Sunburn is one of the most common summer presentations in UK community pharmacies. Despite widespread public health messaging about sun protection, approximately one in three adults and one in four children in England report being sunburned at least once a year, according to Cancer Research UK. Each episode of blistering sunburn in childhood doubles the lifetime risk of melanoma.

Community pharmacists are frequently asked which after-sun products work, whether to use hydrocortisone, and when sunburn warrants medical attention. The evidence base for most commercial after-sun products is limited — but there are genuinely useful interventions the pharmacy can provide.

Assessing sunburn severity

Sunburn is classified similarly to thermal burns:

Most pharmacy presentations are superficial sunburn — painful and uncomfortable but self-limiting, resolving within 3–7 days with peeling.

Evidence-based pharmacy treatments

Cooling and rehydration

The most important first-line measures are non-pharmacological:

• Cool (not cold) compresses or baths — tepid water for 15–20 minutes reduces skin temperature and eases pain. Avoid ice, which can cause further tissue damage.
• Drink plenty of water. Sunburn draws fluid to the skin surface, and dehydration can develop, particularly in children and older adults.
• Stay out of the sun until the burn has fully healed.

Pain relief

• Ibuprofen is the analgesic of choice for sunburn. As an NSAID, it addresses both pain and the inflammatory component. Adults: 200–400mg three times daily with food. Children: age-appropriate dose (check BNF for Children).
• Paracetamol is an alternative for patients who cannot take ibuprofen (e.g. asthmatics with NSAID sensitivity, those on anticoagulants).
• Aspirin should be avoided in children under 16 (Reye's syndrome risk) and in adults taking anticoagulants.

Topical treatments

• Emollients. Simple aqueous cream, E45 or other fragrance-free moisturisers help the skin retain moisture as it heals. Apply frequently. Avoid petroleum-based products (e.g. Vaseline) immediately after a burn, as they can trap heat.
• Aloe vera gel. There is limited clinical trial evidence for aloe vera in sunburn, but it is widely used and has a theoretical anti-inflammatory mechanism. Products containing a high concentration of pure aloe vera (rather than small amounts in a scented lotion) are preferable. It is unlikely to cause harm and many patients find it soothing.
• Hydrocortisone 1% cream. For moderate sunburn with significant inflammation, a short course (up to 7 days) of OTC hydrocortisone can reduce redness and discomfort. It should not be applied to blistered or broken skin. Not suitable for children under 10 without GP advice.
• After-sun lotions. Most commercial after-sun products are moisturisers with added fragrances, menthol or small amounts of aloe vera. They are not harmful, but they are not superior to a plain, fragrance-free emollient — and they cost more. Pharmacists can advise patients that an inexpensive aqueous cream achieves the same effect.

What to avoid

• Spray-on anaesthetics (benzocaine, lidocaine) — these can cause contact sensitisation and are not recommended for sunburn by NICE or the BNF.
• Antihistamines — sunburn itch is not histamine-mediated, so antihistamines have limited benefit. They may cause drowsiness, which could be mistaken for heat illness symptoms.
• Butter, toothpaste, or other home remedies — no evidence of benefit; potential for harm and infection.

When to refer

Pharmacists should direct patients to a GP or urgent care when:

• Extensive blistering — covering more than 10% of body surface area, or involving the face, hands, feet or genitals
• Signs of heat exhaustion or heatstroke — confusion, rapid pulse, nausea, vomiting, headache, temperature above 40°C
• Sunburn in children under 1 year — always refer
• Signs of infection in a healing burn — increasing redness, warmth, swelling, pus or fever developing days after the initial burn
• The patient is on photosensitising medication — including doxycycline, amiodarone, thiazide diuretics, naproxen and some antifungals. These can cause phototoxic reactions that are more severe than ordinary sunburn and may require medical assessment.

Prevention: the pharmacy's strongest role

Treating sunburn is secondary to preventing it. Community pharmacies stock the full range of sun protection products and are well placed to advise:

• SPF 30 or higher, broad-spectrum (UVA + UVB) — the dermatology consensus minimum
• Apply generously — most people apply less than half the recommended amount (2mg/cm², approximately 6–8 teaspoons for a full adult body)
• Reapply every 2 hours and after swimming or sweating
• No sunscreen is waterproof — "water-resistant" means it retains some SPF after 40 or 80 minutes in water
• Children's skin is more vulnerable — hats, shade and UV-protective clothing are more reliable than sunscreen alone for young children

With more than 13,000 community pharmacies across England, pharmacists are among the most accessible healthcare professionals available during the summer months — including evenings and weekends when GP surgeries are closed.

For more information on pharmacies and services near you, visit PharmSee's pharmacy finder.

Sources: NICE Clinical Knowledge Summary — Sunburn; Cancer Research UK — Sun Protection Statistics; British Association of Dermatologists — Sunburn; British National Formulary; PharmSee pharmacy register data (April 2026).