You, Lupus and the Sun

When you have lupus, protecting yourself from sun exposure is an essential part of managing your condition. Photosensitivity or abnormal light sensitivity is very complex and is a major symptom of lupus. The American College of Rheumatology (ACR) loosely defines photosensitivity as “a skin rash as a result of unusual reaction to sunlight.” Beyond skin rashes that can develop, 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 people with lupus have increased sensitivity to ultraviolet rays, either from sunlight or from artificial inside light, such as fluorescent light — or both.

The risks of UV radiation

Ultraviolet (UV) light is a type of invisible radiation that’s present in sunlight. There are three types: UVA, UVB, and UVC. According to research published in Autoimmunity Reviews, UVB rays seem to cause the most problems in people with lupus. UVA radiation can also contribute to symptoms.

When you have lupus, exposure to sunlight may trigger symptoms such as:

lupus rash or lesions
fatigue or weakness
joint pain
internal organ swelling

Wear protective clothing

To protect yourself from UV radiation, wear sun protective clothing that reflects or absorbs sunlight before it reaches your skin.

Your eyes are just as important. Wear sunglasses that provide UVA and UVB protection as close to 100% as you can get.

UV rays can pass through thin, light-colored, and loosely woven fabrics. For optimum 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 absorbs UV rays, while polyester and silk with a high sheen reflect UV radiation. You can also find high-tech “sun protective clothing” designed to block UV rays at many sporting goods stores.

Choose 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

Test the sunscreen on a patch of your skin to check for signs of sensitivity or allergic reactions. Store it in a cool place and throw it away after a year. Sunscreen can become less effective over time and when it’s exposed to heat.

Avoid common sunscreen mistakes

Apply sunscreen about 30 minutes before you head outside. Make sure to cover easy-to-miss areas, such as:

the middle of your back
the sides of your neck
your temples
your ears

If you apply it too thinly, your sunscreen won’t provide the protection indicated by its SPF rating. According to the Skin Cancer Foundation, you should use about an ounce of sunscreen — or a shot glass full — to cover your body.

Don’t be fooled by fog or clouds: UV rays can still be strong in cool and cloudy weather.

Stay in the shade

To protect yourself from UV radiation, avoid sunlight when it’s strongest. For example, stay indoors between 10 a.m. and 4 p.m. If you have to go outside, stay in shade provided by trees, an umbrella, or an awning. Installing sun shields on your house and car windows can also provide the UV protection you need.

Ask your doctor about drugs

Phototoxicity is a dangerous reaction that can happen when light and certain chemicals combine. For example, phototoxic reactions can occur when your skin is exposed to sunlight after you take certain medications. These medications include certain:

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

Talk to your doctor to learn if any medications you’re taking might cause problems.

Don’t forget about artificial light

It’s not just sunlight you need to guard yourself against. For people 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 your condition.

Be Sun Smart With Lupus

If you are photosensitive, the best rule is to avoid midday and tropical sun entirely. Unfortunately, that’s not always the most practical advice, especially if your job or family situation requires that you spend time outside or near UV rays.

People with lupus should not stay in the sun for extended periods and should make every effort to avoid UV rays outside, which are at their peak between 10 a.m. and 4 p.m. Don’t be fooled by an overcast day, because clouds don’t filter out all of the sun’s UV rays. Keep track of the time you spend in the sun. It can take anywhere from hours to days before skin abnormalities occur from sun exposure.

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