11 June 2010
Sun Sense: RA Medications and Increased Photosensitivity
Posted by admin under: Health .
Chances are that one or more of the medications being prescribed to treat your RA increase your sensitivity to the sun…not including other prescriptions, over-the-counter medications, cosmetic preparations and herbal products. Add an already-damaged ozone layer into the mix and you have a recipe for painful sunburn. Read on to find out how you can protect yourself and enjoy the sun safely…
It was a perfect, unusually warm day for early May: 74 degrees, light breeze, not a cloud in the sky. I took my son to the park and lay on a blanket, reading, while my son played with all the other winter-crazed kids. After a couple of hours, I noticed that my shins were becoming a little pink, so we headed on home. By bedtime, I was so burned that the sheets hurt; the next day, I was covered with small blisters. I also developed a low-grade fever, chills and nausea.
So how is it that a brown-eyed, brunette with a history of tanning easily developed sun poisoning on a mild spring day? Three words: methotrexate; prednisone; Celebrex. I was taking not one, not two, but three drugs that increases photosensitivity. Add to that my fondness for lotions containing alpha-hydroxy and the question becomes not how did I become sunburned but rather how did I avoid sunburn for so long?
Prescription Drugs and Photosensitivity
Despite the fact that my prescription bag was stapled with computer-generated warnings about increased photosensitivity, I hadn’t taken any special precautions to protect my skin. I suppose that in light of other possible side effects—liver damage, hair loss, nausea and Cushing’s syndrome, for example—I had grown cavalier about something as harmless-sounding as a sunburn. Perhaps it would have made more of an impression on me if the side effects for photosensitivity had listed: premature wrinkles, skin lesions, cataracts, suppressed immune system, carcinoma and the often fatal melanoma.
Even RA sounds like a walk in the park compared to blindness and cancer.
Some of the prescription drugs used to treat RA that increases photosensitivity are:
* NSAIDS
This includes ibuprofen, naproxen and COX-ll inhibitors like Celebrex.
* Antimalarials
These include Plaquenil and chloroquine.
* DMARDs
Among these are methotrexate and sulfasalazine
* corticosteroids
Prednisone and its cousins thin the skin and make it more fragile.
In all likelihood, if you have RA, then you are taking at least one of the drugs on the above list…if not two or more. Combine these with the more garden-variety medications common to most medicine cabinets and you have a recipe for a serious burn.
* antihistamines
* antibiotics (especially tetracycline and sulfa drugs)
* oral birth control
* anti-anxiety
* antidepressants
* acne medications
* anti-seizure
* hormones
heart/blood pressure
Over-the-counter medications, toiletries, cosmetics, etc
* perfumes and scented soaps
* aftershave
* dandruff shampoos that contain coal-tar ingredients
* skin-bleaching creams
* alpha-hydroxy and beta-hydroxy preparations
* sunscreens (!!) containing para-aminobenzoic acid (PABA)
Other Known Photosensitizers:
* quinoline
* musk ambrette
* 6-methyl-coumarin
* bergamot oil
* sandalwood oil
* St. John’s Wort
Sunscreen is not Enough
* Avoid peak hours.
While this differs according to region, 10 AM to 4 PM is a safe bet.
* Wear protective clothing.
This includes a broad-brimmed hat, UV-protected sunglasses and—depending on the length of exposure—long sleeves and pants.
* Use appropriate sunscreen.
There is evidence that sunscreen containing the ingredient Parsol 1789 may be more effective. Read the ingredient labels…and make sure that your sunscreen is at least SPF-15.
* Replenish sunscreen often.
Some experts feel that sun block should be replenished 30 minutes to one hour before recommended by manufacturers.
* Avoid reflective surfaces.
Pool water or snow, for example, creates a reflective surface that increases your chance for serious sunburn.
* Follow the shade.
Probably the most effective—if most ignored—means of avoiding a burn. If natural shade is unavailable, bring a beach umbrella.
Too Late; Already Burned
Sometimes, despite our best efforts, it is so hard to go inside. The weather is perfect, the company pleasing, the water couldn’t be better. When you’re feeling this fine, this…normal, it’s hard to duck inside, even when you are seeing those telltale traces of pink on your shoulders. Just remember: symptoms of sunburn don’t even begin until 2-4 hours after the sun has already done its damage; peak damage doesn’t occur until after 24 hours.
So what’s the best way to treat a burn? First, evaluate which type of burn you have. Most sunburn will be first-degree burns—red and painful. In case of a first-degree burn:
* Take a cool bath.
Baths are preferable to the pounding of a shower…and make sure the water is cool, not cold.
* Apply cool compresses.
* Take an OTC pain-reliever…but don’t raise “‘caine”.
Tylenol or another over-the-counter pain reliever will help reduce the pain, but avoid pain-relievers whose name ends in “cane” or “caine”. Often people are sensitive to these types of applications…and an allergic reaction is the last thing you need for already ravaged skin.
* Drink plenty of fluids.
Dehydration and sunburn often go hand-in-hand.
* Avoid oil-based products and aunt Minnie’s advice.
Oil-based products and home remedies involving grease or butter clog pores and can cause infection.
A second-degree burn will have the pain and redness of a first-degree burn, plus blisters, blotches, streaks, and/or a rash. Sun poisoning (not a medical term, by the way) is a second-degree burn with chills, nausea and a low-grade fever. If any of these symptoms are present, contact your physician. It probably won’t be necessary to make an office trip, but he or she might prescribe medications that can make you more comfortable.
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