Sensitivity to the sun, also known as photosensitivity, is a frequent reason for presentation to the dermatologist, especially in the spring and summer months.
This problem is different from sunburn, which many of us have experienced occasionally and accidentally, with photosensitivity manifested by itchiness, redness, fluid-filled vesicles, small papules, higher plaques and edematics that appear in exposed areas such as face , exposed areas of the hands and forearms, decolletage. Fortunately, once the causes of photosensitivity are identified, it can be treated with the specialist physician, depending on the particularities of each case.
A person becomes susceptible to photosensitivity when skin rashes occur only in areas exposed to the sun. Causes may be diverse and for this reason the doctor will detail the patient's medical history, which may even be completed with a clinical examination and laboratory analysis in some situations. A careful review of the person's medical history, skin symptoms, possible illnesses and medicines administered orally, or substances applied to the skin (such as medicines or cosmetics) can help the doctor identify the cause of the problem. Eventually, tests can be done to exclude diseases that are known to cause such reactions.
Sun exposure and medication
Fotosensitivity is a common side effect produced by different drugs. "There is a long list of drugs that can cause sensitivity to light, and between the first we could place doxycycline, an antibiotic commonly used in the treatment of vulgar acne and other inflammatory skin diseases. Of the same category are some anti-inflammatory drugs such as ibuprofen or naproxen, medicines used in heart disease such as amiodarone, diltiazem, enalapril, furosemide or isotretinoin prescribed for severe acne. But if there are people who are already undergoing treatment with one or more of these drugs and have no side effects, they should not worry because not everyone develops photosensitivity after their administration, "explains Dr. Laurentiu Vladau, Specialist in Dermatology and Venereology.
Fragrances and cosmetics based on musk can cause sun sensitivity in the areas where they are applied. Paradoxically, even some photosensitive creams (such as those with salicylates, benzophenones or para-aminobenzoic acid) may cause photosensitivity, so if itching, redness, scaling occurs, replacement with a different active substance is recommended.
In turn, cosmetic procedures such as chemical peels, microdermabrasion or retinoid-based creams, hydroxyacids may lead to severe sun exposure reactions, and patients should follow strictly the physician's instructions for avoiding exposure and use of creams photoprotection.
Plants such as parsley, pasturage, celery, some field flowers and green lemons contain a photosensitising substance called psoralen which, after contact with the skin and in the presence of ultraviolet rays, can produce a severe reaction accompanied by urticarial plaque, fluid vesicles, pigmentation spots , with itching and stinging.
Sun and diseases
Last but not least, there are a number of diseases that are triggered by exposure to light and sun, and which are mostly active in the sunny months, which include sun rays and polymorphic rash in the light. In these cases, ultraviolet rays of certain wavelengths will cause an immune reaction that often accompanies release of histamine, edema of small blood vessels, and the onset of an inflammatory cascade that will lead to rash, itching, and discomfort.
"Avoiding excessive exposure and the use of photo-protective creams are extremely important in these cases. In use, antihistamines and corticosteroid based creams are used. Some patients need desensitization by progressive exposure to increasing doses of ultraviolet B (UVB), early spring, under the supervision of the dermatologist, "recommends Dr. Laurentiu Vladau.
Inflamed skin is generally more sensitive to the sun, so patients suffering from inflammatory skin diseases such as acne, eczema, various dermatitis can develop pigmentation after exposure to the sun. Patients with family history or contraceptives, as well as pregnant women, are more susceptible to melasma, a pigmentation of cheekbones and forehead that gets worse in the summer months. The treatment of melasma is difficult and long lasting, and therefore the use of photo-protective creams and maintenance treatments are very important after successful interventions such as chemical peels, depigmenting creams, etc.
"In rare cases, photosensitivity can be seen as more severe affections affecting various systems and organs such as erythematous lupus, which is accompanied by other symptoms such as joint and muscle pain, oral ulceration, hair loss, psychosis, blood, dermatomyositis manifested by marked muscle weakness and breathing and swallowing difficulties or porphyria in its various forms when vesicles and scars associated with gastrointestinal disorders arise due to the accumulation of precursors of HEM that may be photosensitizing once it accumulates in the skin. The treatment of these problems is recommended to be done with the dermatologist who has the experience and training required to diagnose these diseases, which often require a multi-disciplinary approach ", the doctor.
All people should avoid excessive exposure to the sun, and those who are particularly sensitive to UV rays should be even more alert and wear protective clothing, avoid sunlight as much as possible and use sunscreens with regularity.
Occasionally, people with this problem can be desensitized in front of sunlight by gradually increasing their exposure to UV light (by Phototherapy – Using UV light to treat skin disorders).