Urticaire chronique (pour les professionnels)
Although prevention is better than cure, there are chances that you or someone around will get sunburnt. It is more likely in the summer months, when in high altitude, when increasing outdoor activities, when on far-away holidays, and when indulging in sun-seeking behaviour (e.g. sunbathing).
In acute sunburn (erythema, pain, edema, desquamation, bullae)
Always keep in mind that the rash could be a phototoxic drug eruption.Treatment is difficult but here are our recommendations:
-if drug allergy history is negative, immediate oral intake of aspirin or non-steroidal anti-histaminic drugs (NSAIDS) is warranted. This helps to diminish pain and inflammation. Nevertheless, NSAIDS can be responsible for phototoxic reactions.
-in case of moderate dehydration, replenishement can be done with an isotonic drink. But if it is more severe, the patient should be taken to an emergency unit for intra-venous rehydration.
-Locally:
- cold humid compresses applied for 20 minutes 4 to 5 times a day can alleviate the pain. Butter and ointments are not helpful and can irritate the skin.
- In addition calamine lotion can alleviate the symptoms. Topical or oral steroids are not effective, and antihistaminics and local anesthetics which are readily available can give rise to contact allergy.
-sun exposure is best avoided until complete healing of the skin which takes place 1 to 2 weeks after.
On the longer term
A. try to prevent future sunburns:
-avoid sun exposure between 10am and 3pm (11am and 4pm in the summer if daylight saving is used).
-protect oneself against the sun:
- wear a wide brimmed hat
- look out for UV protective clothing
- wear sunglasses : they don’t protect the skin but prevent UV induced cataracts.
- on unprotected areas, apply a sunscreen or sunblock. Remember to reapply the cream every 2 hours and after swimming, even if it is said to be waterproof.
Note: more than 50% of the total lifetime exposure of sunlight is done before the age of 18. As the risk of cancer and aging of the skin is cumulative, it might me advisable to shield the children from direct sunlight.
-The risk of skin cancers, melanoma and non melanoma increases with the quality and quantity of sun exposure respectively. For instance melanoma is most related to the number of sunburns, whereas non melanoma skin cancers are related to the total amount of skin exposure. This observation should be taken as a rough explanation, as both types of skin cancer are related to total exposure as the number of sunburns.
-this is all the more important than the skin is fair (phototype 1 and 2), the eyes are blue and the hair red = celtic skin.
This advice is for informational purposes only and does not replace therapeutic judgement done by a skin doctor.
Bibliography
Dermatology, 1st edition, Thieme
Dermatology Secrets, 3rd edition, Mosby-Elsevier
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