Importance of sun protection in systemic lupus erythematosus patients

Lupus Systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is a complex autoimmune disease that affects various organs and tissues in the body. One of the key triggers of SLE flare-ups is exposure to ultraviolet rays from the sun. About one-third of SLE patients end up getting butterfly rashes due to exposure to the sun, which may worsen without necessary precautions. It is important to understand the relationship between sun protection and SLE

The sun-SLE connection 

UV radiation from the sun can activate immune responses in individuals with SLE, leading to skin inflammation, rashes, and other systematic symptoms. This phenomenon is known as photosensitivity. When UV rays penetrate the skin, they can trigger an immune response that exacerbates SLE symptoms. Common symptoms triggered by sun exposure include joint pain, skin rashes, fatigue, and severe internal organ involvement.  

Photosensitivity is defined as a skin rash because of an unusual reaction to sunlight. Photosensitivity is common in patients with lupus, and about 70% of patients with SLE observe that their disease worsens upon exposure to UV rays from sunlight or artificial light. 

Tips for effective sun protection 

Sunscreen:  It is essential for everyone to apply before being exposed to the sun, and individuals with lupus should be extra diligent in doing so. Always use a broad-spectrum sunscreen with a high sun protection factor (SPF) of at least 30 and apply it generously to all exposed areas of the skin, even on cloudy days. Sunscreen should be applied 20 minutes before going out in the sun and reapplying after every two hours is essential. Individuals with lupus should avoid prolonged sun exposure as it may trigger rashes commonly known as malar or butterfly rash. 

Seek shade: While staying outdoors, try to stay in the shade, especially during peak sun hours. This can significantly reduce your exposure to UV radiation and help control lupus flare-ups. 

UV-blocking sunglasses: Protect your eyes with sunglasses that block both UVA and UVB rays. UV radiation can also worsen eye complications in SLE patients. 

Limit exposure: It is safe to plan outdoor activities early in the morning or later in the afternoon to minimize sun exposure. Avoid tanning beds, as they emit UV radiations that can trigger flare-ups. 

Protective clothing:  While completely avoiding the sun might not always be feasible, individuals with SLE should consider shielding themselves using clothing. Choose garments that provide ample coverage, like long-sleeved tops, trousers, and broad-brimmed hats.  It is ideal to select clothing designed with UV protection to effectively block detrimental sun rays. 

Indoor UV radiation: Individuals can also get exposed to UV radiation while staying indoors. Halogen, fluorescent bulbs, and photocopy machines in offices can also emit UV radiation, which can flare up the symptoms of SLE. Windows also do not provide full protection from UV radiation. Therefore, using shades, filters, shields, and blinds can help in limiting exposure to UV radiation.  

Medications: Some lupus medicines can heighten the skin sensitivity to the sun. So, it is important to discuss with the healthcare provider about such medications, and adjusting the medication regimen might be necessary to manage photosensitivity. 
Regular check-ups: Schedule regular visits with the healthcare provider to monitor SLE symptoms and overall health. They can guide in managing photosensitivity and other SLE-related concerns. 

Sun protection is very important in the management of SLE, and the use of protective creams should be greatly encouraged whenever a patient is exposed to any source of UV light. For individuals living with SLE, sun protection is not merely a recommendation; it is a crucial part of managing their conditions and preventing flare-ups. By taking proactive steps to shield themselves from harmful UV radiations, SLE patients can significantly reduce the risk of exacerbating their symptoms and experiencing unnecessary discomfort. Sun protection is not just a choice-it is an essential component of living well with SLE.