Momwithastethoscope's Weblog

June 4, 2008

Blister in the Sun

Filed under: Skin — momwithastethoscope @ 7:14 pm

The patient was a prototypical tween girl. Over the beautiful, sunny, southern weekend, she attempted to tan her porcelain skin with little to no sunscreen.  The result was a beefy red sunburn over her shoulders and chest. On day 3, a large blister developed on her right shoulder and ruptured.  She came to me for burn care and a sunscreen lecture.

I am amazed at the number of people who still regularly tan.  Maybe it is because I live near a body of water that people feel the need to be brown in the summer (sometimes year round). Maybe it’s a southern thing.  Maybe there is conflicting information about harmful sun exposure and getting enough for vitamin D production.  Maybe putting sunscreen on daily is just an oily pain in the neck.

I debrided the blister on the shoulder of my patient – angry, wet, fragile skin beneath it weeped. My patient wept, too.  Cleaning burns is no fun.  it is preventative pain.  Taking off the gooey dead skin prevents further problems and jump starts the underlying skin to heal.  Looking over the rest of her shoulders I feared that she would loose the whole top layer of her skin all the way across her shoulders.  She was at risk for a big infection to go with the big burn, too. 

In the end, I didn’t need to lecture this young patient about skin care.  Her experience spoke volumes. I believe she will be diligent about sunscreen at least for the rest of this summer.  Next summer, who knows? Her follow-up visit revealed a nicely healing burn on the shoulder with intact skin over the rest of her shoulders.  I gave her the name of my favorite sunscreen, Mexoryl, and told her I would see her for a physical in the fall.




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