Sun Sensitivity During Chemotherapy

Tips for Avoiding Sunburn During Chemotherapy and Radiation

Soaking up some sunshine may feel like a relaxing way to help you cope with the rigors of cancer treatment. In fact, the vitamin D produced by moderate (and safe) sun exposure has been linked not only with a reduced risk of developing cancer, but improved survival from some cancers. The first step is to know if your chemotherapy medications may increase the likelihood of a sunburn: something you definitely don’t need at this point in your life. It's also important to recognize that wearing sunscreen may not be enough.

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What is Photosensitivity?

Sun sensitivity, known as photosensitivity or phototoxicity, is the tendency to sunburn more easily than usual. Most photosensitivity reactions associated with chemotherapy drugs are phototoxic. In a phototoxic reaction, medications such as chemotherapy drugs absorb ultraviolet radiation. This absorption of UV light causes a change in the chemical composition of the drug, which emits skin-damaging energy.

Which Drugs Cause Photosensitivity?

Nearly any chemotherapy agent (or non-cancer-related medications as well) may cause you to be more sensitive to the sun. It’s important to talk with your oncologist about your particular medications. In addition, the combination of different drugs may raise your risk further than a single drug would alone. Some of the commonly used chemotherapy drugs known to cause photosensitivity include:

  • 5-FU (fluorouracil)
  • Methotrexate
  • DTIC (dacarbazine)
  • Oncovir (vinblastine)
  • Taxotere (docetaxel)
  • Adriamycin (doxorubicin)
  • VePesid (etoposide)
  • Gemzar (gemcitabine)

Thankfully, this increased sensitivity to the sun goes away soon after completing chemotherapy.

Some nonchemotherapy medications that could have an additive effect with chemotherapy in causing sun sensitivity include:

  • Antibiotics, such as Cipro (ciprofloxacin), Levaquin (levofloxacin), tetracycline, doxycycline, and Septra or Bactrim (sulfamethoxazole-trimethoprim)
  • Diuretics, such as Lasix (furosemide) and Hydrodiuril (hydrochlorothiazide)
  • Benadryl (diphenhydramine)
  • Cardiac medications, such as diltiazem, quinidine, amiodarone and Procardia (nifedipine)
  • Antidepressants, such as Tofranil (imipramine) and Norpramin (desipramine)
  • Diabetic medicines, such as Micronase (glyburide)
  • Non-steroidal anti-inflammatory drugs, such as Aleve (naproxen) and Feldene (piroxicam)

Talk to your pharmacist or healthcare provider if you aren't certain if your chemotherapy or other medications will increase your risk of a sunburn.

Sun Sensitivity and Radiation Therapy

It's important to keep in mind that chemotherapy isn't the only treatment that can raise your risk of a sunburn. With radiation therapy, a propensity to burn occurs primarily in the regions of your body that are treated with radiation, but unlike that with chemotherapy, a predisposition to burning may last for years after your last treatment is finished. If you've had radiation therapy, you may wish to consider sun protection a long term goal. Not only could a predisposition to burning last far beyond your last treatment, but the combination of radiation damage to your skin and sun damage could increase your risk of developing skin cancer.

When Do the Symptoms Start?

Photosensitivity reactions can occur immediately after you are exposed to the sun, or may not be evident for several hours after returning indoors. If you notice any redness when you are in the sun, apply sunblock, sunscreen, or get out of the sun. It usually takes several hours before the full extent of a sunburn can be realized.

Sun Safety Tips During Chemo

Knowing that your skin may be more sensitive during chemotherapy, what can you do to protect yourself? A combination of things is usually best, including:

  • Avoid mid-day sun exposure. Limit your time outdoors between the hours of 10 a.m. and 3 p.m. when the sun's rays are most intense.
  • Ask your oncologist which sunscreen she would recommend. Some sunscreens work better than others, and the chemicals in some sunscreens may be irritating to your already sensitive skin. Make sure to select a "broad-spectrum" sunscreen that protects against UVA as well as UVB rays. The sunscreens on the market vary considerably as to whether they provide adequate protection, even for those who aren't at an increased risk from chemotherapy. Current packaging can make it challenging to know what products provide adequate coverage, so check the label to make sure the product contains ingredients that block UVA rays. Make sure you have a fresh bottle of sunscreen as well. Last year’s bottle may no longer be effective.
  • If your skin is very sensitive, you may need to use a sunblock. Instead of or in addition to sunscreen you may wish to use sunblock. Sunblocks that are effective include zinc oxide and titanium dioxide. Sunblocks are opaque (think: a white nose) and some people hesitate to use these products, but a white nose or face may well be worth avoiding a painful burn.
  • Cover up. Don’t rely on sunscreen alone. Wear wide-brimmed hats and long-sleeved, loose-fitting clothing to cover sensitive areas of your body. Tightly woven fabrics provide the best protection.
  • Make use of shade. Find a place in the shade under a tree or sit under an umbrella. Walk along paths sheltered by trees.
  • Don’t forget your lips. Sunscreens designed especially for the lips are generally safe if you should swallow some following application.
  • Don’t forget your eyes. Wear sunglasses with UV protection. 
  • Don't forget your head. We've talked with many cancer survivors who learned about protecting their newly bald and vulnerable scalps the hard way. Wigs can be hot in the sun, but a cotton scarf can be comfortable while providing protection.
  • Avoid tanning beds. Not only can tanning beds leave you with a burn, but can increase your risk of developing skin cancer.
  • Keep in mind that you may react differently to the sun while going through chemotherapy than you did in the past. If you were once someone who tanned easily, you may now sunburn.

Benefits of Sun Exposure

Intuitively it seems that some sun exposure would be beneficial during cancer treatment. Getting outside, breathing fresh air, and talking a walk can all help you feel better emotionally. Medical research seems to back that intuition. Other studies have looked at vitamin D and survival for many other cancers, and while there have been mixed results, having an adequate vitamin D level goes far beyond improving survival. Many people simply feel better if their level is optimal.

Thankfully, checking your vitamin D level may be done through a simple blood test. As your oncologist to check this if you have not had it tested, and discuss ways to increase your level if it is low. Make sure to talk to your healthcare provider, however, before using any supplements. Some vitamin and mineral supplements may interfere with some chemotherapy drugs. Vitamin D supplements (if recommended by your oncologist) are usually safe, as long as you don't "megadose." Taking very large doses of vitamin D can lead to painful kidney stones.

What If I Get a Sunburn?

If you develop a sunburn while on chemotherapy, try to stay out of the sun to avoid further injury to your skin. Use cool, wet compresses to ease discomfort. Call your healthcare provider if you have severe redness if the sunburned area involves a significant percentage of your body, if you develop a fever or chills, or if you have any other concerns. Check out these additional tips on how to treat a sunburn.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. UpToDate. Cutaneous Side Effects of Conventional Chemotherapy Agents.

  2. National Cancer Institute. Skin and Nail Changes During Cancer Treatment.

  3. Drucker AM, Rosen CF. Drug-induced photosensitivity: culprit drugs, management and prevention. Drug Saf. 2011;34(10):821-37. doi:10.2165/11592780-000000000-00000

  4. American Cancer Society. Coping with Radiation Treatment.

  5. National Comprehensive Cancer Network. Take Precautions During Cancer Treatment in Warmer Weather.

  6. MD Anderson Cancer Center. Cancer Treatment Side Effect: Skin Changes.

Additional Reading

By Lynne Eldridge, MD
 Lynne Eldrige, MD, is a lung cancer physician, patient advocate, and award-winning author of "Avoiding Cancer One Day at a Time."