How sunburn harms our skin, often years later, and how to avoid it

We have all, at one time or another, forgotten to slather on sunscreen or stick on a hat, and then spent too much time out in the sun – and got burned as a result.

I certainly have, and I remember the aftermath: lying in bed, struggling to get comfortable with chafing skin, and then standing in front of the mirror, regarding my lobster complexion with dismay.

But what actually happens to our skin when we forget to put on sunscreen, or apply too little too late? Hong Kong dermatologist Dr S.Y. Wong puts it bluntly: “You damage it – both the dermis and the epidermis.”

Florence Fatialofa, a skin specialist at Optimal Family Health clinic in Hong Kong, elaborates. “Typically it’s the top layer of our skin, the epidermis, that is affected when we get a sunburn,” she says, “and you see it in the pink – or red – that manifests. And you feel it: that pain.

you feel it: that pain.

Florence Fatialofa. Photo: Florence Fatialofa
Florence Fatialofa. Photo: Florence Fatialofa

“Alongside the feeling of warmth, there is a tightness in the skin as it becomes inflamed and dry,” she says. “If the burn is severe you can get blistering on the skin, and the deeper layer – the dermis – can be affected.

“This is the layer of skin where our collagen lives, so this is what causes premature ageing as well as changes to the way the cells respond, for example, in a slow healing response or triggering hyperpigmentation.”

Burns that make the skin peel can cause structural damage to the skin. Photo: Shutterstock
Burns that make the skin peel can cause structural damage to the skin. Photo: Shutterstock

Considering this, there’s one question that comes to mind: is the damage permanent?

“Any amount of sun exposure causes changes to our skin cells’ DNA, so technically, yes,” says Fatialofa. “Burns where skin has peeled and become very inflamed can cause structural damage due to the weakening of collagen – but this is usually not seen until years later.”

This explains why we sunbathe with reckless abandon when we’re young, because “we don’t realise the damage that is being done until it actually starts to show on our face”.

We sometimes don’t see sun damage until years after exposure. Photo: Shutterstock
We sometimes don’t see sun damage until years after exposure. Photo: Shutterstock

Fatialofa says that the environments we spend the first 25 years of our life in, and how well we look after our skin, are the main factors determining how our skin will look later in life – and not even that much later, because signs of too much sun will begin to manifest in our 30s.

So you’ve let yourself get burned. You feel a fool and you look it. Your face is bright red and you have an important meeting coming up. How are you going to disguise your carelessness?

“Use mineral make-up if you need to cover up,” says Fatialofa. “Mineral make-up is less irritating for skin that is inflamed from the sun.” However, she advises that if you can bear it, it’s best to “focus on cooling, soothing and healing the skin quickly to repair it rather than covering it up”.

“Achieve that cooling by applying yogurt,” she says. “This takes the heat out of the skin and soothes it instantly.”

Another suggestion is to take short, cool showers, and apply aloe vera gel or an unscented, non-essential oil moisturiser to keep the skin moisturised. Also, it’s prudent to drink lots of water to hydrate internally, and to stay out of the sun – obviously.

Some doctors suggest taking over-the-counter pain relief medicine such as ibuprofen if necessary, as this will help alleviate pain, inflammation, and redness.

It is important to put sunscreen on all areas of exposed skin when outside in the sun to avoid getting sunburn. Photo: Shutterstock
It is important to put sunscreen on all areas of exposed skin when outside in the sun to avoid getting sunburn. Photo: Shutterstock

While these soothing suggestions can help with damage limitation and pain relief, the best way to combat sunburn is to not get burned in the first place. But how do you decode all the information on your bottle of sunscreen?

The sound advice is to go for a broad-spectrum sun protection factor (SPF) – meaning it protects against both UVA and UVB. You can’t see UVA and you can’t feel it, and that’s what makes it dangerous, because our skin is being damaged without us knowing.

UVA penetrates deep into the skin where the elastin and collagen are. UVB is what we feel on a hot day – that warm sensation prickling our skin – it’s what gives us a “tan” – or burn.

“Think of the ‘B’ from UVB as ‘burn’. They’re both baddies, so we need protection from both all year round,” says Fatialofa.

Wong says that those UVA (“A” for “ageing”) rays are responsible for “wrinkling as well as potential development of skin cancer”, and “can pass through glass windows”. UVB, on the other hand, is blocked by glass windows.

As for the SPF numbers, the American Academy of Dermatology advocates for daily use of an SPF 30 sunscreen, but Wong recommends SPF 50 for more deliberate and prolonged sun exposure, such as when hiking or golfing.

The extra protection offered by an SPF 100 as opposed to an SPF 50 is marginal and, according to Wong: “Too high factors have been shown to create a false sense of security for consumers, resulting in misuse of the products.”

Apply high-SPF sunblock every two hours when you’re in the sun. Photo: Shutterstock
Apply high-SPF sunblock every two hours when you’re in the sun. Photo: Shutterstock

There are plenty of make-up products, such as foundations and tinted moisturisers, with a sun protection factor, but Wong cautions against using them as your sole protection.

“These products should not replace sunscreens because they are likely to be applied thinly and hence don’t achieve the level of protection they promise to deliver,” she says.

Fatialofa agrees, and notes that SPF 30 will protect you from around 97 per cent of UVB rays and SPF 50 will provide protection from 98 per cent of UVB.

Anything beyond SPF 50 won’t make much difference. “No SPF can protect you 100 per cent from UVB rays,” she says.

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