20% BSA, fever, infection signs.">
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Severe Sunburn Relief: Soothing Itch & Promoting Healing

Severe sunburn (blistering, extensive, systemic symptoms) requires medical evaluation. For moderate sunburn with intense itching (hell's itch), these evidence-based measures help:

Immediate Cooling & Hydration

  • Cool Compresses / Bath: 15–20 min, tepid (not ice-cold) water. Add colloidal oatmeal (Aveno) or baking soda (1 cup). Pat dry; don't rub.
  • Hydrate Aggressively: Water, electrolyte drinks. Sunburn draws fluid into skin → intravascular depletion.

Topical Therapy

AgentMechanismUse
Fragrance-free moisturizer (CeraVe, Vanicream, Aquaphor)Barrier repair, occlusion, ceramide replacementApply frequently to damp skin
Aloe vera gel (pure, 99%+)Anti-inflammatory, cooling, wound healingRefrigerate for extra relief
Topical corticosteroid (1% hydrocortisone OTC; Rx 0.1% triamcinolone)Potent anti-inflammatoryThin layer 2×/day × 3–5 days; avoid face/groin long-term
Topical NSAID (diclofenac gel)COX inhibition → ↓prostaglandinsAlternative to steroids
Calamine / PramoxineCounterirritant / local anestheticSoothe itch

Systemic Relief

  • Oral NSAIDs: Ibuprofen 400–600 mg q6h or naproxen 500 mg q12h (anti-inflammatory + analgesic). Take with food.
  • Oral Antihistamines: Cetirizine 10 mg or loratadine 10 mg AM (non-sedating); diphenhydramine 25–50 mg HS (sedating, helps sleep). Not primary for sunburn itch (not histamine-mediated) but may help sleep.
  • Oral Corticosteroids: Prednisone 0.5–1 mg/kg/day × 5–7 days taper – only for severe, extensive burns under medical supervision.

What NOT To Do

  • Pop blisters (infection risk).
  • Apply petroleum jelly/Vaseline to fresh burn (traps heat).
  • Use "-caine" sprays (benzocaine, lidocaine) – sensitization risk.
  • Exfoliate, scrub, or use retinoids/acids.
  • Sun exposure until fully healed (UPF clothing, shade, broad-spectrum SPF 30+).

Seek Medical Care If:

  • Blisters >20% BSA, or on face/hands/genitals/joints.
  • Fever >38.5°C (101.3°F), chills, confusion.
  • Signs of infection: spreading redness, pus, red streaks.
  • Severe pain uncontrolled by OTC meds.
  • Eye involvement.

Prevention: Broad-spectrum SPF 30+ reapplied q2h, UPF clothing, shade 10 AM–4 PM. Sunburn is radiation injury; damage is cumulative.

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