What are the treatment options for sunburn pain?

Treatment of Sunburn Pain

Immediately cool the sunburn with clean running water for 5-20 minutes, then apply over-the-counter pain medications like ibuprofen or acetaminophen, and cover with petrolatum or aloe vera under a clean non-adherent dressing. 1, 2

Immediate First-Line Management

Cooling (Most Critical Step)

• Apply clean running water for 5-20 minutes as soon as possible to reduce pain and limit tissue damage 1, 2, 3
• This is the single most beneficial intervention with established efficacy and minimal risk 1
• Monitor children for hypothermia during prolonged cooling, especially with larger burns 2, 3
• Remove all jewelry from affected areas before swelling develops to prevent vascular compromise 1, 2, 3

Pain Relief: Systemic Medications

Oral Analgesics (Primary Treatment)

• Administer ibuprofen 400 mg every 4-6 hours or acetaminophen at standard doses for pain control 1, 2, 4
• Ibuprofen doses above 400 mg show no additional analgesic benefit for mild-to-moderate pain 4
• Maximum daily ibuprofen dose is 3200 mg, though lower doses are typically sufficient 4
• Consider combining acetaminophen with NSAIDs for multimodal analgesia if pain is significant 2

Important caveat: While research shows NSAIDs provide only mild early reduction in UV-induced erythema 5, 6, they remain the guideline-recommended standard for symptomatic pain relief in real-world practice 1, 2. The evidence conflict exists because studies measure erythema reduction rather than patient-reported pain relief—the latter being the clinically relevant outcome.

Topical Treatments After Cooling

Recommended Topical Agents

• Apply petrolatum (Vaseline) as first-line topical treatment after cooling 1, 2, 3
• Petrolatum-based antibiotic ointments (polymyxin B or bacitracin) are reasonable alternatives 1, 2
• Aloe vera gel applied directly to the burn is an evidence-supported option 1, 2, 7
• Medical-grade honey can improve healing time in partial-thickness burns 1, 2

Application Method

• Apply a thin layer of chosen topical agent to the cooled burn 2
• Cover with a clean, non-adherent dressing 1, 2, 3
• For burns with intact skin or intact blisters, loosely cover with clean cloth or non-adherent dry dressing 1, 2
• Change dressings daily and monitor for infection signs 3

What NOT to Do (Common Pitfalls)

• Never apply ice directly to sunburns—this causes additional tissue damage 3
• Never apply butter, oils, or other home remedies—these trap heat and worsen injury 3
• Avoid topical corticosteroids—they show no clinically meaningful benefit for sunburn 5, 6

When to Seek Immediate Medical Attention

Activate emergency services or seek urgent care if:

• Burns involve the face, hands, feet, or genitals 1, 2, 3
• Body surface area affected is >10% in adults or >5% in children 1, 2
• Signs of inhalation injury present: difficulty breathing, soot around nose/mouth, singed nasal hairs, or facial burns 1, 2, 3
• Severe pain unresponsive to over-the-counter medications 2
• Signs of infection develop: increased pain, redness, swelling, or purulent drainage 2, 3

Evidence Quality Note

The strongest evidence supports cooling with running water and oral analgesics 1. Research on topical treatments shows mixed results—studies measuring erythema reduction often show minimal benefit 5, 6, but guidelines still recommend topical agents based on wound protection principles and patient comfort 1, 2. One study combining oral NSAIDs with topical corticosteroids showed synergistic effects 8, but this approach is not incorporated into current guidelines, likely due to limited reproducibility and the general ineffectiveness of corticosteroids alone 6.