Treatment of photodermatitis

Redness, itching, and rashes after exposure to the sun may be not an ordinary burn, but a manifestation of sun allergy. The reaction sometimes occurs within a few minutes, and in other cases — after several hours or days. If the symptoms are pronounced or recur, it is important to determine their cause.

At the “Oxford Medical” medical center, you can receive a consultation with an experienced dermatologist, who will conduct an examination, help determine the cause of the skin reaction, and select treatment. To schedule a consultation with a dermatologist, please use the online booking form on the website or call the number provided.

Photodermatosis — is a general name for conditions in which the skin has increased sensitivity to solar radiation. The reaction may occur even after a short stay outdoors. Unlike an ordinary sunburn, such changes are associated with the individual photosensitivity of the skin, and not only with the intensity of ultraviolet radiation.

Increased sensitivity to ultraviolet radiation may appear at any age, even if previously staying in the sun did not cause problems. In some people, the reaction occurs once, while in others — it regularly recurs.

Photodermatoses are divided into several types depending on the mechanism of development and the characteristics of the reaction to sunlight. The following forms are most common:

• polymorphic light eruption — a seasonal reaction that predominantly occurs in spring or at the beginning of summer, when after the winter period the skin is again actively exposed to ultraviolet radiation;

• solar urticaria — a rare form that develops within several minutes after sunlight reaches the skin;

• phototoxic dermatitis — an acute reaction that appears when ultraviolet radiation interacts with substances that increase the skin’s sensitivity to the sun;

• photoallergic dermatitis — a delayed immune reaction that usually occurs a certain time after exposure to the sun.

There are also rare chronic photodermatoses, including actinic prurigo and chronic actinic dermatitis. They have a prolonged course and may worsen even after minor exposure to ultraviolet radiation. Determining the specific type of disease helps the doctor correctly select further management.

According to DermNet, increased sensitivity to light may be an independent characteristic of the skin, arise under the influence of certain substances, or accompany other diseases. In this case, solar radiation becomes a triggering factor: after exposure to ultraviolet radiation, a reaction is initiated, which leads to the appearance of changes on the skin.

The most common causes of photodermatosis are:

• an individual reaction of the immune system to ultraviolet radiation — characteristic of polymorphic light eruption and some other primary photodermatoses;

• taking medications that increase photosensitivity, including certain antibiotics, diuretics, anti-inflammatory drugs, antiarrhythmic agents, and retinoids;

• applying cosmetic or medicinal products to the skin, the components of which may react under the influence of sunlight;

• contact with the juice of certain plants, citrus fruits, or essential oils before exposure to the sun;

• autoimmune and dermatological diseases, the course of which may worsen under the influence of ultraviolet radiation, including systemic lupus erythematosus and dermatomyositis;

• metabolic disorders, such as porphyrias, as well as rare hereditary diseases associated with high photosensitivity.

Sometimes an allergy to sunlight appears after starting a new medication or using a cosmetic product that the person has not used before. At the same time, prescribed medications should not be discontinued independently. It is necessary to inform the doctor when the reaction occurred and which medications or products were used the day before: this will help determine the possible cause more accurately.

With solar urticaria, changes may appear within several minutes after going out into the sun and gradually disappear after moving indoors. With other forms of photodermatosis, the reaction develops after several hours or even the next day and may persist longer.

Doctors at “Oxford Medical” recommend paying attention not only to the appearance of the rashes, but also to the time of their onset and their connection with exposure to the sun. If the reaction is accompanied by pronounced swelling, difficulty breathing, weakness, or dizziness, emergency medical assistance is necessary.

Photodermatosis is diagnosed by a dermatologist. During the consultation, the doctor examines the affected areas and, if necessary, performs dermatoscopy. The doctor also clarifies when the changes appeared and how much time passed after exposure to the sun. It is also important to mention all medications you are taking, as well as cosmetic and medicinal products applied to the skin the day before.

