As we enjoy the sunshine of summer and travel to beach destinations for vacations, sun exposure time increases and the risks that accompany that must be considered. Many people don’t realize that the medications they take may place them at risk for adverse skin reactions. Druginduced photo-sensitivity reactions, although somewhat rare, can be very uncomfortable but they are almost always preventable.

Drug-induced photo-sensitivity reactions are abnormal skin reactions that take place when specific medications, either oral or topical, react in the body with sunlight or artificial sunlight, such as tanning beds. They are not the typical sunburn, but may appear as an exaggerated or severe sunburn.

Characterized by itchy or painful eruptions of redness and inflammation on patches of sun-exposed skin, drug-induced photo-sensitivity can be caused by a host of commonly prescribed drugs. From antibiotics and antidepressants to diabetic and blood pressure medications, these drugs can increase the risk of a skin reaction and possibly increase the damaging effects of sunlight UV exposure.

A drug-induced photo-sensitivity reaction may be suspected or diagnosed when only the area of skin exposed to the sun erupts in inflammation. Treatment initially involves identifying the offending drug or chemical and discontinuing its use if possible. If the drug or chemical cannot be discontinued, then the patient should protect him or herself from the sun by using ample sunscreen application or wearing sun-protective clothing. If a tanning bed is the coculprit, this should obviously be discontinued immediately. The reactions typically resolve on their own after these actions are taken. Prevention is always preferred. Your pharmacist can tell you if medications you take are likely to cause reactions. Fair-skinned individuals and those preparing to go on a beach vacation should inquire with their pharmacist about the medications they are taking.

Certain drugs and drug classes are known to be more likely culprits of photo-sensitivity reactions. With this knowledge, it is often possible to forewarn patients to take precautions when they are prescribed these medications. For example, when patients present with a prescription for doxycycline or Bactrim, both antibiotics known to cause reactions, we warn them to wear sunscreen or otherwise cover their skin for the duration of the treatment and perhaps for a few days thereafter. This is especially important during the summer months and when patients will be going on vacation where their exposure might be increased. Sometimes it is prudent to change therapies when sun exposure cannot be limited, or when previous skin reactions have been a problem.

Especially when taking new medications or when sunlight exposure will be greater, talk to your pharmacist about the risk your medication holds when you will be exposed to sunlight. Sometimes extra precaution can keep that vacation from becoming a miserable memory. In the following table, several medications are identified for their potential to cause photo-sensitivity reactions. This is not an exhaustive list.

References:
http://www.ismp.org/newsletters/ ambulatory/archives/200704_2.asp http://emedicine.medscape.com/ article/1049648-overview http://www.merckmanuals.com/home/ sec18/ch214/ch214c.html http://jama.ama-assn.org/content/ 192/11/989.extract