From the Archives: Summer 2008 issue of Lupus Now
How to live with sun sensitivity
by Mary Dixon Lebeau
Like most people, Laurie Boswell has a routine each morning before leaving her house and going to work. But Boswell’s routine includes more than the typical face scrub, cup of coffee, and tooth-brushing. Before she goes out, Boswell, 47, also has to prepare herself for the light -- both sunlight and artificial -- that she’ll face during the day.
As many people with lupus know, the road to diagnosis can be long. For Boswell, the sun shed light on the problem.
When Boswell moved from Florida to the West Coast, she immediately noticed she reacted more strongly to the sun. "If I was out in the sun for too long, I would get an itchy rash," says Boswell, a senior administrative clerk. "I just assumed the UV rays were stronger on the West Coast than on the East Coast." In the summer of 2006, Boswell developed a cutaneous lupus rash. "I had an all-over rash that did not look like hives. At first it started in just one small area and was diagnosed as fungal. After it spread all over and was biopsied, it was diagnosed as cutaneous lupus," she says.
Photosensitivity -- abnormal sensitivity to light -- is common in people with cutaneous lupus. Often, the sensitivity causes skin lesions, rashes or sores, fatigue, and joint pain. And often, going indoors doesn’t provide relief. To understand why, it may help to understand the basics of UV lighting -- better known as ultraviolet rays.
You’re Not Being Oversensitive
The sun radiates a variety of rays, most notably ultraviolet A (UVA) and ultraviolet B (UVB) rays. UVA rays are equally intense throughout the day and the year, while UVB rays are significantly stronger in summer, especially between 10 a.m. and 4 p.m. Unfortunately, those with lupus can be sensitive to both UVA and UVB rays, though many find relief by avoiding direct sunlight between 10 a.m. and 4 p.m. This same sensitivity can extend to indoor fluorescent light.
"My lupus patients always want to know why they must avoid significant sun exposure. Why am I spoiling their fun?" says Thomas J.A. Lehman, M.D., chief of the Division of Pediatric Rheumatology at Cornell University’s Sanford Weill Medical Center.
"The truth is that the sun -- any source of ultraviolet light -- damages our skin. These high-energy light rays penetrate into skin and damage the superficial cells," Lehman says.
Now living in Nevada, Boswell recently experienced this firsthand -- this time indoors. In February 2008, she had a flare that started with hives and a low-grade fever. She felt extremely worn out, especially after being at work. It turned out to be related to her workplace environment.
"I sit in a cubicle that is surrounded by fluorescent lights," Boswell explains. "I noticed I was itching whenever the lights were shining on my body."
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