Expert Q&A: RA Medications and Sun Exposure

Question: Can RA and my RA medications make me more susceptible to sun exposure?

Answer: Unlike lupus, which may be worsened or triggered by sun exposure, RA itself is not affected by sunlight. However, some of the medications commonly used to treat RA – including hydroxychloroquine (Plaquenil), methotrexate and nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen (Naprosyn) or celecoxib (Celebrex) – can cause reactions such as rashes or sunburn with ultraviolet (UV) light exposure. Methotrexate may also cause rashes in areas of prior sunburn or sun exposure, a phenomenon known as radiation recall. To prevent these reactions, it’s important to avoid prolonged exposure during hours of peak sun intensity (10 a.m.- 2 p.m.), use a broad-spectrum sunscreen (particularly one containing titanium dioxide and zinc) and wear protective clothing, hats and sunglasses. If a significant sun reaction does occur, evaluation by a dermatologist may be helpful. Finally, immunosuppressive medications, particularly biologic medications (i.e., TNF inhibitors such as Enbrel and Humira) may increase the risk of non-melanoma skin cancers. We therefore recommend that our patients with RA undergoing these treatments have annual skin checks by a dermatologist.

Sheila Arvikar, MD

Rhematologist

Harvard Medical School/Massachusetts General Hospital, Boston