Sunburn is the skin’s inflammatory response to cellular damage caused by overexposure to ultraviolet (UV) radiation, resulting in characteristic redness, heat, and discomfort. Over-the-counter cortisone, typically 1% hydrocortisone cream, is a common topical anti-inflammatory treatment. While hydrocortisone can offer symptomatic relief for very mild, superficial burns, it is generally not the most effective first-line treatment for managing sunburn.
How Cortisone Interacts with Sunburned Skin
Hydrocortisone is a low-potency topical corticosteroid, a synthetic version of the hormone cortisol. When applied, it suppresses the immune system’s inflammatory response. It achieves this by inhibiting the production of inflammatory substances, such as prostaglandins and leukotrienes, which cause the painful swelling and redness associated with sunburn.
The steroid binds to glucocorticoid receptors inside skin cells, modulating the expression of genes involved in the inflammatory pathway. By reducing the concentration of inflammatory mediators, hydrocortisone lessens redness and swelling by constricting blood vessels. This mechanism provides a temporary reduction in symptoms, particularly itching, by dampening the body’s reaction to the UV injury.
While cortisone addresses the symptoms of inflammation, it does not repair the underlying DNA damage caused by UV radiation. The application of the cream essentially masks the body’s natural response rather than speeding up the healing process. Topical corticosteroids are primarily for symptomatic relief, offering a targeted anti-itch and anti-redness effect.
When to Use and When to Avoid Topical Steroids
Topical hydrocortisone should be reserved for specific situations, primarily when a mild sunburn is accompanied by significant, localized itching. For minor burns with minimal pain, applying a 1% hydrocortisone cream a few times daily for a short duration, such as one to two days, may provide relief. Cooling the product in the refrigerator before application offers an added soothing sensation.
Avoiding topical steroids is necessary in several scenarios concerning safety and effectiveness. Cortisone should not be applied to severe sunburns characterized by extensive blistering, broken skin, or deep pain. Applying the steroid to large areas of compromised skin increases the risk of systemic absorption, where more of the drug enters the bloodstream.
Prolonged use of topical steroids, even low-potency hydrocortisone, carries the risk of side effects like skin thinning (atrophy). Topical steroids may also mask signs of a developing infection, which is a risk when the skin barrier is damaged. If blistering occurs, the treatment is similar to a partial-thickness burn and should be managed by a doctor, typically without topical steroids.
Primary Relief Methods for Sunburn
Effective steps for sunburn relief focus on cooling the skin and reducing systemic inflammation. Applying cool compresses or taking a cool bath helps draw heat away from the skin and provides fast symptomatic relief. Adding baking soda to a full bath can further enhance the soothing effect.
Hydration is a fundamental part of recovery, as sunburn draws fluid to the skin’s surface, increasing the risk of dehydration. Drinking extra water for a day or two helps replenish this fluid loss. Oral non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen are recommended because they target inflammation internally. Taking an NSAID as soon as possible after sun exposure helps reduce pain and the inflammatory response.
After cooling the skin, applying a moisturizing lotion or gel is important to lock in hydration and prevent peeling. Pure aloe vera gel is a popular choice due to its soothing properties, but choose alcohol-free products, as alcohol can dry out compromised skin. Petroleum-based products should be avoided because they trap heat within the skin, potentially worsening the burn.