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Introduction
Sunburn, also known as erythema, is caused by excessive exposure to ultraviolet radiation (UVR), which results in an acute cutaneous inflammatory response. Sunburn results from over exposure to UVR and can occur from use of indoor tanning beds or over exposure to outdoor sunlight. Sunburn symptoms include redness, warmth, tenderness, or edema, and may cause pain or blistering. Annually, over 33,000 sunburns are reported that require emergency room visits and may occur among people of all racial/ethnic groups. Previous sun burning, particularly experienced at younger ages, is a strong predictor of future skin cancer and especially melanoma, the deadliest form of skin cancer. People with sun sensitive skin are more likely to incur sunburn and are at greater risk for skin cancer, especially melanoma, than those with relatively less sun sensitivity. Sun sensitivity reflects a person’s characteristic skin response (e.g., a burn, a burn and then tan, etc.) after prolonged sun exposure or after a long period or season of being relatively unexposed. Though related to sun sensitivity, skin color and ethnicity are not adequate proxies for sun sensitivity because they are not accurate biological descriptors of at risk populations.
Measure
The percentage of high school students (grades 9-12) who reported having been sunburned in the past 12 months.
The percentage of adults aged 18 years and older who reported having been sunburned in the past 12 months.
Healthy People 2020 Target
- (Developmental) Reduce the proportion of adolescents in grades 9 through 12 who report sunburn.
- Reduce to 33.8 percent the proportion of adults aged 18 years and older who report at least one sunburn in the past 12 months.
Healthy People 2020 is a set of goals set forth by the Department of Health and Human Services.
Note: Goals are indicated as blue line on Detailed Trend Graphs.
Data Source
Adolescents: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Youth Risk Behavior Surveillance System (YRBSS), 2015-2017.
Adults: Centers for Disease Control and Prevention, National Center for Health Statistics. National Health Interview Survey NCI and CDC co-sponsored Cancer Control Supplement, 2000-2010, 2010-2015.
Trends and Most Recent Estimates
Adolescents
By Sex
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2017) | |
|---|---|---|---|
| Percent of adolescents | 95% Confidence Interval | ||
|
Both Sexes
|
57.2 | 54.1 - 60.3 |
Male
|
52.8 | 49.4 - 56.0 | |
Female
|
61.6 | 58.4 - 64.7 | |
By Race/Ethnicity
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2017) | |
|---|---|---|---|
| Percent of adolescents | 95% Confidence Interval | ||
|
All Races
|
57.2 | 54.1 - 60.3 |
Non-Hispanic White
|
74.8 | 73.0 - 76.6 | |
Non-Hispanic Black
|
13.0 | 10.4 - 16.1 | |
Hispanic
|
45.1 | 42.4 - 47.8 | |
By High School Grade
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2017) | |
|---|---|---|---|
| Percent of adolescents | 95% Confidence Interval | ||
|
Grade 9
|
57.7 | 53.9 - 61.4 |
Grade 10
|
57.2 | 53.1 - 61.2 | |
Grade 11
|
55.6 | 51.5 - 59.7 | |
Grade 12
|
58.7 | 54.5 - 62.9 | |
Adults
By Sex
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
Both Sexes
|
35.3 | 34.4 - 36.2 |
Male
|
35.5 | 34.2 - 36.7 | |
Female
|
35.2 | 34.1 - 36.3 | |
By Race/Ethnicity
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
All Races
|
35.3 | 34.4 - 36.2 |
Non-Hispanic White
|
46.3 | 45.1 - 47.5 | |
Non-Hispanic Black
|
9.9 | 8.8 - 11.1 | |
Hispanic
|
22.4 | 20.9 - 24.0 | |
By Age
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
Ages 18-24
|
46.0 | 43.1 - 48.9 |
Ages 25+
|
33.7 | 32.8 - 34.6 | |
