Sun-Smart Strategies for Lupus

Marta Phillips
Newsletter of the Lupus Foundation of America Inc, Volume 23 Number 2 Summer 2003

The great outdoors ?
If you have lupus, when is the last time you played golf, watched the kid's soccer game, or puttered outside in the garden? Called by some the "great escape," the outdoors offers mental and physical treasurers far too important to be neglected.
Photosensitivity, or sun sensitivity, affects 40-70 percent of people with lupus. Excess sun exposure can cause flares in systemic lupus, and can aggravate cutaneous lupus. Exactly how UV light exacerbates lupus is unknown.
But according to San Diego dermatologist Dr Leslie Mark. "People with lupus should not deprive themselves of the great outdoors - they just need to cover up."

Outsmarting the sun
Photosensitivity is a serious problem, especially for those with lupus. But with the proper know-how, those with lupus can lead a normal outdoor life. It is almost like playing a game - a high stakes game where the stakes are all the activities you enjoy outdoors. Your opponent is warm-hearted but wily and potentially dangerous. To win, you need to be well educated, well prepared, and dressed for a successful outing.

Dark -v- Light If you thought that dark-coloured fabrics absorb the sun's heat the same as, say, dark-coloured cars, think again ! In general, it's true that dark colours can absorb more heat - with some fabrics you can feel the difference in temperature, while with other fabrics there is not a noticeable difference. Light-coloured fabrics, however, usually let more UV radiation through - which is what really matters for sun-sensitive people. On a hard surface ( like a piece of wood painted white ) the white would reflect more light that black would. But this is not the case for fabric. In fact, the makers of Solarweave ( who chemically treat their fabrics to achieve a high UPF ) mill a slightly thicker fabric when making their white Solarweave, because light-coloured fabric lets more UV rays through than a darker-coloured fabric. It is interesting to note that the chemical used in Solarweave fabric is actually a dye derivative.

Know your opponent
Our sun gives out a spectrum of radiation, but we will concentrate on the UVA ( ultraviolet A ) and UVB ( ultraviolet B ) rays, both of which cause problems for people with lupus.
It is important to understand two basic characteristics about the radiations you're up against, because the strategies of winning are different. UVB rays are significantly stronger in the summer and between the hours of 10am and 3pm. On the other hand UVA rays stay at the same intensity all day long and throughout the year.
Being sun-safe is a contact game so you'll need full body protection before going out. Let's start at the top. Cutaneous lupus of the scalp and face is very common, even for those with thick hair, so sunscreen and a hat are both essential.

Sunscreens
San Diego rheumatologist Dr. Katherine Nguyen recommends three simple guidelines to her patients when choosing a sunscreen "Look for a sunscreen that is hypoallergenic, has broad spectrum protection, and has an SPF of 30 or greater." As a safety precaution, she suggests first testing the product on a small area of the skin to rule out skin sensitivity or allergy.
As you may know, the term "broad spectrum sunscreens" refers to products that block out UVA and UVB rays. What you might not know is that SPF ( Sun Protection Factor ) only measures UVB protection. Labelling laws regarding UVA have not been defined by the FDA. One way to check if UVA is being blocked is to read the ingredients panel and see if ingredients such as zinc oxide, titanium dioxide, and Parsol 1789 are included.
The Ultraviolet Protection Factor ( UPF ) rating is like the SPF rating used for sunscreens, in that both measure sunburn protection. One important difference between the two is that UPF measures both the UVB and the UVA radiation being blocked.

STRATEGY : You must stay on guard all day, every day and in all four seasons. Planning activities in the morning or late afternoon will increase your success in preventing sun-related symptoms of lupus.

Getting the most from your sunscreen

• Apply enough ! Most people apply a sunscreen like moisturiser, which equates to about half the SPF rating you seen on the bottle. Example SPF 30 lotion-like moisturiser would afford only SPF 15 protection. Rule of thumb - one teaspoon for an adult face and neck ( half teaspoon for a child }.
• Reapply ! Most health experts recommend reapplying sunscreens every 2 or 3 hours, or more if you are being active or swimming. However, a recent study suggests that reapplying 20 minutes after stepping outside, instead of waiting 2 hours, can reduce your UV exposure by as much as 40 percent.
• Store properly ! Heat may change the chemical composition of sunscreens. So don't store it in the car and other places, where temperatures may get high.
• Toss when old ! Throw out your old sun block. Its chemical composition may have changed with age, and it may no longer perform as stated on the bottle. Check the expiration date, or mark the date on the bottle when you buy it.

