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Sun Protection in Lupus
Author: Kevin C. Smith, MD, FRCPC (Dermatology), Diplomate, American Board of Dermatology. Originally published Lupus Canada Bulletin, Volume 4 No. 1, Spring 1994
It has long been known that exposure to sunlight or artificial ultraviolet (UV) light can worsen the skin lesions of lupus in some people. Experiments with ultraviolet A and B light have showed that both parts of the UV spectrum can affect lesions adversely. Approximately 70% of patients with subacute cutaneous lupus (SCLE), 40-60% of patients with discoid lupus (DLE) and 10% of patients with systemic lupus (SLE) are made worse by sunlight or UV light. UV light can cause both local and systemic immune alterations, and some patients find that their systemic symptoms become worse after UV light exposure. Light skinned patients are generally more sensitive to UV light, but even blacks with lupus can be made worse by UV light.Table 1: Characteristics of UV Radiation
Because the degree of sensitivity to UV light can change from time to time in any patient, it is best for all people with any type of lupus to protect themselves carefully from the sun and artificial UV light (for example, tanning beds and welding arcs). Fortunately, fluorescent lights in offices and schools are not a problem for most people because the tiny amounts of UV light which they release are so small as to be of no practical importance, compared with the much greater amounts of UV light a person would be exposed to normally, for example walking out to the car on even a cloudy day.
UV-B light is blocked almost completely by a single pane of window glass, but UV-A passes through even tinted window glass easily. Patients who are sensitive to UV-A light sometimes benefit from the application to windows of tinted plastic film which blocks UV-A light. In addition to inducing skin lesions or lupus, or making existing lesions worse, UV light from the sun or from artificial sources can increase the risk that squamous cell carcinoma (a sometimes fatal cancer) will develop in the skin lesions of lupus.
Because both UV-A and UV-B light can make the skin lesions of lupus more active, it is best to use a broad spectrum sunscreen like OMBRELLE or Photoplex. These sunscreens block both UV-A and UV-B light, and both have a sun protection factor (SPF) of 15, which is more than enough to provide good protection. Many lupus patients apply one of these sunscreens every morning, 365 days per year, to get the best protection. This will also help to keep you looking young and reduce the risk of blotches and wrinkles as you get older.
Table 2 - Guide for Sunscreen Application