Summer has already hit us like a tonne of bricks. Many people hope and dream about the long days spent basking in the sun but fail to realise the risks that these sunny days bring with them. As heat waves become more frequent and intense, the risk for heatstroke continues to rise. Here we discuss sunburns, heatstroke and heat exhaustion in detail and offer you tips on how to make sure you're prepared for the scorching season ahead.

Suntan versus sunburns

Over the years, I have heard many people complain about looking as pale as a ghost and how they would like to get a killer suntan. Having a suntan can be stylish of course and I love to look stylish as much as any other girl, however, my primary concern is the damage done to the skin when exposing it to the sun for long periods of time.

What is a sunburn?

A sunburn is a result of exposing the skin to too much sun and UV (ultraviolet) radiation that will make your skin red, hot and sore. It may flake and peel after a few days and generally, it will get better between 4 and 7 days.

What is UV radiation?

UV radiation is a wavelength of sunlight in a range too short for the human eye to see. It's what makes black-light posters glow and is responsible for our summer tans, as well as sunburns. However, too much exposure to UV radiation is damaging to all living tissue especially our skin since it has such a large surface area.

There are several types of radiation coming from the sun but we are mostly concerned with UVA and UVB radiation since they are directly associated with our skin and health. Ultraviolet A (UVA) is the type of solar radiation linked to skin ageing (wrinkles, pigmentation and long term sunspots). On the other hand, ultraviolet B (UVB) is associated with sunburn. Exposure to both types of radiation can result in skin cancer.

The skin is the largest organ in our body, consisting of several layers all of which contribute to having healthy skin. Melanin is a pigment responsible for our suntan and skin colour that is produced by melanocytes (a type of cell in our skin). When you spend time outside and are exposed to UV light, your body protects the skin by accelerating the production of melanin. The extra melanin creates the darker colour of a tan.

Yet, our body is extremely intelligent and its way of protecting itself from damage is by producing more pigment which results in a suntan. In turn, the suntan helps block the UV rays, preventing sunburn and other types of skin damage. But this protection only goes so far. The amount of melanin you produce is determined genetically which means that many people simply don't produce enough to protect the skin well. Eventually, UV light causes the skin to burn, bringing pain, redness and swelling and at times, even blistering.

And remember that you can get a sunburn on cool, hazy or cloudy days, just as you can during hot sunny days. In fact, as much as 80 per cent of UV rays pass through clouds. The difference is that during summer the UV index is much higher, while elements such as sand, water and other surfaces can reflect these rays, burning your skin as severely as direct sunlight. This explains why you can also get burnt at the beach even under an umbrella as the sand will still reflect the sun rays onto your skin.

Heading to the beach? Here are a few tips on how to pick the perfect beach in the Maltese islands, however, don't forget to visit these businesses listed on Yellow to purchase beach goods.

Risk factors for sunburn

Some of the risk factors that can lead to a sunburn include:

• Having light skin, blue eyes and red or blond hair.
• Babies and young children have more sensitive skin than adults, so they are more prone to sunburn.
• Certain medications, including some antibiotics, birth control pills, anti-inflammatory creams and steroid creams can increase the likelihood of a sunburn.
• Living or vacationing somewhere sunny, warm or at high altitude.
• Working outdoors
• Being outside during the sun's peak hours -- 10:00 a.m. to 4:00 p.m. -- and being on reflective sand or water can increase one's risk of severe sunburn.
• Mixing outdoor recreation and drinking alcohol.
• Having a history of sunburn.
• Regularly exposing unprotected skin to UV light from sunlight or artificial sources, such as tanning beds.
• Using oils on the skin to increase the intensity of a suntan.

What are sunburn blisters?

Sunburn blisters are typically small, white, fluid-filled bumps usually surrounded by red and hot skin. They are painful to the touch and can also be very itchy.

Sunburns that cause blisters can also result in sun poisoning, the symptoms of which are:

• Nausea and vomiting
• Chills
• Fever
• Dizziness and fainting
• Severe blistering

Do not burst blisters as these can become infected easily resulting in further complications. If you experience these symptoms, seek medical attention immediately.

Complications

When you expose the skin repeatedly to the strong intense sun and you often get sunburns, you increase your risk of additional skin damage and certain diseases, such as premature ageing of your skin and skin cancer.

Premature ageing of your skin

Repeated sunburns accelerate the skin's ageing process. Skin changes caused by UV light are called photoaging. The results of this type of sun damage include:

• Weakening of the skin and reduced elasticity
• Deep wrinkles
• Dry, rough skin
• Flaky and itchy skin
• Fine red veins on your cheeks, nose and ears.
• Freckles, mostly on your face and shoulders.
• Sunspots or pigmentation
• Dark or discoloured spots on your face, back of hands, arms, chest and upper back.

