Safe Sun Protection

Updated by Jill Tyrer | April 22, 2024

Protecting your skin from sun exposure is important for everyone, but it’s particularly important for people with certain autoimmune disorders.

“Sun protection is important in general for everyone because of the risk of skin cancer,” says dermatologist Saakshi Khattri, MD, associate professor of dermatology at the Icahn School of Medicine at Mount Sinai in New York City. “Patients with autoimmune diseases are likely on immunosuppressants, which also increases the risk of skin cancer, so it takes on greater importance to sun protect.” 

Additionally, she says, sun exposure can trigger a painful flare in people with lupus. Dermatomyositis also can cause a painful or itchy skin rash on areas that are exposed to the sun. "Rheumatological connective tissue diseases can overlap, [for example] scleroderma patients might have a lupus antibody positive or complain of sun sensitivity, so I just tell all my rheumatic patients about sun sensitivity,” Dr. Khattri says.  

Medications & Sun Sensitivity

In addition to immunosuppressant medications like biologics and Janus kinase inhibitors, which can increase risks of skin cancer, other medications used for arthritis-related conditions also can heighten sun sensitivity. Some people on nonsteroidal anti-inflammatory drugs (NSAIDS) develop increased sensitivity to sunlight.

“Historically we say methotrexate is associated with sun sensitivity,” Dr. Khattri adds. “But what it does is create a reaction called ‘radiation recall,’ so areas where people had sunburns in the past can get irritated when on methotrexate.” 

Protect Yourself

Finding a sunscreen that you like is key to making sure you use enough, she adds. For example, a lot of people don’t like greasy, oily sunscreens unless their skin is dry, and many don’t like the thick creams that leave a white residue on the skin, so they are less likely to use it consistently. 

Once you find one that’s right for you, “make sure you apply it everywhere, especially on the face and ears — and people forget upper chest/neck areas and back of their hands. But if there are other areas that are sun-exposed, they should apply sunscreen there, too,” Dr. Khattri explains. “And most importantly, reapply it if you are out in the sun for extended periods of time or reapply if you are in a pool or at the beach, as water will wash sunscreen off.”

Dermatologists generally recommend an SPF (sun protection factor) of 50 or greater for most people. “We even say higher is better, as there was a small study done looking at different SPF on each side of a face that showed higher SPF is better than lower.” 

Choose “broad spectrum” sunscreen, which protects against harmful UVA and UVB rays. And be aware that a higher SPF doesn’t protect you for a greater amount of time in the sun, but from greater intensity of sun. Use it even on overcast and cloudy days, even though sun intensity is less than on clear days, and try to avoid being in the sun between 10 a.m. and 2 p.m., when the sun is most intense. 

In addition to sunscreen, wear a broad-brimmed hat and consider sun-protective clothing. Coolibar, BloqUV, Solumbra,  Túga Sunwear and UV Skinz  offer a variety of sun-protective clothes.

Sunglasses

Shield your eyes in the sun with lenses labeled as having “broad spectrum coverage” or “protection against UVA and UVB rays.”

Sunglasses that are polarized reduce glare for sharper, clearer vision. Just because lenses are polarized, however, doesn’t mean they offer UV protection, so make sure the lenses are also labeled for UV performance. Use caution if choosing blue-blocking lenses, which are most often yellow or orange. Although these lenses are thought to make vision easier in low light, they may not offer sufficient UV protection.