By Sex and Age
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
Males, Ages 18-24
|
43.6 | 39.8 - 47.4 |
Males, Ages 25+
|
34.3 | 33.0 - 35.5 | |
Females, Ages 18-24
|
48.4 | 44.2 - 52.7 | |
Females, Ages 25+
|
33.2 | 32.2 - 34.3 | |
By Poverty Income Level
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
<200% of federal poverty level
|
26.7 | 25.4 - 28.1 |
>=200% of federal poverty level
|
39.2 | 38.2 - 40.3 | |
By Education Level
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
Less than High School
|
19.7 | 18.0 - 21.5 |
High School
|
30.8 | 29.1 - 32.5 | |
Greater than High School
|
37.2 | 36.3 - 38.2 | |
By Sun Sensitivity
| Overview Graph | Detailed Trend Graphs | Most Recent Estimates (2015) | |
|---|---|---|---|
| Percent of adults | 95% Confidence Interval | ||
|
Sun-Sensitive
|
51.7 | 50.6 - 52.8 |
Not Sun-Sensitive
|
17.7 | 16.7 - 18.7 | |
| Sun sensitivity reflects a person's biological response (e.g., a burn, a burn and then tan, etc.) after prolonged sun exposure or after a long period or season of being relatively unexposed. Although race is related to sun sensitivity, race and ethnicity are not adequate proxies for sun sensitivity. | |||
Evidence-based Resources
Resources are available on sun-protective behaviors that are effective at lowering risk of skin cancer. Visit the sun safety on Cancer Control P.L.A.N.E.T. web portal. Multicomponent community-wide interventions are recommended to prevent skin cancer as well as education and policy approaches.
Additional Information on Sunburn
For the public
- Skin Cancer (including Melanoma)—Patient Version. National Cancer Institute.
- Skin Cancer. American Cancer Society.
- Indoor Tanning Restrictions for Minors – A State-by-State Comparison (May 2019). National Conference of State Legislatures.
- National Council on Skin Cancer Prevention.
- FDA Proposes Sunscreen Regulation Changes. U.S. Food and Drug Administration.
- Sunscreen: How to Help Protect Your Skin from the Sun. U.S. Food and Drug Administration.
- Sunburn protection factor (SPF). U.S. Food and Drug Administration.
For health professionals
- Melanoma Treatment (PDQ®)—Health Professional Version. National Cancer Institute.
- Skin Cancer Treatment (PDQ®)—Health Professional Version. National Cancer Institute.
- Vitamin D and Calcium: A Systematic Review of Health Outcomes (Update). AHRQ Publication No. 14-E004-EF September 2014. Evidence Report/Technology Assessment Number 217.
- Counseling on Sun Protection and Indoor Tanning. Balk SJ, Gottschlich EA, Holman DM, Watson M. Pediatrics. 2017;140(6): e20171680.
- Skin cancer: multicomponent community-wide interventions. Community Preventive Services Task Force.
- Indoor Tanning Association settles FTC charge that it deceived customers about skin cancer risks from tanning. Federal Trade Commission.
- Dietary Reference Intakes for Calcium and Vitamin D (2010). Institute of Medicine.
- Stratosphere: UV index. National Weather Service: Climate Prediction Center.
- Sun Safety. U.S. Environmental Protection Agency.
- Sunscreen: How to Help Protect Your Skin From the Sun. U.S. Food and Drug Administration.
- Sunlamp products and ultraviolet lamps intended for use in sunlamp products. U.S. Food and Drug Administration. Title 21. Food and drugs. CFR 1040.20. Fed Regist.April 2019.
- Radiation-Emitting Products: Sunlamps and Sunlamp Products (Tanning Beds/Booths). U.S. Food and Drug Administration.
- General and plastic surgery devices: reclassification of ultraviolet lamps for tanning, henceforth to be known as sunlamp products and ultraviolet lamps intended for use in sunlamp products. U.S. Food and Drug Administration. Rule. Fed Regist. 2014;79:31205-31214.
