Soaking Up Island Rays? Tips to Get the Red Out

The tourist couldn’t wait to start his Hawaiian vacation. Soon after landing in Honolulu, he was relaxing on the shimmering sand at Waikiki Beach. Blue skies, no smog . . . paradise, for a while.

But he forgot to apply sunscreen, and within hours he was in sunburn hell.

“He had blisters on his chest and his back,” recalls Dr. Bruce Mills, the Honolulu dermatologist who treated him. The blisters were painful and big--silver dollar-size or larger.

“It really ruined his trip,” Mills says.

Hawaii is close to the equator--it lies on about the same latitude as Cuba, India and Saudi Arabia--and visitors often underestimate the sun’s intensity there.

It’s not just beach-goers who suffer. Mills has cared for many sunburned tourists who went fishing, snorkeling or sailing and underestimated how intense the rays are as they bounce off the water.

Sunscreens are a must year-round in Hawaii. Mills suggests sunscreens with a sun protective factor, or SPF, of 15 or higher, and with both UVA (ultraviolet A radiation) and UVB (ultraviolet B radiation) protection. He likes formulas with Parsol 1789 (avobenzone), an over-the-counter product, and those with titanium dioxide.

Zinc oxide is good too, says Dr. Carla Nip-Sakamoto, another Honolulu dermatologist who, like Mills, is on staff at the Queen’s Medical Center, Honolulu.

Whatever the formula, it should be applied 30 to 40 minutes before exposure and reapplied often. Certain brands, including Alligator and Bullfrog, stay on longer during water exposure, Mills says.

Few tourists will heed the advice to stay out of the sun when rays are strongest--from about 10 a.m. until 4 p.m.--so Nip-Sakamoto and Mills dispense more realistic advice. She recommends wraparound sunglasses and either long sleeves, or short sleeves over tank tops. Fair-skinned Hawaiians often wear T-shirts in the water.

A big-brimmed hat can help keep out rays, Nip-Sakamoto says. So can legionnaire-style hats, with ear and neck flaps, that she sees on more and more Hawaiians.

You can also invest in sun protective factor clothing, specially treated to block the sun’s rays. Typical summer shirt fabrics have an SPF of 6.5, but clothes made with the special SPF fabric have an SPF over 30, according to the Skin Cancer Foundation. Keep babies under 6 months out of the sun, and be sure older children wear sunscreen and protective clothing, advises the American Academy of Dermatology.

And what if you get burned despite precautions?

If the burn is not too severe, try self-care. Consider aspirin or an anti-inflammatory drug such as ibuprofen. Acetaminophen (Tylenol) doesn’t work quite as well for sunburn pain relief, Mills says. Topical hydrocortisone creams, some of which are available over the counter, also can help. Mills suggests a 1% formula for the face.

“If skin is pink, not red, and there are no blisters or broken skin, you can take a cool shower and use a moisturizer and hydrocortisone,” Nip-Sakamoto says. Drink plenty of fluids too; a sunburn can leave you dehydrated.

Get medical attention for a severe burn. “If you are red, it’s a severe burn,” Mills says. Fever, chills, nausea and vomiting are other signs. Figure four or five days for recovery, he says.

In the long term, Mills tells travelers, severe sunburns raise the risk of melanoma, the most deadly form of skin cancer.

Healthy Traveler appears the second and fourth Sundays of the month. Kathleen Doheny can be reached at kdoheny@compuserve.com.