The Lupus Group of WA

Lupus and the Sun

The Lupus Group of WA Article Library 2002 - Y Bryce

One of the first things persons with Lupus have to face is the fact that they can no longer be one of the sun-bronzed Australian beach set.
People with Lupus must stay out of the sun. Let us look at why this is and what we can do about it.
Photo- or light-sensitivity is present in all forms of Lupus. This is defined as `a skin rash that results from a reaction to sunlight' ( T Millard, 2002).

Over 50% of people with Lupus have sun sensitivity. Exposure to sunlight may even lead to flares of internal disease activity including joint pain and fatigue.

Sunlight is made up of different wavelengths ultraviolet bands of invisible ultraviolet light. There is UVA, UVB and UVC. The last is absorbed by the atmosphere so is not a problem.

What can we do about this? We live in one of the sunniest countries in the world. Sun avoidance is by far the best method of preventing damage but it is also the most difficult to manage. If we do not wish to stay a prisoner in our home we need to take steps before venturing into the sun :

slip, slop, slap.
cover up with long sleeves, trousers and a hat, and
stay out of the sun through the middle of the day.

Let's look at the slip, slop, slap again. What are sunscreens?

Sunscreens : are used to block out, absorb, or reflect the invisible part of sunlight.
UVC is absorbed by the earth's atmosphere so we don't have to worry about it, but the energy from UVB causes sunburn, resulting in basal and squamous cell carcinomas. The longer wavelength UVA is 1,000 times less effective in causing sunburn but is more plentiful and penetrates deeper into the skin. Once we thought it was relatively harmless but now we know it is as likely as UVB to cause skin cancers, including melanomas. It is also responsible for the aging effect caused by the sun. Both UVA and UVB affect Lupus patients.

Sunscreens carry an SPF rating. This is decided upon by timing how long a small area of skin takes to redden with and without sunscreen. For example if an area of skin takes 10 minutes to redden without sunscreen, it will take 150 minutes to redden when protected by SPF-15 sunscreen. It will take 300 minutes, using an SPF-30.
Currently sunscreens rate from SPF-2 to SPF-50, but many are rated as SPF-30+ although they may be higher, because it is thought a higher figure may encourage people to stay out in the sun.

What to look for in a sunscreen :

A sun protection factor of 30+.
A broad spectrum sunscreen that filters both UVA and UVB rays.
A water resistant cream so that perspiration or swimming does not wash it off.
An `Aust L' number to show it has been tested to ensure its SPF claim is true.
That the use by date is correct. Sunscreens last 2 - 3 years.

Titanium or zinc oxide acts as a physical barrier to the sun, as did the old zinc cream.

Apply sunscreens :

15 Minutes before going out in the sun.
To clean, dry skin.
Liberally to exposed skin and only lightly rub in.
Every 2 hours.
Under make-up, moisturiser or insect repellent.

Sunscreens are an easy, safe way to allow us to have at least some sun exposure. If applied correctly they will work to give the protection we need. If you react to any one of the creams, discontinue its use

Immunosuppressant drugs, some antibiotics and perhaps some other drugs you may be taking can increase your susceptibility to sunburn. Your doctor will tell you if this is the case and it would be wise to simply stay out of the sun.

Sunscreens and babies do go together but it is wise to protect a baby or young child by using hats and clothes that cover the skin. Only those limited areas that are left should have sunscreen applied. A baby has delicate skin that may react to a sunscreen.

So be sun smart :

Avoid the sun from 10am to 3pm.
Use shade whenever possible.
Wear a broad brimmed hat and use protective clothing - long sleeves, collars, trousers.
Use sunscreens with a SPF-30+
Wear wrap around sunglasses which conform to Australian Standard AS 1067 (1990).
Check your skin regularly.

In many ways having Lupus puts patients at an advantage when it comes to sun care. They are continually being reminded to avoid the sun, to use sunscreens, and to cover up. Everyone should be doing this, regardless of having Lupus or not. Therefore instead of worrying about the extra sensitivity Lupus patients have, they should be feeling very smug that at least they have got it right.

References :
Sunscreens: How to use them effectively, Cancer Foundation of Western Australia Inc.
Millard, Thomas P. Light Sensitivity and Lupus, Vol.21.No. 2 (Summer 2002) Lupus News: Lupus Foundation of America, Inc.

Disclaimer :
The Lupus Group of WA ( Inc ) does not recommend or endorse any products, drugs, treatments, procedures, medical or health professional in this article. We suggest you discuss this information with your doctor or specialist.