- Surgeon General Call to Action to Prevent Skin Cancer, 2014. U.S. Department of Health and Human Services.
- Behavioral counseling to prevent skin cancer: U.S. Preventive Services Task Force recommendation statement. U.S. Preventive Services Task Force. JAMA 2018;319(11):1134–1142.
Scientific reports
- Reducing environmental cancer risk: what we can do now. National Cancer Institute. 2008–2009 Annual Report of the President’s Cancer Panel.
- Effect of vitamin D supplementation on non-skeletal disorders: a systematic review of meta-analyses and randomized trials. Autier P, Mullie P, Macacu A et al. Lancet Diabetes Endocrinol. 2017;5(12):986-1004.
- Counseling on Sun Protection and Indoor Tanning. Balk SJ, Gottschlich EA, Holman DM, Watson M. Pediatrics. 2017;140(6): e20171680.
- Buying indoor tanning with university debit cards. Boyers L, Karimkhani C, Crane LA, Asdigian N, Hollonds A, Dellavalle RP. J Am Acad Dermatol. 2014;71(1):199-201.
- VITamin D and OmegA-3 TriaL (VITAL Study). Brigham and Women’s Hospital.
- Prevalence of sunburn, sun protection, and indoor tanning behaviors among Americans: review from national surveys and case studies of 3 states. Buller DB, Cokkinides V, Hall HI, et al. J Am Acad Dermatol. 2011;65(5):S114–S123.
- User-centered development of a smart phone mobile application delivering personalized real-time advice on sun protection. Buller DB, Berwick M, Shane J, Kane I, Lantz K, Buller MK. Transl Behav Med. 2013;3(3):326-334.
- Use of indoor tanning devices by adults – United States, 2010. Centers for Disease Control and Prevention. MMWR 2012;61(18);323–326.
- Interdisciplinary Perspectives on Sun Safety. Geller AC, Jablonski NG, Pagoto SL et al. JAMA Detmatol. 2018:154(1):88-92.
- Reduced melanoma after regular sunscreen use: randomized trial follow-up. Green A, Williams GM, Logan V, and Strutton GM. J Clin Oncol. 2011;29(3):257–263.
- Estimated cost of sunburn-associated visits to US hospital emergency departments. Guy GP, Berkowitz Z, and Watson M. JAMA Dermatol. 2017;153(1):90-92.
- Prevalence of indoor tanning and association with sunburn among youth in the United States. Guy GP, Berkowitz Z, Jones ES et al. JAMA Dermatol 2017;153(5):387-390.
- State indoor tanning laws and adolescent indoor tanning. Guy GP, Berkowitz Z, Jones SE, et al. Am J Public Health. 2014;104(4):e69-e74.
- The association between demographic and behavioral characteristics and sunburn among U.S. Adults – National Health Interview Survey, 2010. Holman DM, Berkowitz Z, Guy GP, Hartman AM, Perna FM. Prev Med. 2014;63:6-12.
- Sunburn prevalence among US adults, National Health Interview Survey 2005, 2010, and 2015. Holman DM, Ding H, Berkowitz Z, Hartman AM, Perna FM. J Am Acad Dermatol. 2019 Mar;80(3):817-820. doi: 10.1016/j.jaad.2018.10.044.
- Correlates of intentional tanning among adolescents in the United States: a systematic review of the literature. Holman DM, Watson M. J Adolesc Health. 2013;52(5 suppl):S52-S59.
- Prevalence of sun protection use and sunburn and association of demographic and behavioral characteristics with sunburn among US adults. Holman DM, Ding H, Guy GP et al. JAMA Dermatol. 2018; 154(5):561-568.
- History and culture of tanning in the United States. Hunt Y, Auguston E, Rutten L, Moser R. In: Heckman CJ, Manne EL, eds. Shedding Light on Indoor Tanning. New York, NY: Springer; 2012:5-30.
- Solar and ultraviolet radiation. International Agency for Research on Cancer. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans 2012;100D:36–102.
