sunburn

from Wikipedia, the free encyclopedia
Classification according to ICD-10
L55.0 1st degree solar dermatitis acute
L55.1 Acute solar dermatitis 2nd degree
L55.2 Acute solar dermatitis 3rd degree
L55.8 Other acute solar dermatitis
L55.9 Acute solar dermatitis, unspecified
ICD-10 online (WHO version 2019)
Sunburn after incomplete protection

The sunburn (also called UV-erythema , solar erythema and dermatitis solaris ) is similar to a burning of the skin first to second degree. It is caused by ultraviolet radiation from the sun or other radiation sources. Within 1–6 hours after irradiation, there is a sharp reddening , sensation of heat, itching, pain, occasionally blistering and edema of the irradiated skin. The symptoms reach their maximum after 12-24 hours and regress within three to seven days, possibly with peeling . In the face, conjunctivitis and solar keratitis can also develop in conjunctivitis and corneal inflammation . Large areas of sunburn can also cause fever, weakness and headaches. Due to the medical history and clinical features, sunburn from other photodermatoses such as meadow grass dermatitis , phototoxic dermatitis , solar urticaria, etc. Ä. easily distinguishable.

The symptoms usually heal without a scar, with reversible hyperpigmentation (darkening) of the skin. More severe burns can leave pale scars. Although the disease is initially harmless, sunburn in children is regarded as the most important risk factor for black skin cancer ( malignant melanoma ).

frequency

Sunburn is an everyday experience. Every sixth adult American gets at least one sunburn per year, every tenth two, every eleventh three or more. Two out of three children have had at least one sunburn in the past year; only a minority of all age groups used sun protection measures. Non-white Americans are only slightly less likely to get sunburn. In Switzerland and Germany, conscious sun protection measures are similarly less widespread among the population, with the exception of parents of small children.

causes

Blistering of the skin after sunburn

UVB rays (280–320 nm) are particularly biologically effective in the skin, as they are shorter-wave and therefore more energetic. At excessive doses they lead to various damage to the DNA , especially to pyrimidine dimers . Damage to the microRNA may also be significant. UVA penetrates deeper into the skin and there damages the collagen in the dermis , which leads to a decrease in skin elasticity. In very high doses, UVA also causes sunburn as well as DNA damage (mutations) and thus skin cancer .

The pathomechanism of sunburn is radiation-induced damage to the epidermal cells , which by releasing mediators causes inflammation of the dermis (dermis). The blood vessels dilate and the skin turns red , increases blood flow (warming) and fluid escapes into the tissue (blistering). The earliest histological signs are vacuolated keratocytes, so-called sunburn cells.

Risks

Sunburn occurs with any excessive exposure to the sun, but predominantly in fair-skinned people of skin types I and II. These people have a shorter self-protection time and a lower minimum erythema dose MED. The MED is reached after 10–45 minutes at noon in pale winter skin type I in Central Europe in summer (Worret / Gehring 2004), according to another source (Altmeyer / Hoffmann 2006) after 20 minutes. Frequently recurring loads just below the MED can cause chronic skin damage (wrinkles, spots) and promote skin cancer .

You can prevent sunburn by avoiding sunbathing , covering clothing and by applying sunscreen . It should be taken into account that window glass and ordinary textiles allow some of the UV-B radiation to pass through, e.g. B. Polyethylene 42%, dry cotton 11%. Water absorbs UV-B only weakly (50% at a depth of 1 m), which is why snorkel divers are particularly at risk. Snow reflects the radiation to almost 100% and thus significantly increases the risk of sunburn (cf. Worret / Gehring 2004).

A suddenly increased UV index , e.g. B. winter vacation in the tropics or the exposure of otherwise covered areas of skin (in spring, in the outdoor pool), is also risky for adults. In this case, sunscreen should definitely be used, even if the cool air deceives the effect of the sun's rays. After a few weeks, the skin protects itself through pigmentation with melanin and a thickened horny layer ( light calluses ).

The lens of the eye, however, accumulates damage from UVB and becomes cloudy ( cataracts ) with age. An acute danger to the eyes is so-called snow blindness , a type of sunburn of the cornea of the eye. Depending on the length of stay in the sun, special glacier or snow goggles should be used. Water and light sand also reflect UV rays strongly, which shortens the protection time.

The cooling effect of wind does not take away any of the sunburn risk of UV light. Even thin clouds hardly reduce UV radiation.

Ozone-poor air from the ozone hole can occasionally flow into the temperate latitudes and suddenly sharply increase the UV index .

Risks to Children

Sunburn, especially in childhood, significantly increases the risk of malignant melanoma .

Babies and toddlers generally cannot tolerate strong sunlight on bare skin or in the eyes, which is why light, but fully covering clothing is necessary for protection on sunny days and throughout the summer months. These include, for example, hats that also cover the neck and sunglasses. An additional parasol for the children provides even better protection.

