by David W. Golann
If you have arthritis, you probably focus on a few tried-and-true management strategies. You may take medicines to treat pain, do exercises to ease stiffness, and use assistive devices to help yourself stay mobile and active. Protecting yourself from the sun probably doesn’t make your to-do list. But for many people with arthritis — either because of the arthritis itself or the drugs they take to treat it — sun protection should be part of a comprehensive self-management plan.
The sun emits visible light — the light that allows us to see what’s in front of us — as well as “invisible” ultraviolet light. There are three types of ultraviolet light: ultraviolet A (UVA), ultraviolet B (UVB), and ultraviolet C (UVC). UVC is mostly absorbed in the Earth’s atmosphere, but UVA and UVB come in contact with our skin every day. The results aren’t always pretty. Excessive exposure to UVA can age the skin, and UVB can burn the skin. Both types of ultraviolet light actually alter the DNA of skin cells, increasing the risk of skin cancer down the line. Because of these risks, sun protection is important for everyone. But for some people with arthritis, it is especially important.
Several types of arthritis make people more sensitive to sunlight.
Lupus. Sun sensitivity is a hallmark of all types of lupus, whether the lupus affects many parts of the body (systemic lupus erythematosus, or SLE) or just the skin (discoid lupus erythematosus and subacute lupus erythematosus). People with lupus can have a variety of skin symptoms, including a “butterfly” rash over the bridge of the nose and the upper cheeks; scaly, purplish lesions on the face and neck; and red, circular rashes on the chest, back, and arms. Sun exposure can bring on any of these rashes or make existing rashes worse. In addition, many people with SLE find that all of their symptoms, including joint pain, fatigue, and fever, flare up after exposure to the sun.
People with lupus have to be especially careful about their sun exposure (see below for useful tips on sun protection). They should also be aware that it is not only the sun that emits ultraviolet light. Fluorescent light bulbs and even photocopy machines can too. It is often thought that “covered” fluorescent bulbs — those that have an extra bulb-shaped layer over the typical spiral-shaped tube — emit less ultraviolet light. A recent study, however, has found that this is not necessarily the case. Although only a small percentage of people with lupus are affected by ultraviolet light from sources other than the sun, if your skin is particularly sensitive and you have to be near a fluorescent light for an extended period of time, you should wear sunscreen.
Other types of arthritis. A few other types of arthritis can make people more susceptible to sun-related problems. Scleroderma causes skin to harden and sometimes to become discolored, and people with the condition may find that sun exposure further damages or discolors their skin. People with dermatomyositis, which causes a skin rash in addition to muscle stiffness and soreness, can be sensitive to the sun as well.
Psoriatic arthritis combines the typical skin symptoms of psoriasis — dry, scaly skin — with the joint pain and stiffness of inflammatory arthritis. Psoriatic arthritis is unusual in that UVA rays can actually improve its skin symptoms. In fact, many people with the condition look forward to the sun and humidity of summer because it brings relief from their dry, itchy skin. That said, there is a limit to the amount of sun people with psoriatic arthritis or psoriasis should get. Excessive sun exposure can damage skin cells and make psoriasis worse. A small percentage of people with psoriatic arthritis or psoriasis are very sensitive to the sun and should avoid unnecessary sun exposure.
A great many drugs — including drugs used to treat arthritis — can increase the skin’s sensitivity to the sun. If you take any of these drugs, you may be at a higher risk of skin redness and burning. Among these medicines are nonsteroidal anti-inflammatory drugs such as ibuprofen (Advil), naproxen (Aleve), and celecoxib (Celebrex), which are used to reduce pain and inflammation in all types of arthritis. Antimalarial drugs such as chloroquine (Aralen) and hydroxychloroquine (Plaquenil), used to treat lupus and rheumatoid arthritis (RA), can increase sun sensitivity as well. And sulfasalazine (Azulfidine) and methotrexate (Rheumatrex, Trexall), common drugs for the treatment of RA, are well known for causing sun sensitivity.
Other classes of drugs, such as some diuretics (for high blood pressure), sulfonylureas (for diabetes), tricyclic antidepressants, antihistamines, antibiotics, and cardiac drugs can increase sun sensitivity as well. It’s a good idea to check the label of any drug you are taking to see if it has this effect.
Last Reviewed on April 18, 2012
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