The other night, I found myself with a Terrible, Horrible, No Good, Very Bad sunburn (as the fabled Alexander would put it). Now, a burn is painful enough on its own, but — as I learned — it's especially bad at night. As I tucked myself into bed, sinking into what suddenly felt like sheets made of sandpaper, my skin screamed.
Sunburns disrupt sleep in a couple different ways, says Ted Lain, MD, a dermatologist and Chief Medical Officer at Sanova Dermatology. “There is inflammation in the skin that causes the heat, as well as the pain from nerve irritation,” he explains. “The skin feels tight and uncomfortable because it has lost its barrier function, or its ability to retain hydration and protect itself from the environment.”
Even worse, you might feel extra-exhausted after being in the sun. That's because the body is sending fluid to your burnt skin's surface, dehydrating you, which can tire you out, says Marisa Garshick, M.D., an assistant clinical professor of dermatology at Cornell-New York Presbyterian Medical Center. Plus, your body is working hard at regulating your core temp, draining your energy even more. And yet, you're unable to nod off and stay asleep.
Luckily, there are things you can do to rest a little easier, even when your skin feels like it’s smouldering. The doctors gave me their best tips in exchange for the promise that I’d reapply my SPF more frequently next time.
Take an ibuprofen or paracetamol
My instinct was correct! “Aloe vera gel is cooling and helps temporarily with discomfort, as do numbing sprays and gels,” Dr. Lain says. “These may be most appropriate if the sunburn is causing nighttime awakenings. But just be careful to follow manufacturer's directions on how and when to apply the numbing sprays, since overdoing it may lead to a dangerous absorption.”
This is an important one, says Dr. Garshick. Not only will it help the skin repair itself, it can help with hydration and overall comfort. She recommends a lighter-weight cream in the first 24 hours after a burn, then something heavier after a few days, when this skin is starting to peel. But she advises against exfoliating to accelerate the peeling, or picking at blisters.
Pick the right PJs
Light cotton PJs or silks are the best fabrics, since they’ll cause less friction against the skin, Dr. Lain says. “Certainly not wearing pyjamas is also an alternative,” he adds, which brings us to...
And the right sheets
If you're going to sleep au naturale, go for cotton or silk bedsheets. Bamboo works too. Dr. Garshick recommends avoiding flannel, wool, and most synthetic fabrics, unless they’re moisture-wicking. Only sleep in the buff when the sheets are clean, she adds.
Hydrate, hydrate, hydrate
Remember when we mentioned burns are dehydrating? Dr. Garshick recommends keeping a glass of water by the bed, and drinking a little more than you usually would before you nod off. It can also help to take a cold shower right before you head to bed to cool down your body, as it can be hard to fall asleep when you're too warm.
When in doubt, go to the doctor
If your burn is causing extreme blistering, or is accompanied by symptoms such as severe pain, a high fever, or nausea, it’s worth having a doctor or dermatologist take a look to rule out sun poisoning or heat stroke. “I usually will tell people to have a low threshold for going to the doctor,” Dr. Garshick says. “If you’re in enough pain it’s really noticeable, it’s reasonable to contact a dermatologist. Some people might be taking medicines that are making them more sensitive to the sun, and they might not be aware of it.”
If a burn is really severe, your doc might prescribe a short course of steroids, a corticosteroid cream, or a prescription grade moisturizer. Dr. Garshick says she also might give patients a friendly reminder to keep slathering on the sunscreen. “People sometimes think, ‘okay, I’ve done my damage,’ after a burn,” she says. “But when the skin is somewhat injured, it’s more susceptible to further damage.”
Lain adds: "Sunburns cause lasting damage to the DNA in the skin cells... This is why sunburns cause so much inflammation and discomfort — it's the body's mechanism to persuade you to avoid doing this again!"
I certainly found my sleepless night convincing.