Summer fun in the sun could mean a bad burn for some taking certain prescription drugs — and sometimes even a few common over-the-counter medications — if they fail to protect themselves properly before heading outdoors.
Although most might not think twice about taking Motrin for a headache before heading off for a day of swimming or baseball, the pain reliever can cause them to become extra sensitive to the sun.
North Adams dermatologist Victoria Cavalli said she most commonly sees photosensitivity — an increase in the reactivity of the skin to sunlight — in her patients with hypertension who take diuretics like hydrochlorothiazide or Lasix. However, those who take non-steroidal anti-inflammatories like Motrin or Naprosyn, too, can become photosensitive, she said.
People on medications that can cause photosensitivity could spend a day in the sun "and have a much worse burn than you would have imagined," Cavalli said.
"The drug that I prescribe the most that causes the problem are tetracycline drugs (used to treat infections and acne). It's very common," she said. "I always tell people, 'You may become more sensitive to the sun.' I have a lot of folks who are not any more sun-sensitive and they're fine, but I've had a couple of people who have gotten second-degree burns because they just didn't
"It sensitizes your skin to exposure to ultra-violet radiation," said Mark Kester, the pharmacy manager at North Adams Regional Hospital. "So whether it's sun or sun tanning booths, you're more sensitive to the exposure. You're going to get suntanned and burned quicker."
According to www.healthatoz.com, there are more than two dozen drugs that can cause photosensitivity. Its primary symptom is sunburn, which is rapid and can be severe enough to blister.
Sulfa drugs — such as Bactrim or Septra — used to treat maladies like urinary tract infections also can cause photosensitivity, Kester said.
Chlordiazepoxide, used to treat anxiety, as well as dacarbazine — an anti-cancer medication and chemotherapy drug, too, can cause the problem. Likewise, antibiotics like ciprofloxacin, lomefloxacin, ofloxacin and nalidixic acid, as well as retinoids — which are used to treat acne — also can cause photosensitivity.
"Some people have that reaction and some people don't," Kester said. "It's not always 100 percent. ... But if you're a person with sensitive skin anyway and often have to avoid the sun, you're going to be even more at risk (for photosensitivity) with these kinds of medications. You have to be more careful."
While many doctors and pharmacists warn their patients about certain side effects for medications, both Kester and Cavalli said it's a good idea that people carefully read through the information that accompanies their prescriptions.
Kester said the typical recommendation to people who take medications known to cause photosensitivity is to not sunbathe and to use sunscreen. They also should wear a long-sleeved shirt and a hat when they go outside.
"Don't go (unprotected) in the bright sun while you're taking the medications," he said.
Kester is speaking from experience. Years ago, while taking a prescribed medication known to cause photosensitivity, he went out in the sun without wearing sunscreen or protective clothing.
"I didn't think about it," he said. "I definitely got burned, like right away. I was just out cutting the lawn."
While some reactions happen after only about 10 minutes of exposure to sun and most are realized in the form in a sunburn immediately after sun exposure, occasionally reactions will not occur until several hours or even days later.
Some people may develop hives or itching, according to the Osceola County Extension at the University of Florida.
People taking a new medication who notice they are more sensitive to the sun should mention it to their doctor as a possible side effect, Kester said. He said photosensitivity reactions to Motrin are not common.
According to Cavalli, when people do have such a reaction to that medication, it is not as severe the reactions she sees in people taking thiazide diuretics or the tetracycline family of drugs.
With an ibuprofen drug like Motrin or naproxen sodium drugs like Aleve or Naprosyn, "People are just getting sunburned quicker than they would normally get sunburned. It's not a prescribed drug so they're probably not going into doctors' offices with it," Cavalli said.
She pointed out that because people could be more likely to get a sunburn while on certain drugs, they are more susceptible to skin cancer — something she sees in her practice every day. About 80 percent of her time is spent with patients with skin cancer. And, those patients are getting younger, with an increasing number of them being in their 20s and 30s, said Cavalli.
In addition, prolonged exposure to ultra-violet radiation leads to premature aging of the skin and wrinkles, irregular pigmentation, brown and red spots and more.
"Motrin's a good drug," Cavalli said. "Just wear a lot of sunscreen and a hat, and just be aware that you may be more susceptible to burning much more quickly than you normally would."
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