The Sunburn Helper Most Parents Forget
And prepping for tomorrow's ACIP meeting
Summer is officially here. This means picnics, pool parties, and too much time in the sun. Whether it’s a sneaky shoulder or forgotten ear, sunburns happen. Proper care for the first 48 hours can make all the difference. Here’s what I would do.
Sunburn: Three Quick Facts
Sunburn causes two problems. When skin is exposed to too much sun, thermal (heat) injury occurs in exposed skin cells, triggering a predictable inflammation cascade. The inflammation contributes to familiar sunburn symptoms — skin redness, itch, and swelling.
Sunburn is sneaky. Once skin is burned, redness will increase for 3-6 hours after damage and peak 24 hours later. Inflammation continues for about 72 hours after exposure. So, expect a sunburn to change — and often worsen — even after you come into the shade.
Sunburn happens in kids with all skin types and colors. Interestingly, sunburn risk has genetic linkage, making some families burn more easily than others. For all of us, preventing the burn is the primary goal. (See prevention tips below.)
Two Types of Sunburn
Care for sunburn is determined by the thickness of the thermal injury to the skin. In my office, I commonly see kids with first- and second-degree burns.
First-degree sunburn (AKA “dry” or epidermal): This is the most common type of sunburn. The damaged skin is red in color, sparing areas protected by clothing, shade, or sunblock. Sunburned skin is dry and smooth to the touch, and highly sensitive to pressure or changes in temperature. Kids with darker skin tones may not notice the initial redness of the burn, but rather the peeling a few days later.
Second-degree sunburn (AKA “wet” or superficial partial-thickness): These sunburns blister due to an increased level of damage to the skin. Blisters form as a protective mechanism to help heal the underlying tissue. They can be various sizes, white in color, and/or fluid-filled.
Note: It’s typically recommended that severe burns be evaluated in the local emergency room or burn treatment center. Severe sunburns have blisters that easily pop, very red or white-ish skin color, and pain with pressure. Severe burns are also often associated with headache, fever, nausea or vomiting. Talk to your doctor if you aren’t sure.
Sunburns Happen: Here’s What To Do
With good care, sunburn pain and redness improves in 3-7 days, peeling happens 4-7 days after the exposure. The goal of sunburn treatment is to moisturize and protect the damaged skin, while keeping your child comfortable.
Offer an anti-inflammatory. This is what most parents miss. For kids over 6 months, ibuprofen helps with pain, fever, and inflammation. Start the medication as soon as the rash starts and every 6-8 hours for the next 48 hours. Remember, sunburn causes an inflammation cascade that lasts for a few days, so offering scheduled ibuprofen will reduce the increasing redness and swelling.
Pro Tip: If you suspect your child got too much sun, offering a weight-based dose of ibuprofen — even before the redness appears — will slow the inflammatory effects, potentially limiting pain or swelling from any developing damage.
Cool the skin. Use cool compresses or baths to soothe the skin. Colloidal oatmeal baths are great, too. After soaking, pat the skin dry and leave it slightly damp. Then, immediately apply moisture.
Keep the skin moisturized. Look for soothing gel-creams or other after-sun products, but avoid products with added fragrances or alcohol. Calamine lotion (the pink stuff), soy creams, and aloe-vera gels famously help sunburn discomfort, but any emollient will do. Apply gently, liberally, and a few times per day.
Push hydration. Healing takes hydration, inside and out. Encourage hydration with water and/or electrolyte solutions during initial recovery.
Keep clothing loose. Light, breathable clothing will keep the skin covered without causing uncomfortable pressure or friction.
Optional additions. Long-acting, non-drowsy antihistamines (like loratadine or certirizine) may help mild itching. I’d skip over-the-counter steroid creams, unless recommended by your clinician.
Blisters? Try to keep the blister intact for as long as possible. Covering the blisters with vaseline-covered gauze can help. You can buy these premade, or make your own. As an alternative, medical-grade honey gauze is a great option. (Links not sponsored, just a place to get you started.)
Prevent. Prevent. Prevent.
Both UVA and UVB can cause sunburn. Be sure your family is applying broad-spectrum sunscreen throughly and frequently. And don’t forget to layer protection with shade, UVF clothing, hats, and sunglasses.
Use an app. If you/your kids have a phone or Apple Watch, there are free apps (e.g. Sunbeam for Apple, UV Index for Google) that give specific sun protection advice based on skin type and local weather. In addition, apps can notify or alarm when it’s time to re-apply.
No phone? No problem. Get your outdoor kids an old-fashioned digital watch with a timer. Set the watch to alarm every 90 minutes to help remember the time to re-apply.
No tanning beds. Like, ever. Getting a safe “base tan” before the Caribbean vacation is a MYTH, and self-tanning lotions are easily available if a tanned skin color is cosmetically desired.
Kids under the age of 6 months CAN be protected by sunscreen. Shade first, UPF clothing second, mineral-based sunscreen to exposed skin as last layer of protection. And, keep young kids hydrated when in the heat.
Good habits start early. When your pre-teen starts a face and body hygiene routine, encourage them to apply a non-comedogenic, hypoallergenic lotion with SPF 30+ EVERYDAY, all year long. This is a foundational habit to prevent the risks of sun damage for a lifetime. Keep it simple, inexpensive, and something that feels good when they wear it.
Need some help picking a sunscreen? Here’s Wirecutter’s 2025 suggestions and a list from the National Eczema Association. I’m a Blue Lizard fan, myself. But, there are lots of great choices out there.
Other Important Notes
I know there are a lot of big things happening in the realms of international relations, science, politics, and vaccines. So. Much. Without negating or ignoring the impact of many recent decisions and events, my attention remains squarely focused on child health and vaccinations.
As a scientist, physician, parent, human, and citizen of Earth, I’m concerned about where vaccine information and availability is headed. Like many others, I’m following everything with compulsive precision, while trying to make sense of our current situation in an actionable and compassionate way.
I’m also trying to stay sane by keeping life moving. Kids still get sick. Parents still need help - that’s why I take the time to be here. Informing and educating on all the millions of other things we can do to keep kids safe and healthy feels like a way I can take control of the uncontrollable.
That being said, here are three reminders for today:
It’s important to know that the vast, vast majority of your KC friends and neighbors are staying up-to-date with their vaccines. When we all stay vaccinated, our community stay healthy. I can’t say it enough — thanks for vaccinating yourself and your kids. Follow the lead of your own pediatrician when it comes to adjusting the vaccine schedule based on changes in domestic and international risk, or local vaccine availability.
Protecting ourselves protects our kids. Especially if you frequently travel for business or pleasure, please be sure you’re up-to-date on your MMR vaccine. I’ve had quite a few parents choose to grab a booster dose this summer. If you have no record or memory of receiving two MMR doses or having active measles infection as a child, you may need a dose. If you aren’t sure, there is little harm in getting an “extra” dose, but always talk to your provider to see what they recommend.
Keep your ear tuned to the next ACIP meeting - it starts June 25th. This meeting (just like all the others before it) is streamed live and open to the public. Should any significant changes result, how they might affect my patients may be drastically different from patients in other clinics, states, or parts of world. My job will be to translate what it all means to my KC community. Once I know more, I’ll share it here.
Today, I am choosing remain hopeful as smart people from all corners of the planet activate and problem-solve in defense of the defenseless. Meanwhile, I’m doing everything I can in my own little part of the world to have honest conversations, share opinions, and acknowledge blind spots, while standing firm in two truths I believe to be scientifically, ethically, and morally supported: vaccines work and vaccines save lives.
Here’s to the helpers,
