Abnormal sensitivity to sunlight, known as photosensitivity, affects over one half of people with lupus. Exposure to sunlight can cause a skin rash or trigger a flare-up of internal lupus resulting in joint pain and fatigue. Because sunlight cannot be avoided altogether, it is very important for individuals with lupus to take precautions to minimize the symptoms of photosensitivity.
Effects of Exposure
Sunlight exposure can cause different types of rash, including the common butterfly rash on the cheeks and nose, a rash with disc-shaped lesions, and a rash with circular red shapes on the chest, back, and arms. The rashes may take weeks or months to heal and may cause scarring. Sunlight can also trigger non-skin symptoms of lupus, such as joint inflammation and fatigue. Moreover, some medications, such as tetracycline antibiotics, amplify the photosensitivity so that the person with lupus is even more susceptible to sunburn.
Causes of Photosensitivity
After studying the relationship between lupus and sunlight for many years, scientists believe that the sun(s ultraviolet rays play a major role. Not only the burning ultraviolet B rays but also the ultraviolet A rays are responsible for the skin problems. The sunlight causes certain genes to accelerate the normal process of skin cells dying. As the skin cells die, certain proteins come to the skin’s surface and cause an immune reaction. The body’s immune system then reacts to the proteins in a way that causes further inflammation. Further research into the gene that begins the process may lead to a treatment for skin conditions caused by lupus.
Some practical steps that may reduce the effects of sunlight exposure are:
- Avoid tropical or mid-day sun.
- When exposed to sunlight, wear protective clothing such as hats, long- sleeved shirts, and long pants.
- Avoid sunlight exposure from highly reflective surfaces, like sand, water, and snow.
- Use sunscreens liberally. Reapply frequently, especially when coming out of the water.
- Tint your car windows with film that blocks both UVB and UVA rays.
- Avoid exposure to unshielded fluorescent lights. Florescent lights covered with acrylic diffusers are not harmful.
- Do not use a copy machine with the top cover up.
- Consider purchasing sun-protective clothing that actually blocks the ultraviolet rays.
- Use an umbrella as a shield from the sunlight.
Lupus sufferers are accustomed to making lifestyle changes or adjustments to curtail the debilitating effects of the disease. In the case of photosensitivity, you may choose to live and vacation in non-tropical areas, to go to the beach or pool either early in the morning or late in the afternoon, or to wear protective clothing rather than tank tops or shorts when participating in outdoor activities. While these measures may be somewhat limiting, you may find that taking the recommended precautions is preferable to experiencing the rashes or internal flare-ups that sunlight exposure can cause. You can also enjoy the additional benefits of avoiding skin cancer and wrinkles.
Researchers are making progress in identifying the processes that cause people with lupus to be photosensitive. Until there is a way to prevent photosensitivity, it is essential that lupus sufferers take protective action to minimize the effects of sunlight exposure.
Photosensitivity and Lupus, Lupus Foundation of America
Photosensitivity and Lupus, from The Skin in Lupus, Lupus Foundation of Minnesota