Beware of Sunburn Boosters

It was a day outdoors like many others and you had slathered on the
sunscreen only to end up with a wicked sunburn. What went wrong? The answer may
lurk in your medicine cabinet. Certain drugs and other substances can increase
the skin's sensitivity to ultraviolet light and cause the skin to burn in less
time or at a lower intensity of sunlight than it would normally.

Sunburn is a serious matter. Exposure to the sun's ultraviolet (UV) rays is
a known risk factor in skin cancer skin cancer . The American Cancer Society estimates
there will be 59,940 new cases of melanoma melanoma , the most serious form of skin cancer, in
2007. The death rate has increased 50% since 1973. WebMD talked with two
experts about medications that heighten your risk for sunburn and how to stay
safe in the sun.

The Leading Culprits

  • Diuretics.Hydrochlorothiazide (HCTZ) is a commonly used diuretic
    ("water pill") used to treat high blood
    pressure high blood
    pressure . Combination drugs, which contain HCTZ, include Maxide,
    Dyazide, Hyzaar, and Zestoretic.

  • Antibiotics. Tetracycline drugs, which include Sumycin,
    Tetracyn, and Vibramycin, are used to treat bacterial infections. Quinolone
    drugs like Cipro, which gained attention during the anthrax scare, and sulfa
    drugs, such as Bactrim, also heighten sun sensitivity. Cipro and Bactrim are
    antibiotics often used for urinary tract infections.

  • Skin care
    products .
    Retin-A, alpha hydroxy acid, and microdermabrasion products used to minimize wrinkles and
    improve skin tone make the skin more susceptible to sun damage.

  • Heart medications. Amiodarone, marketed under the brand
    name Cordarone, is used to treat abnormal heart rhythms.

  • Diabetes Diabetes medications. Glipizide, sold
    also under the brand name Glucotrol, is an oral medication for type 2
    diabetes . Other related drugs include Amaryl and glyburide.

  • NSAIDs (nonsteroidal anti-inflammatory pain drugs). NSAIDs
    include over-the-counter pain relievers such as Advil, Aleve, Motrin, and the
    prescription drug Celebrex.

  • Balsam of Peru. This herbal ingredient is often used in
    perfumed products and aftershave lotions.

Shedding Light on the Subject

Heightened sensitivity to sun, or a phototoxic reaction, occurs when
ultraviolet rays interact with certain chemicals in medications. Even after you
have stopped taking a drug, its effects may linger. "Depending on the type
of drug and how long you've been taking it, it can remain in your system from
one to five days," says Bill Bailey, RPh, director of specialized care
centers for Medicine Shoppe in St. Louis. "To be on the safe side, always
ask the pharmacist about the effects of your medications on sun exposure.
They'll go online and get current, accurate information," he says.

You don't even have to go out in the sun to experience the complications of
medications. You could easily get sunburned in a tanning salon, says
dermatologist Craig Eichler, MD. "There have been some bad cases. Tanning
booths primarily emit UVA rays, and that's what medications mainly interact

And here's another little-known fact about UV rays: They penetrate water.
"Swimmers don't realize they can get sunburned under water," says
Eichler. Water also reflects UV rays, which can add to your exposure.

SPF, UVA, UVB, and Some Good News

There's a debate over whether sunscreens with high SPF ratings provide any
more protection than one rated SPF 15. "I recommend SPF 15. The stronger
sunscreens often give people a false sense of security," says Bailey.

Eichler says SPF 15 blocks 92% of UVB rays, while SPF 30 blocks 97%.
"SPF 15 is fine for going toand from the store, but use SPF 30 for longer
sun exposure or if you're taking medications."

Whether you use sunscreens with SPF 15 or 45 ratings, you're buying
protection from UVB rays, says Eichler, who is with The Cleveland Clinic
Florida in Naples. For protection against UVA rays, a product must contain one
of the following active ingredients: zinc oxide, titanium dioxide, or
avobenzone (Parsol 1789). "A problem is that these ingredients aren't
stable for a very long time."

That's one reason he's glad to see that the FDA has just approved ecamsule,
a broad-spectrum sunscreen that has been marketed since 1993 as Mexoryl SX in
Europe and Canada. It protects against both UVA and UVB rays and has an SPF 15
rating. It is expected to become available in the U.S. over the counter
sometime in the fall as Anthelios SX.

Protecting Yourself

Eichler recommends reapplying sunscreen every couple of hours and making
sure to use enough. "Most people use at best half of what they need. If you
put it on too thin, it doesn't give you protection." The American Cancer
Society says the average adult should use about a palm-full of sunscreen to
cover the arms, legs, neck, and face.

The key to effective sunscreen use is to reapply it often. Bailey advises
applying it one-half hour before you go into the sun, and every half hour
you're exposed. "Sunscreen wears off when you're sweating or in the water.
Remember to cover your hands and feet with sunscreen, too."

Both experts tell WebMD you can't rely on sunscreen alone. Wear a hat, cover
up, and avoid reflected rays from sand, concrete, and metal, which can reach
you even if you've blocked the sun with an umbrella. Also stay out of the sun
during the peak hours of 10 a.m. to 3 p.m.

By Leanna Skarnulis
Reviewed by Brunilda Nazario
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