Can a Bad Sunburn Raise Your Skin Cancer Risk for Life?

Most people are aware that excessive unprotected exposure to the sun’s ultraviolet rays raises skin cancer risk. Now people are going on TikTok to share their fears about a so-called “life-changing sunburn.”

“Is this a life-changing sunburn?” wrote @kiradowlinggover a video of her reddened chest. One poster, who shared a video of her friends applying aloe to her scarlet-hued skin, received a comment advising her to “start looking for a dermatologist now,” because “that’s a life-changing sunburn.”

Doctors say there isn’t a yes-or-no answer.

“UV radiation causes direct and indirect damage to DNA of skin cells,” says Jennifer Tang, MD, a dermatologist and a researcher with Sylvester Comprehensive Cancer Center, part of the University of Miami Health System and the Miller School of Medicine in Florida.

This damage can cause a common DNA mutation in which cytosine becomes thymine, Dr. Tang says. This can cause disruptions in the way DNA replicates, which can eventually lead to cancer.

The body’s immune system is able to monitor minor damage to DNA and repair it, according to Tang. “If damage is too extensive to fix, the cell may die,” Tang says.

Sunburned cells are skin cells that are going through apoptosis, or cell death, Tang says. “However, if the mutated cells escape cell death, cancers may arise,” she explains.

The immune system’s ability to stop this chain of events depends on the severity of the burn and the area of the body that’s involved, says Pooja Sodha, MD, an associate professor of dermatology at the GW School of Medicine & Health Sciences in Washington, DC. “It could be as short as a few days up to a few weeks,” she says.

Blistering can be a sign that a sunburn is especially intense, according to Vernon Sondak, MD, the chair of the department of cutaneous oncology at the Moffitt Cancer Center in Tampa, Florida. This type of sunburn gets into deeper layers of the skin than other sunburns, causing more damage, raising the risk of infection, and increasing the odds of skin cancer, he says.

The blistering is an immune response, in which fluid builds up under damaged skin to create a protective barrier — the blister. “First, the skin gets red. Then, cells begin to die,” Dr. Sondak says. “That’s when the blistering and peeling occurs.”

While there’s no good data to support the claim that a single bad sunburn is enough to raise a person’s lifetime risk of skin cancer, it’s possible, Sondak says.

A bad sunburn is like a game of roulette, he notes. In some cases, one turn of the “wheel” could lead to cancer; in other cases, you might spin and spin without landing on a bad result.

Blistering sunburns in young people may pose special risks. One oft-cited landmark study found that young white women who’d had five or more blistering sunburns between ages 15 and 20 saw their risk of developing melanoma (the most serious type of skin cancer) increase by 80 percent.

In addition to melanoma, another form of skin cancer called squamous cell carcinoma, which begins in the squamous cells that make up the outer layer of skin, is associated with regular UV exposure, Sondak says.

Basal cell carcinoma, which begins in the cells that make new skin cells as old ones die, can be caused by a mixture of blistering sunburns and chronic exposure, he says.

Skin cancer rarely develops immediately after a sunburn. Instead, these mutations tend to build up over time, Sondak says. “Overall, cumulative mutation may be necessary to drive malignancy,” Tang says.

• Asymmetry: Two halves of a spot don’t match.
• Border: The spot’s border is irregular, scalloped, or poorly defined.
• Color: The spot has shades of tan, brown, or black, or areas of white, red, or blue vs. one consistent color.
• Diameter: These spots are typically larger than 6 millimeters, but they can be smaller.
• Evolving: The spot looks different from others on your body, or there are changes in its size, shape, or color.

If you develop a bad, blistering sunburn, there are things you can do to alleviate the discomfort.

Dr. Sodha suggests colloidal oatmeal baths and cool showers, then slathering yourself with aloe vera–, oatmeal- or soy-based lotions. “Cold compresses are useful between baths,” she says.

“Stick to bland emollients and give it time,” Sodha says. “Tylenol and nonsteroidal anti-inflammatory drugs are helpful, too.”

She recommends avoiding products with lidocaine and benzocaine — these can irritate skin.

You can use thick moisturizers like petroleum jelly, but only once skin begins peeling. “They can trap heat and make the early phase of recovery more uncomfortable,” Sodha says.

If you develop symptoms of what’s commonly called sun poisoning, such as fevers, chills, confusion, or blisters on large areas of sunburned skin, Sodha recommends contacting a healthcare provider. Doctors may suggest taking an oral or topical steroid medication in some cases, she says.

A healthcare provider may prescribe antibiotics if they suspect an infection, Sodha adds.

Tang recommends doing these sun-safe skin practices daily.

• Stay in the shade when possible.
• Wear sun-protective clothes, along with a wide-brimmed hat and sunglasses with UV protection.
• Wear broad spectrum, water-resistant sunscreen of at least SPF 30, even on cloudy days.
• Reapply sunscreen every two hours when outdoors or sweating.
• Avoid tanning beds.

“If you have a history of atypical moles, be more stringent about these measures and track changes in lesions or follow-up with your dermatologist,” Sodha says.