A sunburn across the back creates a unique challenge for sleep, as lying down can become intensely painful due to pressure and friction. The inflamed skin, caused by ultraviolet (UV) radiation, triggers an inflammatory response that generates heat and tenderness. Achieving restful sleep requires reducing inflammation, avoiding contact with the burned area, and optimizing the sleep environment. Strategic preparation and positioning minimize discomfort, allowing the body to recover overnight.
Pre-Sleep Pain Management and Preparation
The foundation for a comfortable night involves actively reducing inflammation and heat before bed. Taking an over-the-counter non-steroidal anti-inflammatory drug (NSAID) like ibuprofen or naproxen is recommended. These medications work systemically to alleviate pain and suppress the body’s inflammatory response to UV damage. For best results, take the initial dose as soon as the sunburn is noticed to limit the peak severity of pain.
A quick, cool shower or bath should be the last step before bed to draw heat out of the burned skin. The water should be cool, not cold, as temperature extremes can shock the skin. Adding baking soda to bathwater can provide additional soothing relief. After the cool soak, gently pat the skin dry with a soft towel, leaving a slight layer of moisture.
Immediately following the shower, apply a topical treatment to the damp skin to lock in moisture and provide a cooling effect. Aloe vera gel is an excellent choice for its soothing properties. Applying a thin layer of non-prescription 1% hydrocortisone cream may also help reduce swelling and redness. Avoid products containing petroleum jelly, which traps heat, or topical anesthetics like benzocaine, which can cause allergic reactions. If the back is difficult to reach, a partner should apply the treatment with the lightest possible touch to minimize friction.
Strategic Sleeping Positions
Keeping pressure completely off the sunburned back is the most important step for comfort and preventing further irritation. The most effective position is sleeping on the stomach, which ensures zero contact between the inflamed skin and the mattress. Since stomach sleeping can strain the neck, use a very thin pillow or no pillow under the head to maintain neutral spinal alignment.
If stomach sleeping is impossible, side sleeping is the next best option, requiring careful positioning. Place a large body pillow or a stack of pillows behind the back to create a barrier. This prevents inadvertently rolling onto the burned area during the night. Side sleepers should also place a pillow between their knees to maintain spinal alignment and reduce torso twisting.
A third effective technique is creating a slight elevation that suspends the torso, often called a “tent.” Achieve this by propping the upper body up with a wedge pillow or several firm pillows for a semi-reclined position. This elevation prevents full contact with the sheet and allows air to circulate around the burn, helping dissipate heat. If the sunburn is widespread, a large body pillow can also be positioned down the side of the body to minimize contact with the bed while offering support.
Optimizing Bedding and Environment
Bedding materials must be carefully chosen to minimize friction and promote cooling. Swap out standard bedding for light, breathable fabrics like soft cotton, bamboo, or silk. These materials are smoother and cause less abrasive friction against sensitive skin. Their breathability also helps wick away moisture and prevents heat from building up on the skin’s surface.
Avoid heavy blankets and thick duvets, as their weight and insulation trap heat, intensifying the burning sensation. Use only a single, lightweight sheet made of the recommended materials. Keep the bedroom cooler than usual; a range of 65 to 68 degrees Fahrenheit is optimal for promoting sleep and cooling the skin.
Using a fan provides relief by circulating air and creating a gentle cooling breeze. For an added cooling effect, position a bowl of ice or a damp towel in front of the fan to circulate slightly chilled air. This constant air movement helps dissipate the excess heat generated by the inflamed skin.
When Sunburn Requires Medical Attention
While most sunburns are treated effectively with home care, certain symptoms indicate a severe reaction requiring professional medical evaluation.
Systemic Symptoms
Seek medical attention if the sunburn covers a large area and is accompanied by systemic symptoms. These include a fever higher than 101 degrees Fahrenheit, chills, or persistent nausea and vomiting. These symptoms may signal sun poisoning, dehydration, or a widespread inflammatory response that home remedies cannot manage.
Blistering and Infection
Widespread blistering is another serious sign, especially if blisters cover more than 20% of the body or appear on the face, hands, or genitals. Blisters indicate a second-degree burn and should never be popped, as the intact skin provides a sterile barrier against infection. Signs of infection, such as increasing pain, swelling, yellow or red streaks, or pus draining from a broken blister, also warrant immediate medical consultation.
Unmanageable Pain
Severe or unmanageable pain that is not relieved by over-the-counter medications requires professional help. Also seek care if you experience confusion, dizziness, or faintness, which can indicate shock or severe dehydration. If discomfort is so intense that sleep is impossible despite implementing comfort strategies, a healthcare provider can assess the burn and prescribe stronger medications.