Hats
The next layer of protection is a hat. A four-inch brim or more is recommended for maximum protection. Hats with a downward slanting brim will go far in protecting your face and neck as the sun approaches either horizon. For additional protection on the face and neck and/or for those who can't use sunblocks, a hat with a drape that extends across the face, or a scarf used as a mask, may be a good answer.

STRATEGY : Keep a scarf or sunscreen with you at all times for unplanned exposures. Having a sun umbrella is also a handy tool. Wearing a physical face shield, such as a scarf and spending less time in the sunlight may be necessary on certain occasions such as when you are travelling closer to the equator or at higher altitudes.

Clothing
Now for the body. As with the face, sunscreens and sun blocks are options for your body. But for many, clothing is a better option. With clothing you're not putting chemicals directly on the skin. Plus, the protection won't wash off, sweat off or wear out during the day.
Anything you put between you and the sun will help block the sun's rays. The question is, "How much ?" Rules of thumb for everyday clothing - the thicker, the darker and the tighter the weave, the better.
The type of fabric also makes a difference. Of all the fibers, cotton is the least sun-protective. The average T-shirt blocks out only 50 percent of the ultraviolet light, and when wet that amount of protection drops even lower. Lycra and polyester fabrics have the most blocking ability, followed by nylon.
Garments made from special sun protective fabrics are available commercially. The main difference between these outfits and everyday clothing is that sun-protective fabrics have been rated by an independent laboratory for their sun-blocking ability, and are then given a UPF ( Ultraviolet Protection Factor ) rating.
Most sun-protective fabrics are tightly woven/knit and may ( or may not ) be chemically treated with UV inhibitors. Fabrics from cotton to polyester are used, with the, most common being nylon.
Also unique to sun-protective clothing are special design features to increase the sun protection and help keep the wearer comfortable on a hot day. Such features may include air vents, a roll-up collar for added neck protection, or cuffs with retractable hand flaps. Sun protective clothing also provides protection when damp. By wetting your shirt or hat you can stay fresher with evaporative cooling - a big advantage on a hot day.

Sun Protective Clothing and Accessories : Recommended by dermatologists. Excellent UVA and UVB protection. Unique designs help you stay sun-safe and comfortable. Visit our website at www.sungrubbies.com and see our hats, shirts, pants, umbrellas, sun gloves, sun scarves, 40+UPF fabric-by-the-yard and more !

Sun Savvy Tips

• Beware of the sneak attack ! The sun can play unfairly when you least expect it.
• Don't be deceived by a cloudy or overcast day. As much as 80 percent of the sun's harmful rays can still get through.
• Window glass is also a deceptive blocker. Although UVB rays are stopped by glass, UVA rays are coming through at full strength.
• Sand, cement, water and snow can reflect as much as 80 percent of the sun's original light.
• Remember that the sun's position changes throughout the day. You may be in the shade one minute but in the full sun the next.
• Medications can add to your sun sensitivity or make you sun-sensitive when you were not in the past.
• The sun's intensity increases four to five percent with every 1,000 feet in elevation.

Quick Tips for Sun-Product Safety Throw out your old sun block - its chemical composition may have changed with age and may no longer perform as stated on the bottle. UVA the ultraviolet rays that can be most problematic for people with lupus, stays at the same magnitude throughout the year. Sun precautions used in the warm months of summe r- wide brimmed hat, sunglasses, sun block and sun protective clothing - should also be used during the rest of the year. Don't be fooled by stormy weather. Cool temperatures do not reduce the harmful effects of the sun's rays. And clouds, although they reduce the sun's heat, or infrared radiation, block as little as 20 percent of the UV radiation. Window glass blocks UVB but not UVA radiation, so take extra care when viewing summer scenery from indoors or riding in a car. Antibiotics, such as tetracycline and sulfa drugs, as well as other medications, may cause additional sun sensitivity. Even over-the-counter lotions and creams containing alpha hydroxy acids ( AHAs ) can increase your skin's sun sensitivity. Be sure to check with your doctor or pharmacist about your medications.

 

Disclaimer :
The Lupus Group of W.A. (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.