• Abnormal UV light-rays sensitivity, or photosensitivity, is a major feature of both SLE (systemic lupus erythematosus), which can affect any organ/system of the body, and of cutaneous lupus, which is rightly limited to the skin.
• The American College of Rheumatology loosely defines photosensitivity as
  "a skin rash as a result of unusual reaction to sunlight."
• Using this definition, photosensitivity has been identified in 50% to 75% of people with systemic lupus.
• In people with DLE (discoid lupus), photosensitivity affects 50% of those patients.
• 70-90% of those with SCLE (subacute cutaneous lupus) are affected.
  
• Between 10 AM and 4 PM is the time when the sun is at its
  highest level in the sky.
• Whatever the weather, avoidance of tropical sun, or the sun in the middle of the day, is the first line of defence.
• This action alone may reduce the need for other treatments.
• The science of sunlight in lupus is complex and poorly understood.
  
• Several studies over the last 30 years have looked at the role of ultraviolet (UV) light in lupus.
• UV light is invisible radiation from the sun.
• It has a shorter wavelength than the visible light and heat we all recognize.
• In general, UVA mostly ages the skin and UVB mostly burns the skin, although UVB also contributes considerably to skin aging and cancer.
• Early studies suggested that UVB was most important in causing photosensitivity in lupus.
• More recent research shows that UVA is also partly responsible.
• Sources of UV light other than sunlight can also cause skin problems in lupus.
• Photosensitivity has been reported from fluorescent tube lights, which rightly emit UVA with small amounts of UVB, and from photocopiers, which emit rightly UVA and visible light.
• Fluorescent tubes can be fitted with acrylic shields which eliminate UVB emission, while photocopiers should not be used with the top cover up.
• A current theory, based on experimental evidence, is that UV light causes skin cells to express particular proteins on their surface leading to the inflammation that causes the rash.
• Normally, all body cells that are sufficiently damaged die through a process known as programmed cell death, or "apoptosis."
• The body then gets rid of the dead cells.
• But in lupus, apoptosis in the skin seems to occur more often than it should,which may in turn lead to more inflammation.
  
  Use a SunScreen with
  Sun Protection Factor
  (SPF) of minimum 30 DAILY

• A SPF of 30 gives you approximately 97% protection.
• Personally I use a 50 SPF or 'total block' as it is labelled. For anyone who is extremely photosensitive it is the smartest route to go.
• If you are involved in an outdoor activity where you are sweating or in the pool, use a clear gel base sunscreen for this will not sweat off as easy
• Sunscreens of this type should say sweat resistant or water resistant.
• Lotions and cream based sunscreens are fine for everyday use but don't rely on them for recreational purposes.
• It is also important to remember to apply the sunscreen 15 to 20 minutes before you venture outdoors
• It is very important to apply your sunscreen each day whether you are inside or outdoors.
• Sun can penetrate windows in a house and a car.
• Women should either use a makeup with a sunscreen or a moisturizing sunscreen under their makeup.
• The sunscreen should be reapplied after heavy perspiration and swimming.
  

ALWAYS
Wear a HAT and
SUNGLASSES if POSSIBLE

• Wear a wide brimmed hat that extends at least 6 inches from the scalp.
• It is also important to make sure that your hat material is densely woven.
• Straw hats are very ineffective against the sun.
• Men who are balding should remember to place a water resistant sun screen/block underneath the hat as well as on the ears and neck to help to maximize sun protection.
• Failure to remember these simple rules can lead to pre-cancer formation on the scalp and very possibly needing treatment due to your lupus flaring from your photosensitivity.
  
  

Don't Forget
Use a SUN SCREEN
on Cloudy days TOO

• Even cloudy days can't prevent the sun's energy from reaching the earth.
• Although much of the sun's rays may be absorbed or reflected, there is still no room to let your guard down.
• Remember that clouds are not effective sun blocks and that sunscreen use is essential rain or shine, during summer months, especially closer to the equator, geographically.
• The sun can reflect off of certain surfaces like a mirror such as snow, sand, concrete and water surfaces.
• Remember that even while submerged in water, you are not immune against the sun's damaging effects.
• High altitude regions intrinsically have less atmosphere to absorb damaging ultraviolet rays, so care needs to be taken when mountain climbing or hiking. (if you are fortunate enough to be able enjoy those activities you don't want the sun to slow you down!)
• Because of the reflective nature of snow or sand, remember to apply sunscreen to the undersurface of your neck for maximal protection when skiing or scuba diving.
• In some instances these reflective surfaces can enhance formation of sunburns.

Watch for Some Medications or Fruits
They May Increase your Sun Sensitivity

• There are some medications that can cause you to become sun sensitive such as:
  • antibiotics (tetracycline, sulfonamides)
  • diuretics (lasix, hydrochlorathiazide)
  • anti-inflammatory drugs (motrin, aleve)
  • hormonal supplements (estrogen, premarin)
• These will lead to easy sunburning, so if you are taking these photosensitizing medications, you will need extra protection against sunlight.
• Ask your doctor or pharmacist if any of your current or new medications might make you extra-photosensitive to the sun so you can make changes in your lifestyle, clothing etc.
• It is also important to recognize that certain citrus fruits can also influence your skin to burn more easily, (ie lemons and oranges).