Treatment of Sunburn
For sunburn, immediately cool the affected area with running water, then apply petrolatum-based ointments, honey, or aloe vera to open burns, cover with a clean nonadherent dressing, and use over-the-counter pain medications like acetaminophen or NSAIDs for pain relief 1.
Immediate Cooling
The first and most critical step is immediate active cooling with running water 2. This recommendation comes from the highest-level international consensus guidelines. While no specific duration can be definitively recommended based on the evidence, the cooling should be applied as soon as possible after the burn occurs 2.
Topical Treatment After Cooling
Once cooling is complete, the approach depends on the burn characteristics:
For Small Partial-Thickness Burns (Open Wounds, Including Unroofed Blisters)
- Apply petrolatum, petrolatum-based antibiotic ointment, honey, or aloe vera 1
- Cover with a clean nonadherent dressing 1
- These agents have been shown to improve healing time in partial-thickness burns 1
For Burns With Intact Skin or Intact Blisters
- Loosely cover with a clean cloth or nonadherent dry dressing while awaiting professional evaluation 1
- This protects the wound and reduces pain while avoiding heat entrapment 1
Pain Management
Over-the-counter analgesics are well-tolerated and recommended 1:
- Acetaminophen or NSAIDs (such as ibuprofen 800 mg every 6 hours) 1
- These medications provide effective pain relief with minimal adverse events 1
Important Caveats and When to Seek Emergency Care
Remove Jewelry Early
Remove all jewelry from affected areas before swelling develops to prevent vascular compromise 1.
Signs Requiring Immediate Medical Attention
Activate emergency services if the person has:
- Burns involving face, hands, feet, or genitals 1
- Burns covering >10% body surface area (5% in children) 1
- Signs of inhalation injury: facial burns, difficulty breathing, singed nasal hairs, or soot around nose/mouth 1
These patients require specialized burn center care due to risk of fluid loss, multisystem organ failure, and need for surgical intervention 1.
What Does NOT Work
Topical corticosteroids are ineffective when applied after UV exposure. Research shows that moderate- or high-potency corticosteroids applied 6 or 23 hours after UV exposure provide no clinically useful reduction in sunburn 3. The evidence consistently demonstrates that most pharmacologic interventions beyond symptomatic treatment are ineffective at decreasing recovery time 4.
Clinical Pitfall
The most common mistake is attempting to use corticosteroid creams for established sunburn—this has been thoroughly studied and shown to be ineffective 3, 4. Focus instead on the proven triad: cooling, appropriate topical coverage, and pain control.