From a light pink rash to painful red blisters, sunburns range in severity and can be quite uncomfortable. While they may not seem like a big deal, sunburns can lead to serious health problems, especially as you get older.

In this Q&A, Ahuva Cices, MD, a Mount Sinai dermatologist and Assistant Professor, Dermatology, Icahn School of Medicine at Mount Sinai, explains how to treat sunburns and the best ways to avoid them. Dr. Cices has served as an investigator in numerous clinical trials involving a wide range of skin conditions, is well published in peer-reviewed medical journals and textbooks, and has presented her research at national medical and aesthetic dermatology conferences.

Why should I avoid sunburns?
Besides being painful, sunburns increase the risk of skin cancer over time and accelerate skin aging. Data shows that five or more sunburns cumulatively, or even just one blistering sunburn in childhood, increases the risk of melanoma later in life. In the short term, they can cause skin pain, headaches, fatigue, and dehydration.

Who is most at risk?
Sunburns can happen to everyone, but those with lighter skin are more susceptible. People with darker skin might not see the sunburn, but they will feel it. How long it takes to develop a sunburn depends on your skin tone and how much direct sunlight you are exposed to.

What is the best way to treat or sooth a sunburn?
If you start noticing a sunburn, seek shade and avoid further sun exposure. Apply a cold compress to cool the sunburn. The next step is to moisturize the skin while it’s still damp. Use a bland moisturizer that is not scented, as this may make the pain worse. Some people like to use calamine lotion.

If you are in a lot of pain, I recommend taking an NSAID (nonsteroidal anti-inflammatory drug), such as ibuprofen (Advil^®), unless you have a medical condition that an NSAID would make worse, and follow the instructions. Some patients use a topical steroid, which may reduce some inflammation. Aloe vera lotions are a popular option that many people find soothing. Avoid tight or very warm clothes.

How long does it take sunburns to heal?
It varies. The redness from a sunburn typically starts three to six hours after sun exposure. You might not notice it immediately. The redness typically peaks at about 12 to 24 hours and usually goes away after about 72 hours.

The pain can last about six to 48 hours, and usually starts to go away after day two. If your sunburn is blistering, the outermost layer of the skin will peel. Do not pick or pull off the skin, as it is protective and allows for more rapid healing. Peeling can last for up to a week and severe sunburns may take longer to heal.

When is it time to seek medical treatment?
Sunburns can cause many symptoms. For example, if you spend a long day at the beach, you may feel tired or start to get a headache.  If your sunburn is severe, you may even experience dehydration, fever, nausea, or vomiting.

Sunburns cause increased fluid loss through the skin, which can result in dehydration. Severe dehydration may require a trip to an emergency room or urgent care center, for treatment with intravenous fluids and to manage associated symptoms. If you have a painful sunburn without systemic symptoms, make an appointment with a dermatologist.

How can I prevent sunburns?
Avoid going outside during peak sunlight between 10 am and 3 pm in the summer, when ultraviolet radiation is strongest. Seek shade when you are outdoors and wear a wide-brimmed hat and sunscreen. I recommend an SPF 30 or higher for daily use and SPF 50 or higher for outdoor extended activities, especially at the beach, because there’s more reflection of the ultraviolet radiation off of the sand and water. Sun protection factor (SPF) is the measure of protection against ultraviolet rays and how much time it would take for the skin to turn pink. An SPF 30 will block 97 percent of the UV rays and SPF 50 blocks 99 percent. SPF 15 only blocks 93 percent and is not adequate protection.

How often should I reapply sunscreen?
Sunscreen should be reapplied every two hours. Regardless of what the packaging claims, sunscreens are not waterproof, so reapply them immediately after drying off with a towel after swimming.

What is the best way to apply sunscreen?
Any type of sunscreen application—be it lotion, spray, or sunscreen stick—is fine, but make sure you’re using an adequate amount. If it’s a spray, spray over the area a few times and rub it in over the entire area. If it’s a stick, apply over the same area for several passes. On average, one ounce, or a full shot glass, of sunscreen is recommended, but people who are above average in size will need more.

