What criteria should I use to determine if a patient with sunburn requires referral to a specialist?

Criteria for referral of a patient with sunburn to a specialist are not explicitly detailed in the provided UK guidelines. However, referral to dermatology or specialist care should be considered if the sunburn is severe, complicated by infection, or if there are atypical skin lesions or concerns about skin cancer development.

Specifically, urgent or specialist referral is recommended for suspicious skin lesions that may indicate melanoma or squamous cell carcinoma, such as pigmented lesions with a weighted 7-point checklist score of 3 or more, nodular melanoma, or lesions raising suspicion of squamous cell carcinoma ¹.

Severe skin conditions or complications (e.g., severe eczema, infections) warrant specialist advice, but these are not directly linked to uncomplicated sunburn ²,³.

Therefore, in the context of sunburn, referral should be considered if there are:

• Signs of severe skin damage or blistering with infection
• Persistent or unusual skin lesions suspicious for malignancy
• Complications such as secondary bacterial infection or systemic symptoms

Otherwise, mild to moderate sunburn is managed in primary care without routine specialist referral.