Sun safety and rheumatology information sheet
Contact details
Phone: (02) 9382 1597
Email: [email protected]
Introduction
In summer, UV levels are highest or most extreme between 9am and 4pm. If you are out during the peak UV time, be sure to follow Slip, Slop, Slap, Seek and Slide.
Protecting your child from sun
The Cancer Council tell us there are five ways to protect avoid sun exposure: Slip, Slop, Slap, Seek Shade and Slide on the sunglasses.
When you are outdoors, remember to wear long shirts and long sleeve rashies and long pants. Tightly woven or dark fabric offers the best protection. Some companies specialise in high-UPF (Ultraviolet Protection Factor) clothing, hats, and umbrellas. The Cancer Council sells a range of high-UPF clothing.
Even on cloudy days, we are still exposed to about 80% of the ultraviolet light present on a sunny day. Recreational activities near water require additional caution as water reflects up to 80% of the sun鈥檚 rays.
Window glass blocks UVB light however, UVA can still penetrate. Since UVA can worsen lupus and JDM, light penetrating through windows can flare disease. Protective window films applied to car windows or windowpanes can offer additional protection.
Sunscreen needs to be applied according to instructions and should not be used as the only line of defence against UV. When the UV Index is above 3, protect your child using sun protective clothing, SPF30+ sunscreen or higher, wearing a broad brim hat and sunglasses.
Sun exposure and flare-ups
Sun exposure can cause a flare in people with connective tissue disease or rheumatological conditions.
- sunlight contains harmful ultraviolet rays that increase the risk of skin cancer.
- sunlight that reaches the Earth鈥檚 surface contains two types of ultraviolet (UV) light: A and B.
- UVB light is more damaging, causing sunburns and altering DNA in the body鈥檚 cells.
- sunlight contains about 10-20 times more UVA light, which penetrates the skin more deeply.
- both forms of UV radiation cause premature aging of the skin.
Sun protection is especially important for people with connective tissue disease, such as juvenile dermatomyositis (JDM), systemic lupus erythematous (Lupus) or scleroderma.
Juvenile dermatomyositis (JDM)
For children with JDM, rashes arise in sun-exposed areas, such as the scalp, face, V-neck chest, and shoulders. These rashes can burn, sting or itch. This can also lead to a flare on the skin but also may lead to muscle symptoms as well.
Lupus
For young people with Lupus, sunlight (both UVA and UVB light) leads to a variety of symptoms ranging from skin rashes to internal organ damage, that continues weeks to months after exposure to the sun. UV light can trigger the butterfly rash of lupus and cause scarring in chronic lupus lesions of the skin.
Scleroderma
Some children with scleroderma are photosensitive and develop rashes or sunburns quickly. UV light can also worsen the hyperpigmentation or darkening of scleroderma skin.
Sun light and medication聽
It is important to recognise that many medications cause the skin to be more sensitive to light, also known as photosensitising, which can be seen as sunburn or rashes developing after brief exposure to UVA radiation.
Common photosensitising drugs include:
- antibiotics (eg. Bactrim, Cipro, Levaquin, Doxycycline and other tetracyclines)
- antimalarials (eg. Plaquenil)
- blood pressure medications (eg. Diltiazem/Nifedipine, Hydrochlorothiazine)
- immunosuppressant drugs (eg. Azathioprine, Methotrexate)
Some immunosuppressant medications, such as azathioprine and cyclosporine, used to treat some of these illnesses may also increase the risk of skin cancer.
Despite the challenges in keeping your child well protected from the sun, it is a critical aspect of care for children with any of the above conditions, or for those taking a photosensitising medication.