Sunburn and skin cancer

Repeated sunburns also put your skin at a higher risk of skin cancer. It usually starts off with what is known in the medical community as precancerous skin lesions. These are identifiable local signs (abnormalities) that, with time, have an increased risk of developing into cancer. They appear as rough, scaly patches in areas that have been damaged by the sun and may be whitish, pink, tan or brown. They're usually found on the sun-exposed areas of the head, face, neck and hands of light-skinned people and it is these patches that can evolve into skin cancer.

But excessive sun exposure, even if you do not get sunburnt, can also increase your risk of developing skin cancer. The sun can cause damage to the DNA of our skin cells, while sunburns in childhood and adolescence may increase your risk of developing melanoma later on in life. This is one reason why it is imperative that parents protect their young children from sun damage not only by using sunblock purchased from these pharmacies and stores selling beauty products but also ensuring that they are dressed in appropriate clothing even when at the beach or on a boat.

Skin cancer develops mainly on areas of the body most exposed to sunlight, including the scalp, face, lips, ears, neck, chest, arms, hands and legs. When applying sunblock it's extremely important not to forget the lips, ears and nape of the back as the most severe sunburns we see at the pharmacy are in these areas.

Heat exhaustion

Sunburns tend to be the most common side effect we all generally think about when it comes to sun damage. However, there are two more dangers related to excessive sun exposure and increased temperatures - heatstroke and heat exhaustion. These are conditions health care workers are faced with a lot following local village feasts and with people who are not used to spending a lot of time in the sun. These include individuals who usually work inside or tourists who come from countries where the sun is not so intense. It is also more common in very young and very old people, as well as overweight and obese individuals.

Heat exhaustion, in particular, is a common result of overheating in response to external factors, like high temperature. It can happen to anyone and is more common than we think. Often seen in athletes, particularly those who exercise outdoors during extreme summer weather such as long distance runners, cyclists and tennis players, heat exhaustion can also occur if you're in a hot car stuck in traffic for a long time or another indoor area that isn't air conditioned. Although less severe than heatstroke, it can nonetheless lead to this dangerous condition.

Symptoms of heat exhaustion

Heat exhaustion usually comes on quite suddenly without any warning. You may have one or several symptoms, including:

• A drop in blood pressure which can make you feel dizzy or lightheaded.
• A slight feeling of nausea.
• Feeling faint or having the sense that you are going to blackout.
• Sweating profusely from many areas of the body including the palm of your hands.
• Cold and moist skin, coupled with goosebumps, even in extreme heat.
• A pulse rate that becomes weak.
• Headache
• Muscle cramping

Dehydration

In many cases if you have heat exhaustion, you may also be dehydrated. Dehydration will also contribute to developing heatstroke much quicker so it is important to recognise the symptoms as well as prevent it from occurring as much as possible.

Dehydration symptoms differ in babies, children and adults.

In babies, symptoms may include:

• A soft, sunken area on the top of the head.
• Crying without tears
• Going three or more hours without urinating.
• Crankiness
• Eyes that look sunken
• Dry or sticky mouth
• Listlessness

In older children and adults, dehydration is typically identified by an increased feeling of thirst, dry mouth and urine that is dark in colour. Fatigue and sleepiness, confusion, headache and dizziness may also occur.

To prevent dehydration drink water regularly. As a general rule, adults and adolescents need 1 litre of water for every 25kg of body weight, while you may also want to consume rehydration salts/electrolytes daily as this will replace salts lost due to sweating.

How to prevent heat exhaustion

You can't change the weather, but there are some things you can do to reduce your risk for heat exhaustion during the summer months:

• Stay in a cool place as much as possible. If you don't have air conditioning at home or at work stay in the shade, keep the windows open and use fans. Keep a handheld fan with you and keep thermal water sprays with you to be able to cool down your body temperature.
• Never leave a child or baby in a hot car, even if it is just for a few minutes. Temperatures in cars can rise very rapidly.
• Wear lightweight and light-coloured clothing.
• Wear a lightweight sunhat or cap. Keeping the sun off your head and face can help control your body temperature.
• Wear sunscreen when in the sun to avoid sunburn.
• Reapply sunscreen every two hours.
• Stay hydrated when it's hot outside. Your body can become dehydrated before you notice signs. Keep a bottle of water with you and drink small sips from it frequently.
• Use rehydration salts daily.
• When it's hot outside, limit outdoor workouts to early morning or evening or consider joining a gym that has air conditioning. Swimming is also a great way to get exercise when it's hot outside.
• Keep calm so as to keep your heart rate under control.
• Avoid alcohol and caffeinated drinks.

