Sunburn Symptoms by Severity: Mild, Moderate, Severe, and When to Go to the ER

Sunburn is UV-induced inflammatory skin injury. Severity ranges from mild erythema to systemic illness.

Symptoms by Severity

Mild (1st degree)

• Erythema (redness) — appears 2–6h post-exposure, peaks 12–24h
• Warmth, tenderness, mild edema
• Itching as healing begins
• Peeling at 3–7 days

Moderate (2nd degree)

• Intense erythema, significant edema
• Blistering (vesicles/bullae) — do not pop
• Pain, sometimes severe
• Fever, chills, headache, nausea (systemic cytokine release)

Severe (Sun Poisoning)

• Extensive blistering, skin sloughing
• High fever, chills, confusion, hypotension
• Dehydration, electrolyte imbalance
• Risk: infection, shock, multi-organ failure — seek ER

Management

• Cool compresses, cool baths (colloidal oatmeal)
• Hydrate aggressively (water, electrolytes)
• NSAIDs (ibuprofen) — anti-inflammatory + analgesic
• Topical: aloe vera, fragrance-free moisturizer, 1% hydrocortisone (mild)
• Protect blisters — non-adherent dressing if broken
• Avoid: petroleum (traps heat), lidocaine (allergy risk), further sun

Prevention

• Broad-spectrum SPF 30+, reapplied q2h
• UPF clothing, hat, sunglasses
• Shade 10 AM–4 PM
• Check UV index

Repeated burns ↑ melanoma risk. Childhood burns are especially consequential.