Expert: Jim B - 8/8/2006

Question
Hello, My name is Ricardo, 20 yrs of age. This sunday i went out and got sunburn on my shoulders/arms. im starting to see small (clear) blisters on my arms. Arms are really red and in pain.This is my first time getting burned this bad so i want to make sure i take the proper precautions for a fast, less painful healing. Any help, steps i should take, ointments (sprays would be better since i cant really move arms that much) i should use, cream etc.. plz advice. Any help is greatly appreaciated.Thank you.

Answer
Hi Ricardo,

Second degree sunburns are always a little tough to treat due to the places they most commonly affect (shoulders/arms and back.) There are twopossible causes for the small blisters: the first is that you have a real second degree sunburn. The second is that the sunburn is first degree but damaged the skin sealing it so that persperation cant escape and forms little bubbles between the good skin and the outer epidermis.

SInce you tell me that this is an "all-time worst sunburn" lets assume that these are real second degree blisters.

Get a prescription for Silvadene ointment. Also called thermodene (the generic is silver sulfadiazine)and a large tube of Bacitricin (NOT triple antiotic or neosporin.) Also find and freshly wash a couple of new clean white T-shirts.

Next is the tough part. If you have a friend to help it is always best. You need to remove the blisters. Do this in the shower by washing gently with soap and water and a soft wash cloth. Yes it will hurt. But dont use hat water for obvious reasons. After patting dry with a clean soft towel, apply the silvadene to any of the formerly blistered areas that are pink and wet. Use just enough so that you see the white silvadene area and not the skin. These blistered areas will "weep" a yellow fluid for up to 10 days. when you are home wear the t shirt and (maybe add some gauze pads to keep the mess contained.

Repeat the washing and treating with silvadene as often as needed to keep the shirt or pads from wetting through.

As they begin to stop the weeping stop using the silvadene and switch to the bacitricin. Use it untill the burn is completely dry of seepage and then for another few days just use enough to keep the skin lightly covered or until the burns are less sensitive and can tolerate normal activities comfortably.

Sprays will not work very well with these types of burns by the way.

Lastly, keep these burned areas out of the sun. Any sunlight will delay healing and could cause a sun rash on top of the burn. Healing tends to be an itchy time. The silvadene will help though. For pain, if your doc will Rx you some tylenol 3 take it about 30 min prior to removing the blisters. If not than take a full adult dose of tylenol and then a full adult dose of Ibuprofen. These two can be taken together and work together better than either on its own.

Hope this helps!

JimB

FOLLOW-UP!

Hey Ricardo,

Sorry... Should have covered that too. It is also possible that both have happened.

Start with washing off the blisters. The second degree skin under the blisters will be very sensitive and painful. the little sweat blisters will feel like the rest of the sunburn. The latter can be treated with your favorite xylocaine containing aloe vera lotion. Although the whole thing is likely to itch in a day or so and then flake off. Itching can be reduced with the tylenol/Ibuprofen combo and one 25 mg benadryl (cheaper generic is diphenhydramine).

That help? no bandage required and it will stay dry after the blisters are removed.

Hope we have covered all the bases

JimB