If you suspect you or a loved one might have heat exhaustion, stop what you're doing, find a cool area or a way to cool down your body. You may also want to apply a wet towel or ice pack to the neck and wrists when possible. If your symptoms don't improve quickly, seek emergency medical help since it's important to reduce your body heat to avoid heatstroke.

What is heatstroke?

Heatstroke is the most severe form of heat injury and it can occur if your body temperature rises to 40 degrees Celsius or higher. This usually can occur during the summer months.

I have often noticed people working out with plastic bags wrapped around them so as to lose weight quickly (or so they think) or spending excessive time in a sauna in the hope of boosting their metabolism. These habits can result in heatstroke and will surely not boost metabolism or weight loss.

Also known as sunstroke, it is a very serious condition and must be considered as an emergency. If left untreated, damage to internal organs can occur, with this becoming even more severe the longer it takes you to seek medical attention. It can rapidly damage your brain, heart, kidneys and muscles, while it can result in serious complications or even death.

How to spot heatstroke warning signs

Heatstroke does have early warning signs so keep an eye out on your children and loved ones and if you notice these signs its important to act quickly.

These symptoms include:

• muscle cramps
• general tiredness
• headache
• dizziness
• the feeling of passing out

Additional symptoms to keep in mind:

• Confusion, agitation, slurred speech, delirium, seizures and even coma.
• Nausea and vomiting
• Your skin may turn red but this does not always occur.
• Your breathing may become rapid and shallow and is especially dangerous for asthmatic patients.
• Your pulse may significantly increase because heat stress places a tremendous burden on your heart to help cool your body.
• It is common to get a throbbing headache with heatstroke.
• When heatstroke is brought on by hot weather your skin will feel hot and dry to the touch. But when heatstroke occurs due to strenuous exercise, your skin may feel dry or slightly moist.
• If the body temperature rises above 40 degrees Celsius, the body loses the ability to cool down so you will notice that you won't be sweating much - this is considered to be heatstroke.
• Some people are more susceptible to it, including young people, older adults and overweight individuals.
• Heatstroke can be brought on by physical exertion in hot conditions or simply by being in a hot environment.
• It can be fatal if left untreated.

What to do if you suspect someone is experiencing heat stroke?

Take immediate action to cool the overheated person while waiting for emergency treatment:

• Get the person into shade or indoors immediately.
• Remove excess clothing.
• Cool the person with whatever means available — put in a cool tub of water or a cool shower, spray with a garden hose, sponge with cool water, fan while misting with cool water or place ice packs or cold, wet towels on the person's head, neck, armpits and groin.
• Carry with you Thermal water sprays. There are several brands available locally which you can buy from pharmacies and they can be extremely useful even if you get burnt when touching a hot object.
• Call your doctor or visit a local health centre/hospital where specific medication can be administered.

In what ways does heatstroke affect the elderly and children?

Children and seniors have many things in common when it comes to their susceptibility to heatstroke. They are more at risk as their bodies' ability to keep cool is not as efficient as that of young adults. Parents should be hyperaware when children are outside during heat waves and during peak hours in the summer. Infants and young children, in particular, are at risk because they need someone to watch out for them as they are usually not able to notice when something is wrong.

Similarly to children, older people are just as susceptible to overheating and developing heatstroke, especially those who live without air conditioning units to properly cool their homes. The elderly also tend to wear more clothes in summer so bring this to their attention when you can. In addition, as we age, our bodies lose their ability to regulate our internal body temperature. This coupled with other medical conditions that are typical of old age such as cardiac conditions and diabetes can put them at higher risk. Also, people with chronic diseases such as asthma, chronic obstructive pulmonary disease, congestive heart failure and coronary artery disease are at higher risk for heat-related conditions.

How are heat emergencies treated?

You can help yourself or others experiencing a heat emergency. Remember these four important things as it can help save a life:

• Call an ambulance or go to the hospital if the heat emergency is causing vomiting, seizures or unconsciousness.
• Don't give the person anything to drink if they're vomiting or unconscious.
• Check airways and make sure that the person's tongue is not obstructing their throat.
• Never offer a drink containing alcohol or caffeine to someone experiencing a heat emergency.

Having said all this, summer is a time to enjoy the good weather and if you follow all our guidelines you and your loved ones can enjoy the season without experiencing any of the above-mentioned difficulties. Yet, if you've spent too much time in the sun, make sure you follow these home remedies for those painful sunburns.

Get in touch with one of these general practitioners should a heat-related emergency occur.

Keep on discovering local with Yellow!