From the Guidelines
Delayed hypersensitivity sunburn is typically managed with topical corticosteroids or systemic antihistamines in severe cases, as it usually resolves spontaneously within days to weeks. When treating delayed hypersensitivity sunburn, consider the following measures:
- Topical corticosteroids may be used to reduce inflammation, as suggested by the UK guidelines for the investigation and management of eosinophilia in returning travellers and migrants 1.
- Systemic antihistamines can be used in severe cases to alleviate symptoms.
- It is essential to note that the condition often resolves on its own within a short period, and treatment should focus on managing symptoms and preventing further complications.
- In addition to medical treatment, patients should avoid further sun exposure, use broad-spectrum sunscreen, and wear protective clothing to prevent exacerbating the condition.
- Staying well-hydrated and maintaining skin hydration with fragrance-free lotions can also help alleviate symptoms.
- If the reaction is severe or includes symptoms like fever, severe pain, or blisters covering a large body area, medical attention should be sought, as oral corticosteroids or other prescription medications may be necessary.
From the Research
Treatment for Delayed Hypersensitivity Sunburn
- The treatment for delayed hypersensitivity sunburn is not directly addressed in the provided studies, but some studies discuss the use of topical corticosteroids for sunburn treatment 2, 3.
- Topical corticosteroids, such as 0.1% methylprednisolone aceponate milk and 0.1% hydrocortisone 17-butyrate emulsion, have been shown to be safe and effective in reducing sunburn reactions in healthy volunteers 3.
- However, another study found that treatment with topical moderate-potency or high-potency corticosteroids does not provide a clinically useful decrease in the acute sunburn reaction when applied 6 or 23 hours after UV exposure 2.
- It is essential to note that corticosteroids can induce immediate and delayed hypersensitivity reactions, and patch tests are useful for diagnosing delayed hypersensitivity reactions 4, 5.
- When using topical corticosteroids, it is crucial to consider the strength, potency, and formulation, as well as the patient's individual needs and potential risks, such as atrophy, striae, and other cutaneous reactions 6.
Diagnostic Approach
- Patch tests are useful diagnostic tools for delayed hypersensitivity reactions, including those caused by corticosteroids 4, 5.
- Prick and intradermal skin tests are useful for diagnosing immediate hypersensitivity reactions 4.
- A high index of suspicion is needed to identify the culprit corticosteroid, as the diagnosis of hypersensitivity reactions can be challenging due to the similarity in symptoms with the underlying inflammatory disease 4.
Corticosteroid Use
- Topical corticosteroids are classified by strength and the risk of adverse effects, and the risk increases with prolonged use, large area of application, higher potency, occlusion, and application to areas of thinner skin 6.
- The quantity of corticosteroid prescribed depends on the duration of treatment, frequency of application, skin location, and total surface area treated 6.
- Correct patient application is critical to successful use, and patients may be taught application using the fingertip unit method 6.