Sensitive skin turns red more easily

Increasingly light-sensitive skin: causes and help

Spring air and sunshine - when the days get lighter, tired spirits also come back to life. However, if you are overly sensitive to light, you should now be on your guard. If your own skin were not perfectly protected against light, it could "burn" immediately. Of course, UV light also naturally endangers very fair-skinned people. You can expect sunburn after just a few minutes of exposure to strong sunlight.

But this is a reaction of "normal skin" to excessive sun and is not comparable to abnormal light reactions of the skin such as with photodermatoses. Here the skin is attacked "arbitrarily" by sunlight, mostly UV light, sometimes even behind glass or through clothing. Conventional sunburn in this way is hardly possible. Some people even have problems with daylight.

As a result, acute and chronic skin reactions are possible. These can appear immediately - sometimes massive -, but sometimes only after days or weeks. Phototoxic light reactions occupy an intermediate position: They express themselves like a sunburn. In addition to the influence of light, a prerequisite is a light-sensitive substance with which one has come into contact.

1. Light diseases of the skin - at a glance

  • Skin that is more sensitive to light reacts abnormally under the influence of light with various types of rashes (photodermatoses, also photodermatoses).
  • For example, substances that damage the skin in connection with UV light (phototoxic, can affect everyone; not so rare) or that trigger a skin allergy (photoallergic, does not affect everyone because of their individual predisposition, rather rarely) can be responsible.
  • "Sun allergy" is not an allergy, just like "Mallorca acne" is not acne. Rather, they are polymorphic light dermatoses. They belong to the group of photodermatoses of unknown cause. Phototherapy can sometimes help.
  • UV light can also worsen or cause skin symptoms associated with internal illnesses or skin diseases.
  • Sun protection and avoidance of the sun, rarely also daylight, are essential in photodermatoses, sometimes permanently.
  • In severe cases, various medications such as creams, ointments or by mouth are also indicated, including cortisone.

2. Photosensitive skin: Hypersensitive to UV light

The skin reacts to sunlight, mostly UV radiation, differently than normal skin. The reactions are sometimes unpredictable. The decisive factors are predisposition, immune processes, hormones and unknown factors. Substances that have a sensitizing effect play an important role (Photosensitizers, see point 3.). References to this can occasionally be found in the medication schedule. Tip: Keep the package leaflet for the medicinal products you use. Care products and perfumes can also make the skin sensitive to light.

Sun protection for the skin's sake

Dense clothing in summer? Certainly not a thrilling idea. In fact, if you are very sensitive to light, depending on the clinical picture, optimal light protection is the best prevention, be it for a limited period of time or for a longer period of time. In addition to the right sun cream and sun protection lipstick, this also includes avoiding intense UV radiation or arming yourself with clothing that does not let light through, a hat and sunglasses.

After all: textiles with UV protection (seal of approval) are light, "breathable", still effective when wet and dry quickly, so that they also protect against the sun when bathing. In addition, a medically controlled habituation treatment can improve the light tolerance of some photodermatoses in stubborn cases. More on this in the section "Photodermatoses: Therapy" (phototherapy) below.

3. Phototoxic and photoallergic light dermatoses

They are created like this:

- The photosensitizer gets directly on the skin or is absorbed by the body and reaches the skin via the bloodstream. It can also be a breakdown product of the original substance created in the body.

-Under UV light (less often daylight) develops a phototoxic or photoallergic Skin reaction. Some substances can trigger both, so it can be difficult to differentiate between them.

  • Phototoxic skin reactions - as if it were sunburn: Some drugs, including antibiotics and painkillers, dyes, tars, cosmetic substances such as fragrance and sun protection factors, even some plant substances have what it takes to be photosensitizers: once they get into the skin, they take UV exposure (sun, solarium, sometimes daylight) Light energy and react with molecules of the skin cells. Subsequently, skin inflammation similar to sunburn develops (dermatitis). A brownish discoloration usually remains later. Even drugs that are "skin-neutral" in winter can suddenly trigger light reactions in the spring sun, for example.

    Symptoms:A painful reddening (erythema) occurs, sometimes it is also blisters or blisters. Subsequently, there is a longer lasting brown coloration (hyperpigmentation) of the affected areas of the skin.

    Trigger of "immediate reactions" (within minutes or a few hours):For example, certain dyes or drugs such as amiodarone (antiarrhythmic), chlorpromazine (belongs to psychotropic drugs called phenothiazines), ciprofloxacin (antibiotic) are possible.

    Delayed reaction triggers (after hours or a day or two): Known for this are drugs such as tetracycline (also antibiotics), pain relievers such as naproxen and ketoprofen (so-called non-steroidal anti-inflammatory drugs).

Treasonous?

