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How to treat a photosensitive skin?

Wednesday, 25 February 2009
Answered by: Prof. Jayakar Thomas
Senior Consultant Dermatologist
Kanchi Kamakoti Childs Trust Hospital
Chennai
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Q. I have a photosensitive skin and during winter I develop severe sunburns with rashes. I have been using Clop mg cream to get rid of these patches. I often take medication and it goes off and next summer I am stuck with the same rash again. I use a sun block with 15 SPF and since I have an oily skin I develop pimples and my skin tends to become dark. I can’t get the tan off and I do sneeze continuously for a long time. I am really depressed with this and want to know the cure to this curse or do I have to live with this forever? This really gives me a lack of confidence and an inferiority complex. Please suggest ways so that I can get rid of this and get my life back?

A.  First of all, your photosensitivity must be confirmed by phototests – artificial light from various different sources is shone on small areas of the skin to see whether the rash can be reproduced, or if sunburn occurs more easily than expected. Photosensitivity induced by contact with certain items can be tested by photopatch tests. Adhesive patches containing known photosensitizing materials are applied to the upper back, removed after two days, and light is shone on the area. The reaction is observed two days later. Use these hints to help your skin
  • Confine summer excursions out of doors to early in the morning or late in the evening.
  • Sun protection is needed whatever the weather. It is needed even if you sit in the shade.
  • Protect yourself in the car and house too; UVA can pass through window glass.
  • There are two basic ways of protecting your skin from the damaging effects of UVR:
  • Block out all light with an opaque material such as sun protective clothing. Dark coloured and densely woven fabric is the most effective. Wear shirts with high collar and long sleeves, trousers or a long skirt, socks and shoes, a wide-brimmed hat and if possible gloves. Some clothes are now labelled with UPF, the sun protection factor for fabrics.
  • Choose those with a UPF of 40+.
Use topical sunscreen agents
  • Physical blocker/reflectant sunscreens. These are very effective sunscreens as they block out UVA and UVB by reflecting the ultraviolet radiation. Their only drawback is they can be messy to use and cosmetically unappealing.
  • Chemical sunscreens. It is vital that photosensitive individuals select a sunscreen with a very high Sun Protection Factor (SPF 30+), which is a water resistant and broad spectrum product that complies with current Australian and New Zealand Standard for Sunscreens (AS/NZS2604:1998). Ask your dermatologist which products are most suitable for you. Unfortunately, photosensitive patients like you often find it difficult to find a sunscreen they can tolerate. Contact allergy or contact photodermatitis to the sunscreening chemicals themselves can occur, although this is uncommon, particularly benzophenone or butyl methoxy dibenzoylmethane, and in the past, PABA. Patch and photopatch tests will identify which ones are safe for you. UVR-absorbing film can be applied to windows at home or in the car (e.g. Bonwyke DermaGard ). Masks can be made to cover the face for trips outside too (clear ones are available), but not surprisingly, only the most disabled patients are prepared to wear these. Unguarded fluorescent daylight lamps can occasionally provoke a rash, because they may produce some ultraviolet radiation (UVA). Ordinary tungsten light bulbs are usually alright. It is perfectly safe to watch television.
  • A.  First of all, your photosensitivity must be confirmed by phototests – artificial light from various different sources is shone on small areas of the skin to see whether the rash can be reproduced, or if sunburn occurs more easily than expected. Photosensitivity induced by contact with certain items can be tested by photopatch tests. Adhesive patches containing known photosensitizing materials are applied to the upper back, removed after two days, and light is shone on the area. The reaction is observed two days later. Use these hints to help your skin
    • Confine summer excursions out of doors to early in the morning or late in the evening.
    • Sun protection is needed whatever the weather. It is needed even if you sit in the shade.
    • Protect yourself in the car and house too; UVA can pass through window glass.
    • There are two basic ways of protecting your skin from the damaging effects of UVR:
    • Block out all light with an opaque material such as sun protective clothing. Dark coloured and densely woven fabric is the most effective. Wear shirts with high collar and long sleeves, trousers or a long skirt, socks and shoes, a wide-brimmed hat and if possible gloves. Some clothes are now labelled with UPF, the sun protection factor for fabrics.
    • Choose those with a UPF of 40+.
    Use topical sunscreen agents
  • Physical blocker/reflectant sunscreens. These are very effective sunscreens as they block out UVA and UVB by reflecting the ultraviolet radiation. Their only drawback is they can be messy to use and cosmetically unappealing.
  • Chemical sunscreens. It is vital that photosensitive individuals select a sunscreen with a very high Sun Protection Factor (SPF 30+), which is a water resistant and broad spectrum product that complies with current Australian and New Zealand Standard for Sunscreens (AS/NZS2604:1998). Ask your dermatologist which products are most suitable for you. Unfortunately, photosensitive patients like you often find it difficult to find a sunscreen they can tolerate. Contact allergy or contact photodermatitis to the sunscreening chemicals themselves can occur, although this is uncommon, particularly benzophenone or butyl methoxy dibenzoylmethane, and in the past, PABA. Patch and photopatch tests will identify which ones are safe for you. UVR-absorbing film can be applied to windows at home or in the car (e.g. Bonwyke DermaGard ). Masks can be made to cover the face for trips outside too (clear ones are available), but not surprisingly, only the most disabled patients are prepared to wear these. Unguarded fluorescent daylight lamps can occasionally provoke a rash, because they may produce some ultraviolet radiation (UVA). Ordinary tungsten light bulbs are usually alright. It is perfectly safe to watch television.
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