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BEYOND SUNBURN Photosensitivity
WHO HAS IT? You, and you might not even know it! Every year thousands
of people eagerly seek outdoor sports, the beach and the summer sun. As we
approach summer and enjoy the outdoors we all must be aware of the negative affects
the sun can have on us-such as photosensitivity.
Photosensitivity is the condition in which the sun reacts abnormally
to light, especially sunlight or ultraviolet rays due to the presence of a second
agent.
Sensitivity to the sun may be genetic and related to skin color
and type, or may be related to a skin or internal disease (e.g. metabolic disease).
People with very fair skin (Class 1) are naturally more apt to burn (while never
tanning) whereas, people with very dark skin (class VI) almost never burn.
Normal responses like suntan may occur, or one can display an
adverse Photosensitive reaction with the unwanted effects of sunburn, skin cancer,
sun induced aging, effects on immunity, etc. Photosensitization can also occur
while using oral and topical medications. Even certain plants or types of
food ingested, combined with sunlight can trigger a phototoxic reaction.
Many types of skin reactions can occur due to the sun.
Eruptions in the form of a dermatitis (rash with inflammation of the skin), eczema
(including redness, crusting and scaling, bullae (blisters), and pustules (pus pimples)
can develop on the skin. Some foods, medicines, plants, perfumes and some
sunscreens contain compounds that are phototoxic and photoallergic to certain people. We recommend that the following precautions be taken:
►Avoid certain food types while being exposed
to the sun: Lemon, lime, orange, celery, mustard, dill, fennel, parsnip
and carrots must not be allowed to contact the skin if sun exposure is expected.
Several of these plant families contain photoreactive chemicals capable of causing
a photodermatitis. This can take the form of a red, smart prickling rash on
the skin or what appears to be an exaggerated sunburn sometimes with blistering.
For example, people who accidentally spill lemonade on their skin or use lemon juice
to lighten the color of their hair can windup with a painful rash. Ingesting
these foods prior to sun exposure can also sometimes cause a toxic reaction.
► Avoid certain topical and oral medicines,
plants, and dyes, which can cause either a direct sun reaction (phototoxic
response) or an indirect response via an immune mechanism (photoallergic).
The 48 to 72 hours delay of reaction after the sun light exposure with some plants
makes it quite difficult to recall what caused the rash.
► Avoid increased exposure to sunlight while
taking the following oral or topical medications: Antifungal agents
(ie: MicroGuard Cream), Tranquilizers (ie.: Lorazine, Largectil).
Oral Hypoglycemic agents (ie: Orinase, Diabinese), Antibiotics (ie:
Tetracycline), Ciuretics (ie." Diuril, Lasix,
Hydrodiuril). Reminder: Topical RetinA ® used for acne and wrinkles-increases
the likelihood of a sunburn. Adverse effects can include burning, erythema,
exaggerated sunburn, papular eruption or wheal formation. Continued increased
exposure can lead to chronic photosensitivity. Never stop taking prescription
medications without first consulting your medical doctor.
► Avoid increased exposure to sunlight while
using perfumes and even some sunscreens.
Some sunscreens contain PABA, which can create a photoallergic reaction. Perfumes
can negatively react to sun exposure as well,
so its use should also be avoided
in summer.
IS EVERYONE PHOTOSENSITIVE?
Yes, to a certain extent. If you go outdoors in the sun, the odds are that
you are photosensitive to some degree.
Since it is almost impossible to completely
avoid the sun we should learn about the many effects of sunlight-then we must learn
ways to prevent ourselves and our loved ones from its many damaging effects.
Once a photosensitive reaction happens, take a quick checklist of the above listed
items. You may find the underlying factor hiding there.
Courtesy of Joshua L.
Fox, M.D., F.A.A.D., Director,
and Jody Pagel, CMA, Practice Administrator, Advanced Dermatology 58-47 188th Street,
Fresh Meadows, NY 11365. 1 718 357-8200.
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