Protecting your skin against lighting used in surgery and other medical procedures
As you may already know (perhaps through personal experience!), many people with lupus are sensitive to light. This is a condition known as photosensitivity. Different kinds of light have different effects on the body. Ultraviolet light, which spans wavelengths between 40-400 nanometers, is thought to be the portion of light most frequently responsible for the skin lesions that people with lupus develop. However, studies have demonstrated that people with lupus may also be sensitive to visible light, which is the portion of light spanning 400-700 nanometers.
Surgical lights plainly emit visible light and can also emit small amounts of ultraviolet light. Studies have shown that people who are especially photosensitive may develop reactions to these kinds of lights. It is well-established, for instance, that people with a condition called erythropoietic protoporphyria can develop phototoxic injury to their skin and internal organs during long surgical procedures under strong surgical lights. However, certain measures may be taken to decrease the likelihood of reactions. Flexible membrane filters, such as UV Gard from Madico Co., are available to cover surgical lights and offer some protection for wavelengths from 300nm and above. They are transparent films traditionally used to adhere to car windows to block UV light. The films can be ordered directly from the manufacturer, and users may then cut the films to customize them to the shape of the surgical light. The films contain an adhesive backing that is removed before placement on the surgical light. When the procedure is complete, they peel off the light and can then be discarded.
In addition, certain kinds of lightbulbs such as double-enveloped compact fluorescent lightbulbs and light emitting diodes (LEDs) appear to emit lower levels of ultraviolet light on average than other fluorescent lightbulbs. They therefore may be preferable for photosensitive people. Placing lightbulbs at a greater distance from the skin also decreases the amount of ultraviolet light that reaches the skin. The Health Protection Agency, for instance, recommends that compact fluorescent lightbulbs should not be used at a distance of less than 30 centimeters. Finally, people with special sensitivity to ultraviolet light should consult their physicians about avoiding medications that enhance photosensitivity for the period of time leading up to elective surgical procedures.
- Moseley, et al. The risk to normal and photosensitive individuals from exposure to light from compact fluorescent lamps. Photodermatology, Photoimmunology, and Photomedicine 27, 131-137.
- Fenton, et al. Analysis of energy saving lamps for use by photosensitive individuals. Photochemical and Photobiological Sciences11, 1346.
- Fenton, et al. Impact assessment of energy-efficient lighting in patients with lupus erythematosus: a pilot study. British Journal of Dermatology 170, 694-698.
- Eadie, et al. A preliminary investigation into the effect of exposure of photosensitive individuals to light from compact fluorescent lamps. British Journal of Dermatology 160, 659-664.
- Klein, et al. The risk of ultraviolet radiation exposure from indoor lamps in lupus erythematosus. Autoimmunity Reviews 8, 320-324.
- Wahlin, et al. Protection from phototoxic injury during surgery and endoscopy in erythropoietic protoporphyria. Liver Transplantation 14, 1340-46.
Victoria P. Werth, MD
Professor of Dermatology at the Hospital of the University of Pennsylvania
Dr. Werth specializes in autoimmune skin disease and cutaneous Lupus Erythematosus. Read Bio