Does sunburn increase ESR (erythrocyte sedimentation rate) levels?

There is no direct evidence that sunburn increases ESR (erythrocyte sedimentation rate) levels, but sunburn does trigger acute inflammation, which can elevate ESR in general.

 

Sunburn and Inflammation

Sunburn is a classic example of acute skin inflammation caused by excessive ultraviolet (UV) exposure. It leads to redness, swelling, and increased expression of proinflammatory mediators in the skin, such as tumor necrosis factor-alpha (TNF-α) and inducible nitric oxide synthase (iNOS) (Scott et al., 2017; Hartono et al., 2021). These inflammatory responses are well-documented and can be modulated by interventions like high-dose vitamin D (Scott et al., 2017).

ESR as a Marker of Inflammation

The erythrocyte sedimentation rate (ESR) is a nonspecific blood test used to detect inflammation in the body. ESR increases in response to acute and chronic inflammatory processes, as it reflects changes in plasma proteins (like fibrinogen) that occur during inflammation (Lapić et al., 2019; Dasanna et al., 2021). While ESR is commonly used to monitor systemic inflammation, it is not specific to the cause—any significant inflammatory event, including infections, autoimmune diseases, or tissue injury, can elevate ESR (Lapić et al., 2019; Dasanna et al., 2021).

Evidence Linking Sunburn and ESR

No studies directly measure ESR levels after sunburn in humans. However, since sunburn is an acute inflammatory event, it is biologically plausible that severe sunburn could cause a temporary rise in ESR, similar to other acute inflammatory conditions (Scott et al., 2017; Lapić et al., 2019; Dasanna et al., 2021). The magnitude and clinical significance of this potential increase remain unstudied.

Key Claims & Evidence

Claim	Evidence Strength	Reasoning	Papers
Sunburn causes acute inflammation	Evidence strength: Strong (9/10)	Multiple studies confirm sunburn triggers strong inflammatory responses	(Scott et al., 2017; Hartono et al., 2021)
Acute inflammation can increase ESR	Evidence strength: Strong (8/10)	ESR is a validated marker for inflammation, but not specific to sunburn	(Lapić et al., 2019; Dasanna et al., 2021)
Sunburn specifically increases ESR in humans	Evidence strength: Weak (2/10)	No direct studies; only indirect biological plausibility

Figure 2: Evidence table for sunburn, inflammation, and ESR

Conclusion

While sunburn clearly causes acute inflammation, and inflammation can increase ESR, there is no direct research showing that sunburn alone raises ESR levels in humans. Any increase in ESR from sunburn would likely be mild and transient, reflecting the general inflammatory response.

References

Scott, J., Das, L., Ahsanuddin, S., Qiu, Y., Binko, A., Traylor, Z., Debanne, S., Cooper, K., Boxer, R., & Lu, K. (2017). Oral Vitamin D Rapidly Attenuates Inflammation from Sunburn: An Interventional Study.. The Journal of investigative dermatology, 137 10, 2078-2086. https://doi.org/10.1016/j.jid.2017.04.040

Lapić, I., Padoan, A., Bozzato, D., & Plebani, M. (2019). Erythrocyte Sedimentation Rate and C-Reactive Protein in Acute Inflammation.. American journal of clinical pathology. https://doi.org/10.1093/ajcp/aqz142

Hartono, S., Bedell, V., Alam, S., O’Gorman, M., Serres, M., Hall, S., Pal, K., Kudgus, R., Mukherjee, P., Seelig, D., Meves, A., Mukhopadhyay, D., Ekker, S., & Hoeppner, L. (2021). Vascular Endothelial Growth Factor as an Immediate-Early Activator of Ultraviolet-Induced Skin Injury.. Mayo Clinic proceedings. https://doi.org/10.1016/j.mayocp.2021.08.018

Dasanna, A., Darras, A., John, T., Gompper, G., Kaestner, L., Wagner, C., & Fedosov, D. (2021). Erythrocyte sedimentation: Effect of aggregation energy on gel structure during collapse.. Physical review. E, 105 2-1, 024610. https://doi.org/10.1103/PhysRevE.105.024610