According to the Radiation Protection Commission at the Federal Ministry for the Environment, Nature Conservation and Nuclear Safety, even slight exposure to solar radiation, even if the skin is reddened, causes cancer in the long term: “Recurring intermittent UV exposure in early childhood (0 to 6 years) is responsible for the development of malignant melanoma. These already include isolated suberythemal exposures and even more mild and severe sunburns, as can occur during holidays in sunny regions. "

treatment

severe sunburn

Severe sunburn should be treated by a doctor. The treatment is based on cooling e.g. B. by moist and cold compresses, Lotio alba , and on anti-inflammatory drugs, e.g. B. topical steroids of class 2 (as cream, lotion or milk, ointments are unsuitable). Burn blisters can be opened sterile. For general symptoms, steroids in tablet form and NSAIDs such as ibuprofen are prescribed. Ascorbic acid (vitamin C) should - if taken early - be useful due to its antioxidant effect (Reinhardt 2004). Further sun exposure should be avoided completely for three weeks.

A slight sunburn can also be alleviated at home, preferably with cooling topicals, moisturizing lotions, wraps, compresses with cold water, quark wraps or pads (except for milk protein allergies).

Even with successful treatment, the risk of skin cancer increases with the number of sunburns suffered.

Risks to plants

Boskoop apple with sunburn

Plants can also be damaged by increased UV exposure, see e.g. B. the sunburn of grapes .

Some plants can protect themselves from this. These change the chlorophyll composition in extremely strong sunlight: The chlorophyll combines with a carotenoid . Radiated energy is now converted into heat. If the strength of the solar radiation decreases again, the carotenoid separates from the chlorophyll and the plant uses the solar radiation again to generate energy.

See also

Individual evidence

  1. ↑ HI Hall, M. Saraiya, T. Thompson, A. Hartman, K. Glanz, B. Rimer: Correlates of sunburn experiences among US adults: results of the 2000 National Health Interview Survey. In: Public health reports (Washington, DC: 1974). Volume 118, Number 6, 2003 Nov-Dec, pp. 540-549, ISSN  0033-3549 . PMID 14563911 . PMC 1497591 (free full text).
  2. ↑ DB Buller, V. Cokkinides, HI Hall, AM Hartman, M. Saraiya, E. Miller, L. Paddock, K. gloss: Prevalence of sunburn, sun protection, and indoor tanning behaviors among Americans: review from national surveys and case studies of 3 states. In: Journal of the American Academy of Dermatology . Volume 65, Number 5 Suppl 1, November 2011, pp. S114-S123, ISSN  1097-6787 . doi: 10.1016 / j.jaad.2011.05.033 . PMID 22018060 . (Review).
  3. ↑ SL Park, L. Le Marchand, LR Wilkens, LN Kolonel, BE Henderson, ZF Zhang, VW Setiawan: Risk factors for malignant melanoma in white and non-white / non-African American populations: the multiethnic cohort. In: Cancer Prevention Research . Volume 5, Number 3, March 2012, pp. 423-434, ISSN  1940-6215 . doi: 10.1158 / 1940-6207.CAPR-11-0460 . PMID 22246617 . PMC 3294037 (free full text).
  4. ↑ D. Reinau, C. Meier, N. Gerber, GF Hofbauer, C. Surber: Sun protective behavior of primary and secondary school students in North-Western Switzerland. In: Swiss medical weekly. Volume 142, 2012, p. W13520, ISSN  1424-3997 . doi: 10.4414 / smw.2012.13520 . PMID 22367965 .
  5. ^ J. Li, W. Uter, A. Pfahlberg, O. Gefeller: A comparison of patterns of sun protection during beach holidays and everyday outdoor activities in a population sample of young German children. In: British Journal of Dermatology . Volume 166, Number 4, April 2012, pp. 803-810, ISSN  1365-2133 . doi: 10.1111 / j.1365-2133.2012.10805.x . PMID 22229912 .
  6. ↑ J. Morlet: Tierversuche: Researchers explore the origins of sunburn. In: Spiegel online - Wissenschaft. July 9, 2012.
  7. ↑ Health risks from UV exposure of children and adolescents - opinion of the Radiation Protection Commission, adopted on 28/29. September 2006 . (PDF) p. 2. Radiation Protection Commission at the Federal Ministry for the Environment, Nature Conservation and Nuclear Safety; Retrieved March 6, 2012.
  8. ↑ Liliane Juchli (Gre.): Thiemes care . Ed .: Edith Kellnhauser . Georg Thieme Verlag, 2004, ISBN 3-13-500010-9 , p. 321 ( google.com ).
  9. ↑ Brigitte Merk, Ute Baumgärtner: Wraps and pads . Georg Thieme Verlag, 2010, ISBN 978-3-13-152583-3 , p. 60 ( google.com ).

literature

Web links

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