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Psoriasis and the Sun

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Will the sun help my psoriasis?

Those who have psoriasis find that the sun helps to improve their skin’s appearance. For some the change is dramatic, with red scaly patches almost disappearing altogether during summer months in a warm climate.

Because ultraviolet light is so effective for so many with psoriasis, it is often used in various artificial forms by doctors. Ultraviolet treatment with a sun lamp is often given in hospitals for plaque psoriasis (the most common type) and guttate psoriasis. In severe cases of psoriasis, dermatologists may use a treatment known as PUVA – P for psoralens plus UVA. Psoralens are chemicals found in certain plants which make the skin respond to UVA, the least dangerous form of UV light.

I am too embarrassed to sunbathe

People with psoriasis often face a dilemma ­ they have heard that the sun is good for their condition, yet are loathed to reveal any more of their skin than they are absolutely obliged to. You aren’t alone if you are one of those who wear polo necks, long sleeves and trousers or leggings even on the hottest summer days and never sunbathe.

What are the benefits?

The benefit for psoriasis comes from UVB, one of the forms of ultraviolet light (UV) that comes from the sun. There are three forms: UVA, UVB and UVC. Short wavelength UVC is absorbed by the ozone layer of the atmosphere and doesn’t reach the Earth’s surface at all. The ultraviolet light that does reach us is mainly long wavelength UVA with some intermediate wavelength UVB, it is the UVB rays which help psoriasis.

UVB starts the tanning processes and it is this reddening effect immediately after exposure to the sun that is the healing element in psoriasis. However, too much UVB is not a good thing because it burns. Even UVA is not harmless and too much of both can prematurely age the skin and increase risk of skin cancer, so you really need to take care even if you do find that the sunshine helps your skin. You are at highest risk if you are fair and your skin does not tan easily.

It is recommended that to get the most from the sun for your psoriasis short bursts to sunlight exposure is advisable making sure that all the affected areas have equal and adequate exposure but at the same time avoiding over exposure and sunburn. Please consult your doctor for further advice on this method and advice on spotting sun damage. It should be noted that sunburn can worsen your condition causing psoriasis to flare as it is in theory an injury site. These flare ups to injury sites can trigger the Koebner effect, (psoriatic lesions that appear at the site of injury, infection or other skin problem). Sunburn can also increase the risks of skin cancer and premature ageing. If sunburn occurs a first aid treatment option could be to have a cool bath with soothing oatmeal, bland non­irritant moisturisers. Please consult your pharmacist for additional information in alleviating the pain associated with sunburn injuries. Always seek medical attention for severe sunburn if accompanied by headaches, chills or fever.

Remember:

Whilst the sun can be beneficial it can also be potentially dangerous if not treated with caution. The following tips may help:

  • Do not get overheated
  • Use suitable sunscreens; always use an appropriate SPF for your skin type making sure to protect all unaffected areas of your body to ensure prevention of skin damage and skin cancer.
  • Always make sure to reapply your sunscreen every few hours, after sporting activities and especially after swimming if non waterproof SPF is used.
  • Do not get dehydrated
  • Do not sit in direct sunlight without protection
  • Wear a hat
  • Try and stay out of the sun at the hottest part of the day between 10 – 3
  • Do not over­consume alcohol as this will dehydrate you further and may cause drowsiness
  • Be careful not to get your feet burnt
  • Special care needs to be taken for children and babies
  • Always protect your eyes and avoid direct contact with sunlight

Sunglasses ­ adequate protection of the eyes is essential and wearing good filter UVA and UVB sunglasses will help protect them. Too much exposure to ultraviolet light can produce cataracts. If unsure about your grade of sunglasses talk to your local optician who will be able to advise. Sunglasses sold in retail stores may seem suitable but may not always provide you with the necessary protection you need. If you work or sunbathe in the sun regularly good quality sunglasses are essential. For those having artificial light therapy particular care is needed.

PUVA, Phototherapy treatments – some of these treatments can cause light sensitivity. If you are having any of these treatments please consult your doctor or opticians for expert advice on protecting your eyes. Other topical medications used in the treatment of psoriasis may also cause sensitivity to sunlight. Again consult your doctor regarding advice in the sun and remain cautious about your exposure to sun.

Food and dietary supplements – there are certain foods such as celery for example and certain supplements such as St Johns Wort, that can cause photosensitivity in people. If you are taking these supplements and are embarking on a course of photo light therapy treatment or spending time in the sun again advise your doctor of the supplements that you are taken for further advice and guidance.

Sunlight and skin cancer ­ there is much evidence to support the damage caused by sunlight resulting in skin cancer and premature ageing. Sunscreens, clothing, and good sense can reduce your exposure and damage to skin areas. As always if you are worried or see anything that appears on your skin it is advisable to get this checked for peace of mind or reassurance.

Use and safety of tanning beds

It should be noted that commercial tanning beds in salons usually release UVA light and NOT UVB which is used in phototherapy treatment in hospital units. Both UVB and UVA rays are found in natural sunlight but the benefits of sunlight is usually due to the UVB element. It is not usually advised by healthcare professionals to use tanning beds but if people do have restricted access to UVB, PUVA and natural sunlight this may be an option. Further professional guidance should be sought before any tanning sessions are booked. There is still much controversy from healthcare professionals about the use of tanning beds and sun lamps because they are said to transmit doses of ultraviolet radiation which can damage the skin, increase the risk of skin cancers and cause premature ageing. It is also advisable if you do want to book such sessions to find a reputable tanning salon and advise them of your condition so that they can take precautions bearing in mind your condition. If you are on any courses of medication for your psoriasis always consult your doctor before booking the sessions as they may cause additional sensitivity to your skin. Another point to bear in mind when finding a reputable salon is how often their tanning beds are maintained and their bulbs checked for UV output. Bad maintenance may cause serious sunburn injuries to people and trigger flareups in those with psoriasis.

Travelling abroad

When travelling abroad please bear in mind that you may need extra protection in other countries due to extra hours of daylight, stronger UVA and UVB rays and climatical conditions. It is essential to bear this in mind when choosing adequate sunscreens, clothing, headwear etc.

This article is adapted from the Psoriasis and the Sun leaflet. 

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Further information

Always consult a doctor or your healthcare provider

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