As spring turns into summer, people become more aware of protecting their skin from environmental factors like the sun and pollution. However, taking care of your skin and finding the right sunscreen is important to consider year round.

In this Q&A, Helen He, MD, Assistant Professor of Dermatology at the Icahn School of Medicine at Mount Sinai, discusses how to build a solid skincare routine and the importance of sunscreen.

Should you change your skin routine as the weather changes?

The foundation for a good skin routine, which includes a cleanser, moisturizer, and sunscreen during the day, is constant year-round. However, there are adjustments you can make as the weather changes.

Because the cold air in the winter can dry out your skin, hydration is key, so you might want a rich, creamy cleanser and a thicker moisturizer rich with glycerin and ceramides to protect the skin barrier. In the summer, sweat and oils build up and cause the skin to be more prone to acne breakouts. To adjust, switch to a gel-based cleanser or even a cleansing oil to remove extra oils and a more lightweight moisturizer that won’t clog your pores.

What are the steps to a good daytime and nighttime skin routine?

The first step for both daytime and nighttime routines is to wash the face with a gentle hydrating cleanser to remove excess oils and dirt that may have accumulated during the day or night. Afterwards, some patients may opt for toners, serums, and eye creams. While this step is optional and should be kept simple, there are active ingredients that can be helpful.

For example, vitamin C serum during the day can brighten your complexion and has antioxidant benefits, while retinol/retinoids in the night can help with skin anti-aging, texture, pigmentation, and acne. If your skin is sensitive, add these ingredients to your routine gradually, and with guidance from a dermatologist.

The next step is to use a moisturizer to seal in the water content and keep the skin hydrated. During the daytime, sunscreen is also critical, and you can opt for a moisturizer that contains sunscreen to simplify your routine.

What is the most forgotten skincare step you see in patients?

Patients think sunscreen is only for the summer, but it is important to wear sunscreen year round. Also, many patients apply sunscreen diligently on their face but neglect other sun-exposed areas like the neck and the back of the hands. Equally important, sunscreen needs to be reapplied every two hours, and even more frequently after exercising and/or sweating.

How important is wearing sunscreen daily?

Daily sunscreen is very important. UV radiation has many harmful effects, from sunburns in the short-term to long-term consequences of cumulative exposure, such as increased risk of skin cancer, premature aging and wrinkles, and other issues with skin dyspigmentation and texture.

How do you choose the best sunscreen?

Use a broad-spectrum tinted sunscreen, which covers UVA, UVB, and visible light. For most patients, sun protection factor (SPF) of 30 or higher is recommended, but if you are particularly sensitive to the sun, have a history or high risk of skin cancer, or have skin concerns like rosacea or melanoma, SPF 50 may be better. While both mineral and chemical sunscreens are effective, mineral sunscreens tend to be broader spectrum and less sensitizing.

If you are active outdoors or swim, water-resistant sunscreen is best. Remember to reapply it frequently.

What cosmetic dermatology treatments do you recommend for aging?

As you age, consider incorporating anti-aging and antioxidant ingredients into your skincare regimen such as vitamin C, niacinamide, and retinoids. With consistent use, these ingredients can help to improve skin complexion and texture, reduce wrinkles, and promote collagen production. You can also explore elective procedures such as lasers and other energy-based devices that resurface and tighten skin, neurotoxins (e.g. Botox®), and soft tissue filler augmentation.

Do I need a complicated skincare routine?

Consistency and simplicity are key. The best cleanser, moisturizer, and sunscreen is the one you will use consistently. Having a complicated skincare regimen with many steps is not necessarily better and can do more harm than good. If you do introduce a new product to your skincare regimen, you should introduce it slowly, perhaps starting out with a few times a week and gradually increase the frequency to daily. Also, only introduce one new product at a time so that if you do get a reaction, you can more easily identify the culprit.