During the examination, the doctor pays attention to:

• the appearance and location of the rashes;

• the presence of a clear boundary between exposed areas and areas covered by clothing;

• the duration of the reaction and the frequency of its recurrence;

• the connection of symptoms with medications, cosmetics, or contact with plants.

In many cases, an examination and detailed information about the onset of symptoms are sufficient for a preliminary diagnosis. Laboratory tests may additionally be prescribed. For example, if an autoimmune process is suspected, the doctor may recommend testing for antinuclear and other specific antibodies. To rule out porphyria, blood, urine, and stool tests are performed for porphyrins and the substances from which they are formed. The specific list of tests is determined taking into account the symptoms and the presumed cause of photosensitivity.

Doctors at “Oxford Medical” recommend recalling before the consultation which medications and products you used before the rashes appeared. If the reaction has already passed, it is advisable to show the doctor photographs of it — they will help assess the nature and location of the skin changes.

In photodermatitis, treatment is selected taking into account the severity of the symptoms and the cause of the skin’s increased sensitivity to the sun. During an exacerbation, it is important to limit exposure to sunlight and not use products after which the rashes may have appeared.

Treatment of sun allergy may include:

• topical corticosteroid products to reduce redness, swelling, and inflammation;

• antihistamines for pronounced itching or solar urticaria;

• moisturizing and restorative products that help eliminate dryness and peeling of the skin;

• systemic medications in severe or prolonged cases — they are prescribed by the doctor after an examination.

If solar dermatitis is associated with cosmetics, perfumery products, or a topical medicinal product, it is necessary to stop applying it. In the case of a reaction to medications, the dermatologist may recommend a consultation with the doctor who prescribed them in order to adjust the dosage or select a replacement. Medications must not be discontinued independently.

When increased photosensitivity occurs against the background of an autoimmune, metabolic, or other disease, treatment is also directed at the underlying cause. In cases of frequent seasonal exacerbations, the dermatologist may recommend a course of controlled phototherapy, which gradually increases the skin’s resistance to ultraviolet radiation. Such treatment is carried out according to an individual regimen under medical supervision. British Association of Dermatologists notes that this method may be used for pronounced polymorphic light eruption.

Doctors at “Oxford Medical” emphasize: hormonal ointments should not be applied to the rashes independently, and antiallergic medications should not be taken without medical advice. Products that help with one form of photodermatosis may be insufficient or inappropriate for another. In any form of photodermatosis, treatment must be prescribed by a dermatologist.

Regular protection of the skin from ultraviolet radiation helps reduce the risk of a repeated reaction. It is necessary to be especially careful in spring and at the beginning of summer, as well as while resting near water or in the mountains, where the intensity of solar radiation is higher.

Main recommendations:

• use a broad-spectrum sunscreen with SPF 50 and apply it to exposed areas of the skin 15–30 minutes before going outside;

• reapply sunscreen every two hours, as well as after swimming, intense sweating, or drying with a towel;

• during periods of active sun, wear light clothing that covers the skin, a hat, and sunglasses, and, whenever possible, remain in the shade from 10:00 to 16:00;

• before using new cosmetics or starting to take medications, check whether they can increase photosensitivity.

If photodermatosis recurs every year, doctors at “Oxford Medical” recommend consulting a dermatologist in advance. The doctor will help identify possible provoking factors and develop an individual plan for preventing exacerbations.

The cost of photodermatosis treatment depends on the severity of the symptoms, the need for additional examinations, and the prescribed therapy. After the examination, the dermatologist determines the possible cause of the skin’s increased sensitivity to the sun and develops an individual treatment regimen.

You can review the price of a dermatologist consultation here in advance. Make an appointment with a doctor at a time convenient for you through the online appointment form on the website or by calling the contact center.

The information is for informational purposes and does not replace a doctor’s consultation.

Sources:

• US National Library of Medicine — Photosensitivity and Photodermatoses
• British Association of Dermatologists — Polymorphic Light Eruption
• British Association of Dermatologists — Solar Urticaria