Meadow grass dermatitis: Furanocoumarins are natural substances that can be found in meadow grasses such as bindweed and hogweed. If parts of the plants get on uncovered skin exposed to sunlight, photoxic dermatitis with reddening, pain, burning, possibly also with nettle-like bumps on the skin (wheals) occurs there after one to two days. Sometimes parts of the plant appear outlined like a copy on the skin. Healing begins about two weeks later and usually leaves brownish spots for months.

Often bizarre rashes:

Berloque dermatitis: If a perfume or cosmetic product that contains bergamot oil (which also contains furanocoumarins) is behind a rash after exposure to light, dermatologists speak of berloque dermatitis. Typical areas are the inside of the wrist, the neck or the cleavage. Sometimes the skin reacts so weakly that only the subsequent brown discoloration is noticeable.

! Danger: Furanocoumarins can also be found in essential massage oils such as sandalwood oil, cedar oil, lavender oil. After a massage with it you should avoid sunlight on the relevant areas.

Less popular:

Photoxic nail attacks: Tetracycline, ciprofloxacin, and a substance called psoralen can also cause phototoxic detachment of toenails or fingernails, such as the front of the thumb or big toe.

  • Photoallergic skin reactions - less common and more complicated: When exposed to light, the triggering photosensitizer combines with a skin protein to form a new substance with allergenic properties (photo-contact allergen). Certain immune cells, on the other hand, are made sensitive and ready to react. The next contact with the original trigger will result in an itchy rash under UV light (UV-A).

    Possible triggers: Again medication, such as the diuretic hydrochlorothiazide (HCT), a water draining agent. Ketoprofen in pain gels (external), some working materials (occupational allergens), then fragrances and auxiliary substances in care products, and more rarely chemical light filters in sunscreens are allergy-triggering photosensitizers.
    Symptoms: Redness and / or nodular papules and vesicles, so-called eczema, appear on the diseased skin areas. They are always itchy, oozing, and crusty. The areas are blurred. If contact with the trigger persists, e.g. a drug or care product is still used, the skin is constantly irritated: the affected areas are moderately red, inflamed, flaky and itchy, the skin becomes coarse (lichenification). Itchy spots can also develop on other areas of the skin.

Also read:

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4. "Sun allergy" & Co .: Photodermatoses of unknown cause

  • Polymorphic light dermatosis (PLD): With up to 20 percent, the skin disease, incorrectly called sun allergy, is very common in Central and Northern Europe. It can look different from one affected person to another, which is expressed in the word polymorphic. In the individual patient himself, the rash is almost always the same (monomorphic). The cause is unclear; immune changes are suspected to be involved.

    Symptoms: Skin that has been exposed to the sun for the first time after a long period of time begins to itch severely within a few hours or one or two days. Reddish spots, nodules, vesicles, and possibly blisters soon follow. The changes can flow together to form larger spots. The main locations are the face, especially in children, then the cleavage and back of the hands, upper arms and thighs. If those affected consistently avoid the sun, the skin slowly calms down again. In the course of summer (moderately enjoyed) sunlight is usually increasingly better tolerated.

    Fact check:
    - Who? Women get sick three times as often as men; mostly up to the mid-30s (40) years;
    Trigger: Predominantly UV-A light, also through window glass, and sometimes daylight.
    - PLD only in spring / early summer? It occurs extremely seldom with us (through natural sunlight) even in winter.
    - Once a PLD, always a PLD? Partial: Relapses are common, but not inevitable. So it is quite possible that the next time the sun shines or the next spring, another rash will show up. Therefore ensure good protection. In women, the tendency to PLD usually subsides before menopause.
    - What protects? Sun cream or lotion with a high sun protection factor (SPF at least 30, UV-A and UV-B filters) without allergenic substances such as fragrances and preservatives. After-sun, day and night care also without these additives. In general, sun creams with sun-stable chemical UV filters without allergy potential and / or with mineral UV filter (s) are recommended. The latter, however, sometimes form a light film on the skin. They should also be suitable for photosensitivity to daylight (chemical UV filters are useless here). Mineral micro or nano UV filters, depending on the level of the protection factor, have almost no white effect, but some sun cream users accept this instead of "nano". Regarding the characteristic of the UVA symbol in the circle: The UV-A protection corresponds to at least one third of the sun protection factor. The UV-B protection is also stated on the packaging. Sunscreens with high UV-A protection exceed the minimum requirement. The addition of antioxidants can protect against harmful oxygen compounds caused by UV light.
    But: Sun cream alone is not enough, textile protection and observance of the rules of conduct in the sun are also required: Slowly getting the skin used to the sun, initially only a few minutes a day, but not in the midday sun (in Central Europe between 11 a.m. and 3 p.m. from March to October).
    Danger: Even outside of this "core time", UV light can cause damage to very light-sensitive skin.
    - Cortisone? If necessary, dermatologists prescribe a cortisone preparation for a short time, primarily for external use.
    - Antihistamines? Can help with itching.
    - Does phototherapy help? In the case of pronounced skin symptoms, treatment with UV light is an option (see below: "Photodermatoses: Therapy").