I have a bad sunburn! What should I do?

Most sunburns can be managed with products that can be purchased over-the-counter. If you get a sunburn that causes the skin to turn dusky or causes you to feel physically ill (nausea, vomiting, fever/chills, etc) you should go to the nearest emergency room to be evaluated.

One of the most widely used products to treat sunburns is aloe vera. It is a natural botanical product found in tropical climates. The mucilage released from plant leaves is a colorless gel that contains water and a mixture of mucopolysaccharides, proteins and minerals. Some of the products include aloin, salicylates, choline and aletinic acid. These products lead to decreased inflammation, decreased bacterial colonization and improved wound healing.

Interestingly, most packaged aloe vera products don’t contain the natural mucilage found in the plant. Rather, the aloe vera is added as a powder to a manufactured gel. The composition from these products may not be the same as that found in the natural leaves. It is estimated that the aloe vera content in packaged products should be at least 10% to have a moisturizing effect.

Personally, I think it may be best to use the natural product.

In addition, ant-inflammatory pain relievers can help. We often recommend a combination of both oral ibuprofen and oral acetaminophen. They work through different pain pathways. The acetaminophen is cleared by the liver and the iboprofen is cleared by the kidneys, so there is less chance of toxicity.

Cool compresses and showers will also help. If the skin gets crusted, gentle application of dilute vinegar soaks to remove the crusts can assist in cleaning the areas up. Over-the-counter hydrocortisone may also provide some mild relief.

Avoid topical benzocaine products as these may often irritate the skin and make symptoms worse. Also avoid applying products that contain alcohol as these will also irritate the skin.

It often takes several days for symptoms to improve. If there has been no improvement after at least three days, seek medical attention.

Probably the most widely used botanical additive to soothe the skin is aloe vera. The mucilage is released from the plant leaves as a colorless gel and contains 99.5% water and a complex mixture of mucopolysaccharides, amino acids, hydroxy quinone glycosides, and minerals. Compounds isolated from aloe vera juice include: aloin, aloe emodin, aletinic acid, choline, and choline salicylate. The reported cutaneous effects of aloe vera include increased blood flow, reduced inflammation, decreased skin bacterial colonization, and enhanced wound healing.

In most skin preparations, aloe vera is added as a powder, not as a mucilage. The composition of aloe vera powder may not be the same as aloe vera juice that oozes from the freshly broken plant leaf. Aloe vera extract is found in soaps, hair shampoos, hand lotions, body moisturizers, etc. It is estimated that aloe vera must be present at a concentration of 10% to have a moisturizing effect in products designed to remain on the skin for extended periods of time. Concentration and formulation are important considerations when determining whether or not a botanical additive has a skin benefit.

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