Skin rash after taking antibiotics

There are some drugs that can cause photosensitization of the skin. This means that the photosensitivity of the skin increases. This can lead to phototoxic or photoallergic reactions when exposed to sunlight.

However, it is often not possible to differentiate between these two exactly. The result is skin rashes, which are characterized by various skin symptoms such as redness, papules, pustules, blisters or nodules. Itching can also be characteristic.

One group of drugs that can lead to such reactions are antibiotics. However, not all antibiotics are equally capable of photosensitizing the skin. In particular, the group of tetracyclines, can cause rashes, itching and increased sensitivity of the skin when exposed to sunlight.

The so-called doxycycline is particularly important here. It is used, for example, for respiratory tract infections such as pneumonia. Another area of application is infections of the ear, nose and throat area such as sinusitis or middle ear infection.

Doxycycline is also used to treat infections of the urogenital and gastrointestinal tract. The field of application is therefore very large. When taking tetracyclines, one should avoid sunbathing, visits to solariums and a long stay in the sun (e.g. gardening) to prevent a rash.

Besides tetracyclines, the so-called gyrase inhibitors are also known to cause phototoxic reactions in the skin. Gyrase inhibitors include the fluoroquinolones, which contain various active ingredients. They are often used in the treatment of urinary tract infections. These include norfloxacin, ciprofloxacin or ofloxacin. Other fluoroquinolones are levofloxacin and moxifloxacin, which are also used for respiratory tract infections.While taking these antibiotics, the skin should also not be exposed to the sun, as this can lead to rashes and sunburn.

Therapy

The therapy of a skin rash caused by the sun depends on the underlying cause. Since sun rays can cause different skin rashes, the therapeutic approaches also differ in some cases. The following section is intended to provide a compact overview of the most important skin rashes caused by the sun and their treatment options.

SunburnDermatitis solaris: In the event of sunburn, it is recommended to first apply cooling and moist compresses to the affected skin areas. Cooling relieves the inflammation and has a pain-relieving effect. In case of light sunburn, gels, ointments and creams containing corticosteroids (e.g. betamethasone) are also used.
For more severe sunburns, systemic therapy with anti-inflammatory and pain-relieving agents such as diclofenac is recommended. These are taken as tablets. If necessary, skin compresses with antiseptic additives are also used.

You can find more about this topic under Sunburn Treatment
Polymorphic light dermatosis: In the case of a polymorphic light dermatosis, the first priority is the consistent avoidance of sun exposure, since the skin rash is caused and maintained by UV-A radiation. However, if further exposure to sunlight is avoided, the rash usually heals within a week without any consequences. If the skin is nevertheless exposed to the sun, consistent sun protection in the form of tightly woven clothing and sunscreen is important.
It is still possible to get used to the light, which is applied 4 to 6 weeks before a stronger exposure. For this purpose, a slowly increasing whole body irradiation with UV-B rays is carried out. The purpose of this is to “harden” the skin and prepare it for the sun’s rays of spring and summer.

In very severe cases, a so-called PUVA therapy is also considered. PUVA stands for psoralen plus UV-A. Psoralen is a substance that sensitizes the skin to UV radiation.

Psoralen is applied to the skin and then irradiated with UV-A rays. Psoralen can also be taken in tablet form.
In addition to the therapeutic options mentioned above, local glucocorticoids can be used to treat fresh skin changes. The benefit of antihistamines against itching is controversial, therefore they are used rather cautiously.
Phototoxic/photoallergic dermatoses: In the foreground is the avoidance of the triggering substances, e.g. drugs, cosmetics and the like, as well as consistent sun protection. In the acute stage glucocorticoids can be applied in the form of ointments and creams.
Many botanicals act as a home remedy for a rash by calming and moisturizing the skin.