THE American College of Rheumatology (ACR) defines photosensitivity as “a skin rash as a result of unusual reaction to sunlight. Photosensitivity is common in people with lupus, and 40 per cent to 70 per cent of people with lupus will find that their disease is made worse by exposure to UV rays from sunlight or artificial light.

In addition to worsening of skin lupus lesions, many people with lupus exposed to UV light can also activate lupus flares, triggering symptoms like fatigue, joint pain, tingling, and numbness. These symptoms can occur a few days or weeks after UV exposure.

How to protect yourself?

Sunscreens

Sunscreen products protect the skin by absorbing and blocking harmful ultraviolet light generated by the sun. Topical sunscreens can be broadly classified into two groups: chemical sunscreens and physical blocking sunscreens.

1) Chemical sunscreens are formulated with ingredients like avobenzone and oxybenzone that absorb UV rays to keep them from penetrating your skin. These ingredients can sometimes cause irritation if you’re prone to sensitivity, but they tend to be easier to apply and leave less of a white residue.

2) Physical sunscreens sit on top of your skin, forming a barrier to protect you. They feature ingredients such as zinc and titanium dioxide to protect skin. These two ingredients won’t burn or sting. These are best for sensitive skin.

Sunscreens come in different vehicles such as creams, lotions, sprays, gels, and sticks. If your skin is dry, you will benefit from sunscreen in a moisturising cream or ointment. If you have oily skin or readily develop acne, choose a sunscreen in a lighter base, such as an alcohol-based lotion, spray, or gel. Lighter sunscreens are also better in hairy skin areas. Sunscreen sticks are suitable for nose, lips, and around the eyes. Ultimately, the vehicle you choose will reflect your personal preference — the best sunscreen is the one you will wear.

It is important to choose a broad spectrum sunscreen. A broad spectrum sunscreen protects against both UVA and UVB rays. Choose a sunscreen with sun protection factor (SPF) 30 or higher.

Sunscreens should be applied at least 20 to 30 minutes before going outdoors. When it is cloudy, 80 per cent of ultraviolet light passes through clouds, this means, if it is cloudy, we need to still apply sunscreen

To achieve the SPF labelled on a sunscreen bottle, it is recommended to use two milligrams of sunscreen per square centimetre of skin, which is equivalent to two tablespoons of sunscreen for the exposed areas of the body.

• Half a teaspoon of sunscreen is needed for the face and neck combined.

• A single teaspoon of sunscreen for both arms.

• One teaspoon of sunscreen for each leg

The recommendations for sunscreens that you are unable to measure the amount by squeezing out are as follows: For stick sunscreens apply four passes back and forth then rub in for even coverage, for mists and sprays, spray sunscreen until the area is shining then rub in.

Apply sunscreen to all skin not covered by clothing. Protect your lips with a lip balm with an SPF of at least 15. If you plan to be active outdoors and may get wet or sweaty, choose a sunscreen that is labelled “water resistant”. Apply sunscreen prior to applying make-up. Reapply sunscreen every two hours.

Other sun protective measures

Sunscreens do not provide total protection and should be used in conjunction with other sun protective measures, such as sun avoidance and wearing protective clothing. Stay indoors or out of the sun during peak sunshine hours (10:00 am – 4:00 pm). Use UV-blocking shades to cover windows and prevent sunlight from streaming in. Wear tightly woven clothing that covers your skin, a wide-brimmed hat, umbrella, and sunglasses to protect you from head to toe.

Protection against artificial light

Artificial lighting also plays a role in photosensitivity, therefore, measures should be taken to protect yourselves indoors. Choose light bulbs that have the lowest possible irradiance (intensity), for example, warm white LED bulbs (avoid cool white and super bright LED bulbs). Use fittings that reflect the light off the wall or ceiling rather than shining directly on you. Have the light as far away from you as possible. A few smaller light sources are better than one larger one.

Most patients with lupus can live normal lives. However, it is important to make the necessary lifestyle changes to stay healthy. One such change is to simply protect yourself from ultraviolet and artificial light which can lead to lupus flares. Make it a point to go out and choose a sunscreen that you like and commit to wearing your sunscreen daily.

Dr Kerry-Ann Clarke is a dermatologist at Kingston Public Hospital and can be contacted at viewpointophthalmology@gmail.com.This article was contributed by Lupus Foundation of Jamaica. Visit the website: www.lupusfoundationofjamaica.org or e-mail them at info@lupusfoundationjamaica.org