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Suggest Treatment For Sun Burn

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Posted on Thu, 10 Jul 2014
Question: 13yo son is having an intense itching reaction. he's had this before, after sun exposure, sand, saltwater & chlorine. he is not sunburned. the itching is in his back -all of it. he hasn't had extended sun exposure since last Saturday, but the itching started yesterday. it started as seemingly dry skin. now he's literally crying & coming out of his skin. he's taken Benadryl and 10 mg prednisone.
doctor
Answered by Dr. Johny Chacko (28 minutes later)
Brief Answer:
?Polymorphic light eruption/ ?Xerosis

Detailed Answer:
Hello,
Welcome to healthcare magic.
I understand that your son has been having intense itching over his entire back of 1 day duration.

With your history and description, I would consider the possibilities of Polymorphic light eruption, phototoxic reaction and Xerosis with eczematisation.

You have a feature to upload the images by yourself at the right side of the query page, please utilize that so that I can answer your query better. You can also send the image as attachment to YYYY@YYYY , with the subject as 'Attn: Dr. Johny Chacko'.

I see that you have given him 10 mg of Prednisolone 1 hour back and 50 mg Diphenhydramine. I would also suggest that you could apply a topical steroid like 1% hydrocortisone ( available over the counter) 2-3 times a day for 5 days.
You could continue Diphenhydramine at bedtime for 5 days.

Please revert back to me with the clinical picture.

Regards,
Dr. Johny Chacko
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Johny Chacko (45 minutes later)
topicals are not an option - they increase the itching, including hydrocortisone. It is typically over in 12 hours. this started last night & seems to be peaking (I hope). I've tried calming lotions, hydrocortisone, baby oil, aloe w/lidocaine, cold vinegar water compresses, warm baths, cool baths.

itch seems internal if that makes any sense. the more you touch, the worse it gets.

no whelps or bumps on the skin. can't get a picture to upload. no rashes. no burn.
doctor
Answered by Dr. Johny Chacko (8 hours later)
Brief Answer:
Phototoxic reaction

Detailed Answer:
Hello,
Thank you for your clarifications.

I have seen the clinical picture.

There is intense redness on the lower back. I would consider the possibility of aan acute phototoxic reaction / acute sunburn reaction.

If your son has been started on any oral medications in the last 10 days, ( apart from what you have given for this problem), it could lead to a phototoxic reaction. You need to stop it. I am assuming he has not been started on any since you have not mentioned anything in your history.

The sunburn reaction could sometimes be delayed by a few days.

I would suggest that you continue oral prednisolone 10 mg twice a day for 3 days.
You could also give him diphenhydramine twice a day for 3-5 days.
Continue only cold compresses.
Vinegar and even oil could further irritate the skin.

Avoid sun exposure for next 2 weeks. Thereafter, use a sunscreen covering both UV-A and UV-B spectrum 20 minutes before stepping out in the sun. Re apply every 4 hours and if in water, every 2 hours.

Hope this helps you.
I understand you must be in distress and I hope your son finds relief soon.

Regards,
Dr. Johny Chacko
Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Johny Chacko

Dermatologist

Practicing since :2005

Answered : 1916 Questions

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Suggest Treatment For Sun Burn

Brief Answer: ?Polymorphic light eruption/ ?Xerosis Detailed Answer: Hello, Welcome to healthcare magic. I understand that your son has been having intense itching over his entire back of 1 day duration. With your history and description, I would consider the possibilities of Polymorphic light eruption, phototoxic reaction and Xerosis with eczematisation. You have a feature to upload the images by yourself at the right side of the query page, please utilize that so that I can answer your query better. You can also send the image as attachment to YYYY@YYYY , with the subject as 'Attn: Dr. Johny Chacko'. I see that you have given him 10 mg of Prednisolone 1 hour back and 50 mg Diphenhydramine. I would also suggest that you could apply a topical steroid like 1% hydrocortisone ( available over the counter) 2-3 times a day for 5 days. You could continue Diphenhydramine at bedtime for 5 days. Please revert back to me with the clinical picture. Regards, Dr. Johny Chacko