Lupus and Photosensitivity

Continuing the lupus blog series, this article explores photosensitivity as a symptom of lupus. To maintain healthy skin, we suggest five ways to protect yourself from the sun and other light.

Photosensitivity, or abnormal light sensitivity, is very complex and a major symptom of lupus. The American College of Rheumatology defines photosensitivity as “a skin rash as a result of unusual reaction to sunlight.” Beyond skin rashes, exposure to the sun can cause those living with lupus to experience increased disease activity with symptoms such as joint pains, weakness, fatigue, and fever. Two-thirds of patients with lupus have increased sensitivity to ultraviolet rays, either from sunlight, artificial light such as fluorescent light, or both.

Normally, skin and other cells that are seriously damaged die through a pre-determined process within the body. However, in patients with lupus, this process occurs more often than it should, which leads to more inflammation and other complications. In addition to worsening of skin lupus lesions, many patients also undergo more systemic reactions to light that are not typical of their skin lupus.

Each person with lupus may have a different level of photosensitivity just like in the general population. If photosensitivity is an issue, here are some ways to protect oneself from the sun:

Wear protective clothing

To protect oneself from UV radiation, it is essential to wear sun protective clothing that reflects or absorbs sunlight before it reaches the skin. UV rays can pass through thin, light-colored, and loosely woven fabrics. For best protection, wear tightly woven, dark-colored, long-sleeved shirts and pants as well as wide-brimmed hats. Certain types of fibers also provide more protection than others. Unbleached cotton absorb UV rays, while polyester and silk reflect UV radiation.

Select the right sunscreen

In addition to wearing protective clothing, cover exposed skin with sunscreen. Look for sunscreen that: 

• has a sun protection factor (SPF) of 30 or more
• provides broad spectrum protection, blocking UVB and UVA rays
• contains physical blockers, such as zinc oxide and titanium dioxide
• is hypoallergenic

First, test the sunscreen on a patch of skin to check for signs of sensitivity or allergic reactions. Sunscreen can become less effective over time and when it’s exposed to heat. It is recommended to apply sunscreen about 30 minutes before going outside. Make sure to cover easy-to-miss areas, such as the middle of the back, the sides of the neck, temples and ears. If applied too thinly, the sunscreen won’t provide the protection indicated by its SPF rating. According to the Skin Cancer Foundation, one should use about an ounce of sunscreen to cover the entire body.

Stay in the shade

To get protection from UV radiation, avoid sunlight when it is most potent. Specifically, stay indoors between 10 a.m. and 4 p.m. If a person has to go outside, stay in shade provided by trees or an umbrella. Installing sun shields in the house and car windows can also provide the UV protection needed.

Ask about photosensitivity-inducing drugs

Phototoxicity is a dangerous reaction that may also occur when light and certain chemicals combine. For example, phototoxic reactions can occur when skin is exposed to sunlight after taking certain medications, including: 

• antibiotics, such as azithromycin
• nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
• diuretics
• oral diabetes drugs
• cardiac medications

Talk to a doctor to learn if any medications being taken might cause problems.

Beware of artificial light

It is not just sunlight to protect oneself against. For patients with lupus, artificial light with UV rays can also cause problems. Sources of this light include:

• fluorescent lighting
• photocopiers
• tanning beds

Limit or avoid exposure to these artificial light sources. Avoid tanning beds altogether, since they could worsen the condition.