up through the anti-inflammatory group from
aspirin, to NSAID'S (Advil, Nuprin, ibuprofen, Aleve, Naprosyn, Lodine, Etc.) on
up to corticosteroids (Prednisone if you want the cheap stuff or Medrol
Dosepack if you want to spend more money). When the sunburn makes it to the ER
I almost always prescribe Prednisone if there is no contraindication.
5. Sunburn hurts more at night as do most inflammatory conditions. But also
the night pain is from the gauging of clothes seams into the burn; therefore,
wear your clothes "inside out". The rough sewn seams are on the inside and the
smooth part is the outside!
6. Anesthetics such as sunburn sprays are dangerous because there are a
significant number of patients who will become allergic. They usually contain
Benzocaine. Allergy (and poison ivy) on top of sunburn can be very serious.
7. Sunburn is rarely a serious problem in a healthy patient since these are
first and superficial second degree burns. The risk is in the burn extending
deeper by further exposure, infection, or allergy, or further abrasion (from a
rubbing backpack). Diabetics and the immune deficient are at higher risk. I
have never seen a patient need hospitalized (but it does happen). Once
sunburned the skin is very sensitive for the rest of that sun season.
8. The reason there are so many suggested treatments is because none are
perfect.
9. Prevention is a good idea.
10. Babies at the beach will get burned from reflected light even when under a
beach umbrella. Keep the babies off the beach (and the umbrellas off the
trail!!!!)
Gary Buffington
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<DIV><FONT color=#000000 size=2>In my ER I see sunburned Yankees (mostly from
Birmingham and Montgomery and Atlanta!!) who come to Pensacola Beach. The
best treatment is as follows:</FONT></DIV>
<DIV><FONT color=#000000 size=2></FONT><FONT size=2>1. Vinegar (or Aloe
Green Jelly) will help cool the skin and feels good. Probably cures
nothing, but might reduce infection rates.</FONT></DIV>
<DIV><FONT size=2>2. Soap and water wash two or three times a day reduces
the staphylococcal count and probably the skin infection rate.</FONT></DIV>
<DIV><FONT size=2>3. Caladryl (Calamine lotion and Benadryl mixture)
applied to the burn area feels good as the Benadryl is a local anesthetic (yes,
it's also an antihistamine but that's not the effect of benefit in
sunburn).</FONT></DIV>
<DIV><FONT size=2>4. The major pain is from skin and subcutaneous tissue
swelling. That is, the sunburn is an inflammatory process.
Therefore, anti-inflammatory medication does a great job. You can progress
up through the anti-inflammatory group from aspirin, to NSAID'S (Advil, Nuprin,
ibuprofen, Aleve, Naprosyn, Lodine, Etc.) on up to corticosteroids
(Prednisone if you want the cheap stuff or Medrol Dosepack if
you want to spend more money). When the sunburn makes it to the ER I
almost always prescribe Prednisone if there is no
contraindication.</FONT></DIV>
<DIV><FONT size=2>5. Sunburn hurts more at night as do most inflammatory
conditions. But also the night pain is from the gauging of clothes seams
into the burn; therefore, wear your clothes "inside out". The
rough sewn seams are on the inside and the smooth part is the
outside!</FONT></DIV>
<DIV><FONT size=2>6. Anesthetics such as sunburn sprays are dangerous
because there are a significant number of patients who will become
allergic. They usually contain Benzocaine. Allergy (and poison ivy)
on top of sunburn can be very serious.</FONT></DIV>
<DIV><FONT size=2>7. Sunburn is rarely a serious problem in a healthy
patient since these are first and superficial second degree burns. The
risk is in the burn extending deeper by further exposure, infection, or allergy,
or further abrasion (from a rubbing backpack). Diabetics and the immune
deficient are at higher risk. I have never seen a patient need
hospitalized (but it does happen). Once sunburned the skin is very
sensitive for the rest of that sun season.</FONT></DIV>
<DIV><FONT size=2>8. The reason there are so many suggested treatments is
because none are perfect.</FONT></DIV>
<DIV><FONT size=2>9. Prevention is a good idea.</FONT></DIV>
<DIV><FONT size=2>10. Babies at the beach will get burned from reflected
light even when under a beach umbrella. Keep the babies off the beach (and the
umbrellas off the trail!!!!) </FONT></DIV>
<DIV><FONT color=#000000 size=2>Gary Buffington</FONT></DIV></BODY></HTML>