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Medical Disability Advisor  >  Sunburn

Sunburn


Related Terms


  • First-degree Burn
  • Second-degree Burn

Specialists


  • Dermatologist
  • Family Practice Physician

Comorbid Conditions


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Factors Influencing Duration


The severity, location of the burn, and job requirements determine the length of disability, if any. Symptoms may persist for a longer time period in elderly individuals.

Medical Codes


ICD-9-CM:
692.71 - Contact Dermatitis and Other Eczema Due to Sunburn; First Degree Sunburn
692.76 - Contact Dermatitis and Other Eczema Due to Solar Radiation, Sunburn of Second-degree
692.77 - Contact Dermatitis and Other Eczema Due to Solar Radiation, Sunburn of Third-degree

Definition


Sunburn is a painful burning of the skin caused by overexposure to ultraviolet radiation from the sun or an artificial source (sunlamp, tanning beds). Ultraviolet radiation exposure causes acute, delayed, and temporary skin inflammation. Ultraviolet radiation is comprised of A and B wavelengths, referred to as UVA and UVB, respectively. UVB is responsible for 85% of sunburns (Foster). Minor sunburn is considered a first-degree burn. Severe sunburn that causes blistering is considered a second-degree burn.

Sunburn has long been known to prematurely age the skin, causing wrinkling, spotting, and sagging. Now experts believe that each serious sunburn doubles an individual's risk of developing malignant melanoma.

Risk: Light-skinned and fair-haired individuals are at greater risk for sunburn. Men are at higher risk than women, possibly due to greater amount of time spent outdoors and/or insufficient use of sunscreen. Spending time outdoors between the hours of 10 a.m. and 3 p.m., when sunlight is most intense, places individuals at greater risk for sunburn. Other risk factors for sunburn include sunbathing, using tanning beds, or living in or traveling to higher altitudes or tropical areas.

Incidence and Prevalence: Sunburn is very common, although the incidence has decreased in recent years. This decrease is probably due to efforts to educate the public about the hazards of sun exposure.

Source: Medical Disability Advisor



History


History: Individuals usually notice reddening of the skin beginning 2 to 6 hours after exposure to ultraviolet radiation. Symptoms, which include swelling and pain, peak at 24 hours. Some individuals may report blistering and peeling skin. Mild cases of sunburn can cause itching. Individuals with severe sunburn may also complain of fever, headache, chills, nausea, and a feeling of discomfort and fatigue (malaise).

Physical exam: An exam reveals a red, swollen (edematous), well-defined area of exposed skin. Most individuals with sunburn seek medical advice only if severe blistering, rash, pain, or fever is involved.

Tests: Tests are not necessary to diagnose sunburn. However, photo testing (irradiation testing) may be performed if a photosensitivity reaction is suspected.

Source: Medical Disability Advisor



Treatment


Started early and carried out for 2 days, cool baths or compresses and analgesics can help minimize discomfort. Itching can be relieved with antihistamines. The individual should drink ample amounts of fluids to compensate for dehydration and may benefit from applying a nonprescription hydrocortisone cream or moisturizer 3 times a day. Application of anesthetic sunburn spray can provide temporary relief from pain. Individuals with severe sunburn benefit from bed rest and burn dressings. Blisters can be drained and the area treated with an antibiotic cream. In cases of severe inflammation and pain, nonsteroidal anti-inflammatory medications (NSAIDs) or even oral corticosteroid medications may be prescribed. In cases of severe dehydration, intravenous (IV) fluids may be given.

Source: Medical Disability Advisor



Prognosis


Sunburn symptoms resolve in 4 to 7 days.

Source: Medical Disability Advisor



Complications


In serious cases, a sunburn can cause blisters that become infected, which can cause a high fever. Sunburn can trigger outbreaks of herpes simplex lesions, psoriasis, or porphyria. Repeated sunburns are known to increase an individual's risk for developing actinic keratoses and skin cancer.

Source: Medical Disability Advisor



Return to Work (Restrictions / Accommodations)


Individuals who work outdoors should avoid sun exposure until the sunburn is fully healed. Depending upon the location of the sunburn, the use of personal protective equipment may be restricted.

Source: Medical Disability Advisor



Failure to Recover


If an individual fails to recover within the expected maximum duration period, the reader may wish to consider the following questions to better understand the specifics of an individual's medical case.

Regarding diagnosis:

  • Has individual recently had an ultraviolet radiation exposure?
  • Is individual's skin red, blistering, or peeling? Is there swelling and pain?
  • Does individual complain of itching, fever, headache, chills, nausea, or malaise?
  • Did individual seek medical care?
  • Was irradiation testing performed (if a photosensitivity reaction is suspected)?
  • Have conditions with similar symptoms been ruled out?

Regarding treatment:

  • Were symptoms treated with cool compresses or baths, analgesics, antihistamines, or nonprescription hydrocortisone creams or moisturizers?
  • Is individual drinking adequate fluids?
  • Was a topical anesthetic spray used?
  • Were bed rest and burn dressings necessary?

Regarding prognosis:

  • Can individual's employer accommodate any necessary restrictions?
  • Does individual have any conditions that may affect ability to recover?
  • Does individual have any complications such as infected blisters, outbreaks of herpes simplex lesions, psoriasis, porphyria, actinic keratoses, and skin cancer?

Source: Medical Disability Advisor



Cited References


Foster, James. "Sunburn." eMedicine. Eds. James Li, et al. 27 Oct. 2004. Medscape. 28 Oct. 2004 <http://emedicine.com/emerg/topic798.htm>.

Source: Medical Disability Advisor






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