Here's How You Can Manage Your Sun Sensitivity This Summer

Before Arushi Tandon, a writer in her twenties based in Delhi-NCR, India, was diagnosed with systemic lupus erythematosus, she noticed that she would get rashes when she was out in the sun. This sun sensitivity started around the same time as Tandon's other lupus symptoms.

"I used to get a rash and headache post-sun exposure and it wasn't until my diagnosis that my doctor informed me this was a consequence of lupus," Tandon tells Verywell. Tandon also says that "too much ultraviolet (UV) light exposure makes me itchy and triggers headaches too."

Now, before Tandon heads outside, she prepares for her day with her sun sensitivity in mind.

"I use an SPF 50 sunscreen prescribed by my doctor specifically," she says. "I have also been told to avoid direct sun exposure as much as I can. So activities like sunbathing are a complete no." Tandon also carries a dark umbrella with her so that she's "able to go to the beach and for picnics as well with my family and friends without exposing [herself] to the sun directly."

For people with certain rheumatic conditions, dealing with photosensitivity can be all too common. And the blazing summer sun can make it tricky to navigate.

Photosensitivity in People With Rheumatoid Conditions

Anca Askanase, MD, a rheumatologist at Columbia University Irving Medical Center and the founder and clinical director of Columbia's new Lupus Center and the Director of Rheumatology Clinical Trials, tells Verywell that people who live with the autoimmune diseases lupus, scleroderma, and Sjogren syndrome may be particularly susceptible to sun sensitivity.

Dysfunction within the immune cells called Langerhans could be causing photosensitivity for people with autoimmune and dermatologic conditions.

Around 40-70% of people who live with lupus find that their symptoms become worse when exposed to UV rays, either from sunlight or artificial light. This photosensitivity can seriously interfere with daily routine.

"Getting a rash in the middle of the day when you're about to go to work, to school or an event is disruptive," Askanase says.  "If that sun exposure triggers a big systemic flare that's even more disruptive, because now instead of going on with your life, you need to you know get to the doctor get treated for the immune system attack."

And for some people, sun sensitivity isn't just a problem dealt in the midst of a hot summer. Some may need to be vigilant all year round, including in the middle of the winter.

"You're not going to be outdoors so much so, the exposure is going to be less, but if you're going outdoors you still need to apply sunscreen," Askanase says.

Why a Person's Photosensitivity Can Change

If someone with an autoimmune disease like lupus notices that they're breaking out in hives more easily when out in the sun, their medication could be playing a role.

"Some of the big things that we need to use to treat autoimmune conditions like hydroxychloroquine are photosensitizing," Askanase explains. "It's the main drug that we use to treat lupus and Sjogren's. Sometimes we're caught between a rock and a hard place in terms of sensitivity." However, some patients may find that hydroxychloroquine protects them from sun sensitivity.

The Lupus Foundation of America also shared that these other medications that can increase photosensitivity:

• Antibiotics, such as doxycycline and tetracycline
• Anti-inflammatory drugs, such as ibuprofen 
• Blood pressure medications, such as hydrochlorothiazide and lisinopril
• Methetrextae

What Is Polymorphous Light Eruption?

People who do not have autoimmune diseases can still experience sun sensitivity. In fact, those who were inside more than usual last year may have a higher risk of experiencing polymorphous light eruption.

"If you've been spending a lot of time inside, this could increase your risk of experiencing polymorphous light eruption, or PMLE, a reaction to sun exposure," Hadley King, MD, a New York City-based dermatologist and clinical instructor of dermatology at the Weill Medical College of Cornell University, tells Verywell. "This is usually seen in the spring and early summer when the skin has not recently been exposed to sun and dissipates later in the season."

King says that this condition affects around 10 to 15% of Americans.

Heidi B. Prather, MD, an Austin-based dermatologist at Westlake Dermatology says that she is seeing her patients experience more flares. "I am seeing a lot of flares of pigment from the sun," Prather says. "We're kind of getting into that season in summer, where we're seeing more of this, because of new exposures, people are traveling again, and the sun is finally back out."

PMLE, according to the American Osteopathic College of Dermatology, "is the most common light-induced skin disease." People with this condition often have a reaction in limited areas during their first summer but have a more increased reaction in following summers. Topical steroids can be used in intermittent 3 to 14 day periods to help people manage PMLE.

People with PMLE can also go into remission for a number of years.

This is something that Meenakshi J, an independent freelance writer and content specialist based in India, knows well. "My condition isn't chronic...it happens on and off," she tells Verywell. "I often have to wear high-necked clothes to cover my nape or a small [reaction] develops quickly that leads to itching and then spreads around the neck in a few weeks."

How to Protect Yourself From the Sun

If you have sun sensitivity, there are steps you can take to better manage your symptoms and protect your skin. But most people, even those without sun sensitivity, can benefit from similar measures.

"We need to sort of start with the fact that sun protection is something that the whole world should be thinking about," Askanase says.

Sunscreen

Wearing sunscreen can lower your risk of developing cancer and slow premature aging in the skin.

"We all should be compelled to wear sunscreen regardless, and then for people that are more sensitive, that level of paying attention to avoiding sun exposure and getting protective should be more to the forefront," Askanase says.

You should apply sunscreen "before you go on the sun, as opposed to wait until you're outside and apply sunscreen," Askanase adds. It is also important for people to reapply sunscreen throughout the day.

It's important to get a sunscreen that offers protection from both UVA and UVB rays. Both types of rays can trigger reactions in people who live with lupus.

Supplements

In addition to sunscreen, Prather says you can try sun supplements. She specifically recommends Helioplex's sun supplements.

"Sun supplements are a combination of antioxidants that have been shown to provide some level of systemic SPF protection and decreases the inflammatory response caused by this setting by giving you this element of photoprotection," Prather explains.

The U.S. Food and Drug Administration advises against solely relying on sun supplements, though. So it may be best to combine this tactic with other measures like sunscreen.

A May 2018 statement from then-commissioner of food and drugs Scott Gottlieb, MD, says that some companies give "consumers a false sense of security that a dietary supplement could prevent sunburn, reduce early skin aging caused by the sun, or protect from the risks of skin cancer."

Be Cautious When You Go Outside

If you have moderate to severe photosensitivity you may want to avoid going outside between 10 a.m. and 2 p.m., which is when UVB light is especially strong.

Isabela Wieczorek, MD, and Horatio F. Wildman, MD, wrote in an article for the Hospital for Special Surgery that people should still be cautious on cloudy days. "Remember that, even on cloudy days, we still are exposed to about 80% of the ultraviolet light present on a sunny day," they wrote. "Recreational activities near water require additional caution as water reflects up to 80% of the sun’s rays."

Invest In UV-Protected Clothing

The experts who spoke to Verywell all agree that it may be a good idea to invest in UV-protected clothing. The Lupus Foundation of America recommends that you buy clothing from sporting goods stores and from sun protective clothing companies online. 

Clothes and hats which offer sun protection should be labeled with an ultraviolet protection factor (UPF) number. However, no federal agencies regulate the effectiveness of UPF products. Sunglasses labeled with a label of "UVA/UVB rating of 100%" can also help protect your eyes.

Check Out Your Windows

If you realize that you experience sun sensitivity while working inside too, check out whether your windows are UV-protected. Window glass blocks UVB rays, but UVA rays can still penetrate. 

"Some people, they're very photosensitive, even being by a window that is not to be protected can be a problem," Askanase says. Buying and setting up protective window films applied to windowpanes can offer additional protection.