The sun allergy or photoallergy is a colloquial collective term for all skin problems that arise or are promoted by sunlight. In the narrow sense, sun allergies are called light dermatoses because they affect the skin, which has reactions due to exposure to sunlight. In a broader sense, various metabolic diseases or autoimmune diseases are also popularly referred to as sun allergies. Symptoms of various types from itching to redness to severe changes in the skin occur in association with sunlight.
What is a sun allergy?
Red skin and itching after sun exposure? That could be a sun allergy. A sun allergy (photoallergy) is an umbrella term used to describe the occurrence of skin symptoms caused by exposure to light. They occur over a period of a few hours to a few days and manifest themselves in the form of redness, wheals, nodules, blistering, scarring, pustules and thickening. In addition, sufferers of sun allergy experience extreme itching and severe burning. However, these symptoms can vary greatly, as sun allergy as such is not a disease, but encompasses various causes. An accurate diagnosis must be made in order to treat sun allergy.
Causes
Sun allergy is rarely an allergic reaction to sunlight per se. Rather, causes such as allergies to other substances, autoimmune diseases, or metabolic disorders play a role. The most common are polymorphous light dermatosis (PLD) (overexposure of the skin, which is not accustomed to light), “Mallorca acne” (similar to PLD, but slightly different appearance) and photoallergic reactions. For example, in the photoallergic reaction, a sun allergy turns out to be meadow grass dermatitis, a reaction of the skin to certain meadow grasses in combination with exposure to light. Here, light is perceived as the cause, but is actually only one component of the overall reaction. Sun allergy can also occur as an overreaction of the skin to unaccustomed exposure to UV-A or UV-B radiation. Other explanatory models attribute the development of a sun allergy to free radicals. The cause of sun allergy must therefore always be determined individually in each case. Sun allergy is rarely a true allergy. Much more often, the respective diseases are due to the fact that the skin reacts intolerantly to sunlight or certain rays it contains. Particularly frequently, as already noted, the skin reacts to various forms of UV radiation. Polymorphic light dermatosis, also known as Majorca acne, is a classic type of sun allergy – in which changes in the skin occur in various areas of the skin due to exposure to UV-A and UV-B rays. In the autoimmune disease lupus erythematosus, which is also known as sun allergy, the changes in the skin are often more severe when it has been exposed to sunlight. However, sunlight also causes other symptoms in the affected person, such as headaches or fever. The metabolic disease porphyria is also not an allergenic reaction; the person merely reacts to sunlight with increased sensitivity and may experience pain without the sunlight visibly harming him or her.
Symptoms, complaints and signs
A sun allergy – which is not actually a classic allergy – is accompanied by itching and other skin changes, such as blistering and pustules. The symptoms can also occur hours or days after being in the sun. Depending on the person, the symptoms appear differently, but in repeated cases always the same. Light-skinned people are more often affected than dark-skinned people. The skin begins to itch and burn. Another sign is skin redness in the form of reddish spots. The development of nodules, blisters or even real blisters is also a symptom and in the worst case the skin swells. Often, sun allergy occurs when the skin has not been exposed to sunlight for a long time. This means that this disease develops especially in spring or summer. Possible, however, also on vacation abroad in different climatic conditions than in the home country in summer as well as in winter.Parts of the body that were covered in winter or during the colder season are now exposed to the sun. This mainly affects the neck, décolleté, arms, back of the hands and legs. Since the face is not covered in either cold or heat, sun allergy occurs less here.
Complications
If excessive sun exposure occurs despite sun allergy, discomfort and complications can occur. In addition to the typical skin irritations – itching, redness, blistering – burns and severe inflammation may occur. Accompanying allergic symptoms such as watery eyes occasionally occur. In severe cases, visual disturbances such as visual field loss and veil vision may occur. Further complications arise if these complaints are not treated. For example, the skin changes can develop into serious infections or chronic pain can set in. After prolonged exposure to the sun, scars or pigmentary disorders occasionally develop. Typical treatment methods such as photochemotherapy also carry risks. For example, corneal and conjunctival inflammations repeatedly occur in connection with light therapy. Liver spots and pigmentary disorders also develop. Exposure to light causes the skin to age prematurely and wrinkles and other cosmetic blemishes to form. After taking antihistamines, headaches, dry mouth and drowsiness may occur. In addition, serious kidney and liver damage can occur if the drug is taken regularly. Severe complications occur with overdose or interactions with other medications or existing medical conditions.
When should you see a doctor?
Changes in the appearance of the skin should always be presented to a doctor. If there is pain on the skin, the formation of spots or an unpleasant itching, clarification of the cause is advisable. If open wounds develop as a result of scratching the affected areas of skin or if signs of inflammation appear, a doctor is needed. There is a risk of blood poisoning if wounds are not treated in a sterile manner. This poses a potential danger to life and should be examined by a physician as soon as possible. Nodules on the skin, blisters, or discomfort when touched should be examined by a physician. There is particular concern if the discomfort increases continuously or multiplies with exposure to sunlight. A physician should be consulted in a timely manner, as sun allergy often results in a rapid increase in symptoms and a marked decrease in well-being. With adequate medical care, relief of symptoms is initiated. Swelling, redness of the skin, and interference with movement or a resting position are indications of a health disorder that should be discussed with a physician. Sun allergy usually occurs on the back of the hand or legs of the affected person. If clothing cannot be worn without discomfort or if a decrease in physical performance occurs, help should be sought.
