What is the treatment plan for sunburn with peeling?

From the Guidelines

For sunburn with peeling, the primary treatment goal is to relieve symptoms, promote healing, and prevent infection, with a focus on protecting the wound and reducing pain, as emphasized in the 2024 American Heart Association and American Red Cross guidelines for first aid 1. To achieve this, several strategies can be employed:

• Apply cool compresses or take cool baths to soothe the skin and reduce heat entrapment.
• Use moisturizers containing aloe vera or soy multiple times daily, especially after bathing while skin is still damp, to support the skin's natural healing process.
• For pain relief, take over-the-counter NSAIDs like ibuprofen (400-600mg every 6-8 hours) or acetaminophen (650mg every 4-6 hours) for 1-2 days.
• Hydrocortisone cream (1%) can reduce inflammation when applied 2-3 times daily to affected areas.
• Drink plenty of water to rehydrate, as dehydration can exacerbate sunburn symptoms.
• Avoid picking at peeling skin as this can lead to infection and scarring; instead, let it shed naturally.
• Stay out of the sun until healed, and when exposure is necessary, use broad-spectrum sunscreen (SPF 30+), wear protective clothing, and seek shade.
• Covering the affected area with a nonadherent bandage or clean cloth, as recommended by the 2024 guidelines 1, can protect the wound and reduce pain while avoiding heat entrapment until the burn can be assessed by a health care professional. If the sunburn is severe (with blisters covering large areas), accompanied by fever, extreme pain, or signs of infection, medical attention should be sought promptly.

From the Research

Treatment Plan for Sunburn with Peeling

• The treatment plan for sunburn with peeling is primarily focused on symptomatic relief, as there is no consensus on a specific algorithm for treatment 2.
• Topical corticosteroids have been studied as a potential treatment for sunburn, with some studies showing a reduction in erythema and sunburn reaction 3, 4.
• However, other studies have found that topical corticosteroids do not provide a clinically useful decrease in the acute sunburn reaction when applied 6 or 23 hours after UV exposure 3.
• Oral nonsteroidal anti-inflammatory drugs (NSAIDs) have also been studied in combination with topical corticosteroids, showing a synergistic effect in reducing UVB-induced erythema and skin blood flow 5.
• Despite these findings, the current recommendation is for conservative local symptomatic treatment with adequate pain control until the sunburn naturally resolves, due to the lack of demonstrated clinical efficacy of pharmacologic agents in eliminating sunburn or decreasing healing time 2, 6.

Symptomatic Treatment Options

• Topical corticosteroids, such as moderate-potency or high-potency corticosteroids, may be used to reduce erythema and sunburn reaction, although their effectiveness is limited 3, 4.
• Oral NSAIDs, such as ibuprofen or indomethacin, may be used in combination with topical corticosteroids to reduce UVB-induced erythema and skin blood flow 5.
• Emollients and other topical agents may be used to provide symptomatic relief and promote healing 2.
• Adequate pain control is essential to manage the discomfort associated with sunburn 6.