- Sun safety practices among schools in the United States. Jones SE, Guy GP. JAMA Dermatol. 2017;153(5):391-397
- Indoor tanning and risk of melanoma: a case-control study in a highly exposed population. Lazovich D, Vogel R, Berwick M, et al. Cancer Epidemiol Biomarkers Prev 2010;19(6):1557–68.
- Adverse effects of ultraviolet radiation from the use of indoor tanning equipment: time to ban the tan. Lim HW, James WD, Rigel DS, et al. J Am Acad Dermatol. 2011;64(4):e51–60.
- Behavioral counseling to prevent skin cancer: a systematic review for the U.S. Preventive Service Task Force. Lin JS, Eder M, Weinmann S. Ann Intern Med. 2011;154:190–201.
- Adolescents’ use of indoor tanning: a large-scale evaluation of psychosocial, environmental, and policy- level correlates. Mayer JA, Woodruff SI, Slymen DJ, et al. Am J Public Health. 2011;101(5):930-938.
- Decision tree model v traditional measures to identify patterns of sun-protective behaviors and sun sensitivity associated with sunburn. Morris KL and Perna FM. JAMA Dermatol. 2018;154(8):897-902.
- Behavioral counseling to prevent skin cancer: U.S. Preventive Services Task Force recommendation statement. U.S. Preventive Services Task Force. JAMA 2018;319(11):1134–1142.
- Subsequent primary malignancies in patients with nonmelanoma skin cancer in England: a national record-linkage study. Ong EL, Goldacre R, Hoang U, Sinclair R, Goldacre M. Cancer Epidemiol Biomarkers Prev. 2014;23(3):490-498.
- Age-Specific Incidence of Melanoma in the United States. Paulson KG, Gupta D, Kim TS, et al. JAMA Dermatol. 2019. doi: 10.1001/jamadermatol.2019.3353. [Epub ahead of print]
- Research on Skin Cancer-Related Behaviors and Outcomes in the NIH Grant Portfolio, 2000-2014: Skin Cancer Intervention Across the Cancer Control Continuum (SCI-3C). Perna FM, Dwyer LA, Tesauro G et al. JAMA Dermatol. 2017;153(5): 398-405
- Community-wide interventions to prevent skin cancer: two community guide systematic reviews. Reed KB, Brewer JD, Lohse CM, et al. Mayo Clin Proc. 2012;87(4):328–334.
- Increasing incidence of melanoma among young adults: an epidemiological study in Olmsted County, Minnesota. Sandhu PK, Elder R, Patel M, et al. Am J Prev Med. 2016;51(4):531-9.
- Implications of lessons learned from tobacco control for tanning bed reform. Sinclair C, Makin JK. Prev Chronic Dis. 2013;10:e28.
- Implementation of the SunSmart program and population sun protection behaviour in Melbourne, Australia: Results from cross-sectional summer surveys from 1987 to 2017. Tabbakh T, Volkov A, Wakefield M, Dobbinson S. PLoS Med. 2019;16(10):e1002932.
- Surgeon General Call to Action to Prevent Skin Cancer, 2014. U.S. Department of Health and Human Services
- Indoor tanning: The risks of ultraviolet rays. U.S. Food and Drug Administration.
- Tanning Salon Compliance Rates in States with Legislation to Protect Youth Access to UV Tanning. Williams MS, Buhalog B, Blumenthal L, Stratman EJ. JAMA Dermatol 2018;154(1):67-72 .
Statistics
- SEER Cancer Statistics Review. National Cancer Institute.
- Cancer Statistics Center, 2019 Estimates. American Cancer Society.
- National Health Interview Survey. Centers for Disease Control and Prevention, National Center for Health Statistics.
Year Range
2000-2015
Recent Summary Trend Year Range
2010-2015
Summary Tables
Sun Protection
Recent Summary Trend
Falling
Desired Direction
Falling