Be Aware: Some Medicine Can Increase Sensitivity to Sunlight

The summer heat and sun is always a welcome return for those who love the great outdoors and spending more time at the park or on the beach.

But did you know that if you are taking certain medications, whether prescription or over the counter, sunlight may not be the best for you, even in the colder months?

“Certain drugs can impair your ability to deal with the heat and increase your sensitivity to sunlight called drug-induced photosensitivity,” said Mark Heelon, medication safety coordinator at Baystate Medical Center.

As a result, your skin can burn at a much quicker rate than usual, even with a lower intensity of sunlight. Skin can burn, develop blisters and rashes. What happens is that the sun’s ultraviolent rays (both UVA longer wavelengths and UVB shorter wavelengths) interact with chemicals in a medication that then reacts with proteins in the skin. Some drugs reduce blood flow to the skin preventing the body from cooling down, others increase heat production and sweating, resulting in dehydration, which can lead to sunstroke or heatstroke. Still others decrease sweating, resulting in decreased heat loss and overheating.

Are You on Any of these Medications?

There are many medications that may cause drug-induced photosensitivity. Among the many medications that can heighten your risk of sunburn are:

• Antibiotics – such as Doxycycline, Floxin, Minocycline, Tetracycline, Cipro and Bactrim which are often used to treat urinary tract infections, and others
• Antihistamines – such as Benadryl and others often used to treat nasal and various allergies
• Antihypertensives – diuretics, also called water pills, used to treat high blood pressure such as Hydrochlorothiazide (HCTZ), or certain combination drugs which contain HCTZ such as Maxide, Dyazide, Hyzaar, and Zestoretic
• Antiplatelets – Plavix
• Chemotherapy drugs – the most common being Methotrexate, as well as many others like Fluorouracil and Vinblastine
• Diabetes medications – including Glucotrol, an oral medication used to treat type 2 diabetes, and others such as Amaryl and glyburide
• Heart medications – such as Cordarone , which is used to treat abnormal heart rhythms
• Hormones – such as oral contraceptives, corticosteroids
• NSAIDS – used to treat pain and inflammation, these nonsteroidal anti-inflammatory pain drugs include over-the-counter pain relievers such as Advil, Aleve, Motrin, as well as such prescription drugs as Naprosyn and Celebrex
• Seizure medications – including Tegretol, Neurontin, Topamax, Depakine
• Sedatives – such as Xanax, Ambien
• Skin agents – including Accutane, Rogaine, coal tar
• Vitamins – B6 and Vitamin A

Also, those taking psychiatric medication – anti-psychotics, anti-depressants and anti-parkinsonians – need to be especially careful and are at a higher risk for heatstroke and heat-related illnesses, as well as sunburn.

And, it’s not just the sunlight that you need to be aware of.

“Visiting tanning booths which emit UVA rays can also cause complications with your medications,” Heelon said.

He noted patients should also avoid sources of high-intensity light such as sunlamps.

Take Precautions

Consider taking the following precautions if your doctor or pharmacist has warned you that the medication you are taking can cause photosensitivity:

• Use a broad-spectrum sunscreen (with an SPF of at least 15, 30 or more for those with a fair complexion or those who are more sun-sensitive) that offers protection against UVA and UVB rays. Also, remember to frequently reapply sunscreen every two hours or after swimming or perspiring heavily.
• Wear shirts with high collars and long sleeves, pants or a long skirt, socks, and shoes, a wide-brimmed hat, and sunglasses.
• Avoid direct UV exposure from natural sunlight between 10 a.m. and 3 p.m. when the atmosphere absorbs less of the harmful UV rays from sunlight.

“My best advice is before leaving the pharmacy to always ask your pharmacist if sun exposure should be limited while using a new medication. Also, don’t stop any medication before first talking with your doctor,” Heelon said.

Your photosensitivity often doesn’t end with the last pill.

“Your sensitivity to sunlight may continue for a day to even weeks until the medication has fully left your system,” Heelon said. 

Mild reactions can be handled similarly to a sunburn with topical remedies such as cooling with dressings, antihistamines, and topical steroids. For more severe burns, see your physician.