If you have arthritis of any kind, the sun may not be your friend. A few forms of arthritis - and a fistful of arthritis medications - can make skin extremely sensitive to sunlight. Most people with lupus and dermatomyositis know that sun exposure can not only damage their skin but also dramatically worsen their disease.
But most people with arthritis don't know that drugs for other types of arthritis - even some common over-the-counter medications - can make you sun sensitive. When you're sensitized to the sun, even minor exposure can cause rashes, red bumps, severe burns, blistering, bizarre crusting reactions, and pigment changes.
Photosensitizing medications include (generic names first, brand names in parentheses):
- cyclosporine (Sandimmune, Neoral),
- diclofenac (Voltaren),
- diflunisal (Dolobid),
- gold preparations (Ridaura),
- ketoprofen (Orudis, Oruvail),
- methotrexate (Rheumatrex, Trexall),
- naproxen (Aleve Naprosyn),
- piroxicam (Feldene).
How should you use sunscreens?
Year-round, even when it's cloudy. The worst sun-sensitive reactions occur in the late spring and summer or in winter when you are in the sun-reflecting snow or at high altitudes.
Choose a sunscreen with a high SPF - such as SPF 30 - and that's protective for both UVA and UVB light. Help your skin by matching the formula to your skin type - creams for dry skin, lotions for normal, alcohol-based and gels for oily.
Apply sunscreens 30 to 60 minutes before going outdoors to give the chemicals tht absorb the rays time to be absorbed into your skin. The exception: sunscreens based on titanium dioxide or zinc oxide, which go to work immediately by acting as physical barriers.
Use plenty. It takes at least an ounce (a shot-glassful) to cover a swimsuit-clad body. Most commonly missed spots are: around the hairline, eyes, nose, and mouth.
Reapply your sunscreen every two hours or as directed on the package. Remember that "water resistant" means a sunscreen will remain moderately active after two 20-minute dips; "waterproof," after four.
What else should you do if you're sun sensitive?
Try to stay indoors as much as possible between 11 am and 4 pm, especially in the late spring and summer - although sun sensitivity can be triggered year-round and even when it's cloudy.
Know that light summer clothing is a poor substitute for sunscreen. A white T-shirt only has an SPF of 7. Explore lightweight but densely woven garments with an SPF 30. Search under "sun protective clothing" on the web.
Cars aren't much better than T-shirts because UVA light penetrates windshields and windows. Find out about UV-blocking tinted film that you can apply.
Avoid sun-sensitizing foods, such as lemons, limes, celery, parsley, parsnips and figs. All contain chemicals called psoralens that can enhance the sun's effect in anyone.
Before starting any medication, ask your doctor whether if it's a photosensitizer.
Finally, don't go anywhere near a tanning salon. The light there is no safer than unadulterated sunshine.
