Published on 25. July 2017

Watch out for sun allergy

Sun allergy is not sunburn. Prof. Dr. Wiebke Ludwig-Peitsch, head of dermatology at Vivantes Friedrichshain Hospital, explains the symptoms and what can be done about them in this interview.

Interview with Prof. Dr. Wiebke Ludwig-Peitsch on the subject of sun allergy

This summer has been rather rainy – all the more dangerous sun rays can affect the skin on vacation. Prof. Dr. Wiebke Ludwig-Peitsch, Chief Physician of the Clinic for Dermatology at the Vivantes Friedrichshain Hospital explains what to look out for.

How do you recognize that you don't have sunburn (dermatitis solaris in medical terminology), but a sun allergy?

Prof. Dr. Wiebke Ludwig-Peitsch: Sunburn is characterized by reddening and burning of the skin, and in severe cases by blistering. It is limited to areas of the body that have been in contact with the sun and occurs within a few hours after sunbathing.
The popularly used term "sun allergy" is somewhat misleading. This usually refers to polymorphous light dermatosis (PLD), which is not actually an allergy. It only occurs in people who have a special predisposition to it. In Central Europe, this is 10-20% of the population. The symptoms of PLD are polymorphic; however, they are always similar in the same patient. They can be papules (small nodules), vesicles (blisters), pustules (pimples) or plaques (red, raised areas), which sometimes appear the day after sun exposure and are accompanied by severe itching.

How dangerous are the symptoms of sunburn and the so-called "sun allergy"?

Ludwig-Peitsch: A large-area, severe sunburn can be quite threatening and may also require hospitalization. In particular, a doctor should be consulted if symptoms such as blistering, fever and chills occur.  PLD can be very unpleasant due to itching and also require a visit to the doctor.

What can you do immediately if you have already been in the sun?

Ludwig-Peitsch: First, you should avoid further UV radiation, go into the shade or into a light-protected room and cool the sunburn with cold compresses. Cooling gels or lotions are also helpful. Against itching can be taken anti-allergic tablets (antihistamines), which are available over the counter in pharmacies, against pain anti-inflammatory tablets (non-steroidal anti-inflammatory drugs). In cases of more severe sunburn or PLD, a cream containing cortisone may also be prescribed. In very severe cases, cortisone tablets are sometimes necessary for a short time.

Of course, prevention is especially important. Careful application of sunscreen is necessary not only before sunbathing, but also after swimming and when you have been sweating. The sun protection factor should be selected according to the skin type and the strength of the sun exposure. If you have fair skin (skin type 1 or 2) and are going on vacation to the south, sun protection factor 30-50 is appropriate.

Is there any hope that one day you will be able to go out in the sun again, because the so-called "sun allergy" will disappear?

Ludwig-Peitsch: PLD usually occurs during the first sun exposure in spring, when the skin is not yet accustomed to the sun. As the summer progresses, the symptoms diminish. This phenomenon can also be exploited therapeutically. In the case of severe PLD, the dermatologist can perform a so-called "light hardening", in which the patients are irradiated in light cabs before the beginning of summer and thus accustomed to UV light.

Are there other diseases that can be similar to sun allergy?

Ludwig-Peitsch: Far less common than sunburn and PLD can be photoallergic eczema, which is actually based on an allergy.  The allergens are found, for example, in sun creams, cosmetics or medications that have an allergenic effect in combination with the sun. In this case, symptoms can also develop on parts of the body that the sun has not directly reached, often in the form of scattered lesions.

In addition, there are phototoxic reactions. In these cases, the skin reaction is caused by contact with substances that have a toxic effect in combination with sunlight. These can be, for example, plant ingredients, essential oils or medications such as certain antibiotics and St. John's wort.

 
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