More than 160 Kiwis and Aussies have been so badly sunburnt they were admitted to burns units and almost one in five of those people needed surgery.
Australian researchers scoured the Burns Registry of Australia and New Zealand to determine how many patients had been admitted for sunburn in the 10 years between 2010 and 2019.
Their findings were today published in the Journal of the American Medical Association.
One of the authors, Dr Lincoln Tracy, research fellow with Monash University, told the Herald that, while it was a small percentage of the total burns cases treated, the figure was alarming given Australia and New Zealand have the highest incidence of melanoma worldwide at about 50 cases per 100,000 person-years.
Most sunburn was able to be treated at home while some was bad enough to seek specialist treatment as an out-patient.
But the research found 167 people had been out in the sun so long their burns required they be admitted for in-patient treatment by specialist burns services.
Of those, 59 per cent were superficial burns and 25 per cent were middermal but 17 people had deep dermal burns and six people had full-thickness burns.
The data showed 32 people needed a surgical procedure, which could have been anything from a dressing change under sedation to a skin graft, and six were so unwell they were admitted to the intensive care unit.
"Despite widespread campaigns about sun protection and the availability of sun protection products, the number of patients with sunburns severe enough to warrant admission to a specialist burn service for management for this entirely preventable injury is concerning," the authors wrote.
"These preventable burns unnecessarily divert valuable resources from being used elsewhere."
The study found the median age of patients was 18 but showed 22 patients were aged 12 months or younger and 18 were under five years old. The largest group were five to 14 year olds whose 36 patients made up 22 per cent of cases.
Males were the worst offenders, making up 63 per cent of patients.
The registry showed the vast majority of the sunburn took place while people were participating in leisure or sporting activities (64 per cent) while another 12 per cent were sleeping or resting.
Slightly over half the patients had burns to less than 5 per cent of their body's surface area and the median stay in hospital was 3.2 days.
Tracy said most concerning to him was the number of five to 14 year olds.
"That's a lot of people in the primary and early secondary school age where there's been a lot of work done in the 'no hat, no play' area."
As for children under one, they should not be in the system at all, he said.
"For the very young it will take far less exposure - there's a difference between the strength and durability of the skin."
But the damage did not always end when released from hospital.
Excess exposure to UV that ended in sunburn drove up the incidence of melanoma, Tracy said.
"That's the main point we were trying to raise - that despite all the great work being done the messaging still isn't getting through to everyone and people are ending up in specialist burns care."
The Cancer Society said more than 90 per cent of skin cancer was caused by too much exposure to ultraviolet radiation from the sun.
They reminded people to wear sun protective clothing and stay in the shade where possible; slop on sunscreen regularly; slap on a hat; and wrap on some sunglasses when outdoors to keep from burning.
Michele Henry of the Burns Support Group Charitable Trust said she had heard of the odd case, mainly involving children, but it was rare.