Treatment and therapy
If a sun allergy is present in an acute case, the extreme irritation of the skin must first be reduced. Cortisone preparations such as ointments and creams are used for this purpose. In extreme cases, internal application via tablets is also an option. Usually, this cortisone treatment is kept as short as possible, as cortisone can cause significant side effects. There is no blanket treatment for the symptoms of sun allergy. Depending on the underlying disease, treatment must be different. In some cases, the changes in the skin are treated directly, but in other cases this would do little good, which is why it is primarily the individual disease that must be combated. In the case of polymorphous light dermatosis, allergic attacks can play a role, which are combated with antihistamines. However, these only help in the case of genuine sun allergies; in all other forms they remain ineffective. In turn, various medications can be prescribed to treat the changes in the skin. For example, to combat blackheads caused by sunlight, creams containing cortisone are applied. In the case of autoimmune diseases or metabolic disorders, changes in the skin are treated individually, as they are not blackheads, but reactions. However, the accompanying treatment of the underlying disease is important.In the case of autoimmune diseases, an attempt is basically made to prevent the immune system from reacting defensively to the respective influence, which should also alleviate the symptoms. The same treatment principle also applies to metabolic diseases, which are considered to be sun allergies. Nevertheless, in patients with frequent skin problems, permanent treatment with lighter preparations is not always avoidable. If irritation is present, the skin must be protected from further irritation. Intensive sun protection using products with UV filters and protection of the skin by wearing clothing that covers the skin as much as possible are important means of protecting the skin. In the case of very severe skin irritations, the administration of antibiotics may be necessary, as germs could penetrate through open skin lesions (for example scratched open pustules) and penetrate the irritated immune system. In addition to relieving the skin of irritation and regenerating it, the causes of sun allergy must be clarified and treated first and foremost.
Prevention
The development of the diseases called sun allergy can hardly be actively prevented. Especially autoimmune diseases develop independently of factors that the patient can influence himself. The symptoms of the respective diseases, on the other hand, can be prevented much better. As a rule, it is advisable to stay away from sunlight if possible, if it is harmful to the skin. Some extreme manifestations even require this in order to avoid worse symptoms of the disease for the most part. In less severe cases, you can go out in the sunlight, but you should make sure that you have effective protection from UV radiation. An effective sunscreen is the absolute basic requirement for spending time in direct sunlight. Since acute treatment of sun allergy can be lengthy and the symptoms are agonizing for the patient, the major part of its treatment thus lies in prevention. This means, above all, protecting the skin from intense or prolonged exposure. Constant use of UV protection and the best possible protection by clothing are advisable, because constant avoidance of the sun is neither possible nor really effective in the long run, as the skin becomes more and more sensitive that way. Taking carotene has a positive effect on the skin’s own protection, but must be supervised by a doctor, especially in the case of smokers. In addition to skin protection, a slow habituation of the skin to light (desensitization) is recommended. Usually this is done by therapeutic irradiation of the skin under medical supervision.
Aftercare
As a rule, the measures and options for direct aftercare are significantly limited in the case of a sun allergy, and in many cases they are not even available to the affected person. Therefore, the affected person should in any case turn to a doctor at an early stage in this disease and thereby also possibly initiate treatment, since it can also not come to an independent cure. In general, the person affected by sun allergy should avoid the direct sun in any case and protect himself particularly well against the sun. Sun creams and various ointments should be applied to protect the skin well from the sun. Likewise, direct exposure to the sun should be avoided. The sufferers of sun allergy are advised to have regular checkups and examinations by a doctor to possibly detect and treat skin cancer and other skin conditions at a very early stage. It may also be necessary to take various medications for sun allergy. It is always important to ensure that the medication is taken regularly and in the correct dosage. The sun allergy itself usually does not reduce the life expectancy of the affected person.
What you can do yourself
People with sun allergy should adequately protect themselves from exposure to UV light. Direct exposure of the affected person’s skin or body to the sun should be completely avoided in everyday life. The wearing of clothes that lead to a good covering of the skin as well as the head is advisable. Wide and long garments that provide complete coverage of the limbs are recommended. If possible, an umbrella or a slightly larger head covering should be used so that the face is also adequately protected. In addition, the skin should be provided with a care product. A sunscreen with a sun protection factor or a prescribed preparation from a doctor is recommended.The latter is often tailored to the needs of the affected person and therefore produced individually. At the first allergic reactions of the organism should be reacted immediately. Finding places in the shade is essential in this respect. It is important that the affected person develops various strategies to protect himself in everyday life from sudden and unexpected exposure to the sun. When leaving the house, people should always take precautionary clothing or objects with them, which can be of additional help in protecting themselves from sunlight. In everyday life, places with little shade, such as visits to the beach, should be kept to a minimum or should only take place after a sunset.
