What is the recommended treatment for facial sunburn in an adult?

Treatment of Facial Sunburn in Adults

For facial sunburn in adults, the recommended treatment includes gentle cleansing with warmed sterile water or saline, followed by application of a greasy emollient such as 50% white soft paraffin with 50% liquid paraffin to soothe the skin and promote healing. 1

Initial Assessment and Management

• Assess the severity of the sunburn:

  • Mild: Erythema (redness) only
  • Moderate: Erythema with pain and mild edema
  • Severe: Erythema, pain, edema, and blistering

• For facial sunburn, prioritize:

  • Gentle cleansing with warmed sterile water, saline, or dilute chlorhexidine (1/5000) 1
  • Avoid harsh soaps or scrubbing that could further damage the skin
  • Handle skin carefully to minimize further damage

Treatment Protocol

Immediate Care

1. Cleansing: Gently cleanse the affected facial skin with warmed sterile water or saline 1
2. Cooling: Apply cool compresses for 10-15 minutes several times a day to reduce pain and heat
3. Moisturizing: Apply a greasy emollient such as 50% white soft paraffin with 50% liquid paraffin over the affected area 1
   • Consider using aerosolized formulations to minimize shearing forces during application
   • Avoid preparations containing sensitizers or irritants

Blister Management

• If blisters form, do not break them intentionally
• If blisters rupture naturally, gently cleanse the area and apply the recommended emollient 1
• For intact blisters, decompress by piercing and expression or aspiration of fluid 1

Pain Management

• Use appropriate pain assessment to guide analgesic needs 1
• For mild to moderate pain:
  • Oral NSAIDs (ibuprofen) can help reduce inflammation and pain
  • Acetaminophen may be used for pain relief if NSAIDs are contraindicated
• For severe pain:
  • Consider stronger analgesics if pain is not controlled with over-the-counter options

Special Considerations for Facial Skin

• Avoid adhesive dressings on facial skin as they can cause further trauma upon removal 2
• Apply nonadherent dressings to any denuded areas if needed (suitable dressings include Mepitel™ or Telfa™) 1
• Avoid topical corticosteroids as they do not provide clinically useful decrease in acute sunburn reaction when applied after UV exposure 3, 4
• Avoid topical anesthetics containing benzocaine due to potential for contact sensitization

Prevention of Future Sunburn

• Use broad-spectrum sunscreen with SPF of 15 or greater 1
• Wear hats or other shade-protective clothing 1
• Avoid outdoor exposure during midday hours (10 a.m. to 3 p.m.) 1
• Avoid indoor tanning 1

When to Seek Medical Attention

• Severe blistering covering a large portion of the face
• Signs of infection (increased pain, swelling, warmth, pus, red streaks)
• Fever or chills
• Severe pain not relieved by over-the-counter pain medications
• Facial swelling that affects vision or breathing

Common Pitfalls to Avoid

• Do not use topical corticosteroids for sunburn treatment as studies show they are ineffective when applied 6 or 23 hours after UV exposure 3
• Do not apply petroleum jelly or butter to sunburned skin as these can trap heat and worsen the burn
• Do not use exfoliating products on sunburned skin as they can further damage the skin
• Do not rely solely on sunscreen for future prevention; utilize multiple sun protection methods including protective clothing and sun avoidance during peak hours 5

Remember that the best treatment for sunburn is prevention through proper sun protection behaviors 1, 6. However, when sunburn does occur, gentle cleansing and application of emollients remain the cornerstone of treatment.