Myositis and Sun Protection

Idiopathic inflammatory myopathies (IIMs) are a group of chronic diseases that cause inflammation in different parts of your body. Dermatomyositis is an IIM that most commonly targets skin and muscle. When you add sun into the picture with dermatomyositis, it can make it harder to keep your skin healthy and strong if you’re left unprotected.

Dermatologist Anthony Fernandez, MD, PhD, shares why the sun can aggravate dermatomyositis symptoms and what you can do to avoid them.

Why is sun exposure bad for dermatomyositis?

“Too much sun causes sunburns,” explains Dr. Fernandez. “If you look at sunburned skin under a microscope, you’ll see dead cells in the top layer of skin.”

Those dead cells spill their contents into a deeper layer of the skin where your immune cells live and protect you from infections.

“We think dead skin cell contents and UV rays trigger those immune cells to become activated,” he continues. “Once this happens, it can lead to ongoing inflammation.”

When dermatomyositis flares, you can get painful, itchy bumps or patches on different parts of your body, like your:

• Face
• Hands
• Neck
• Knees
• Feet

“These symptoms typically get worse when your skin is exposed to the sun without any protection,” he adds.

Sun protective measures for dermatomyositis

Sensitivity to the sun is just one characteristic of dermatomyositis — but it’s one that can make life more difficult. Inflammation can make it hard to move or do everyday tasks. It can also feel limiting when you have to be careful about how much time you spend outside.

“We want people to go outside and enjoy their lives,” says Dr. Fernandez. “There are things you can do to protect your quality of life without making your symptoms worse.”

Dr. Fernandez recommends the following strategies:

• Use a broad-spectrum sunscreen of SPF 30 or higher.
• Reapply sunscreen every couple hours when outside for long periods.
• Use a moisturizer with sunscreen every day to help soothe and protect your skin.
• Wear UV-protective clothing or long sleeves, wide-brimmed hats and sunglasses.
• Minimize sun exposure between the hours of 10 a.m. and 4 p.m., when the sun is at its strongest.
• Close your curtains or blinds when indoors.
• Consider adding UV-protective tinting to your windows at home and/or your car.
• Avoid tanning beds.

Key considerations

Without protection, the sun can make dermatomyositis worse. The bright side is you don’t have to stay in the dark to live a full, healthy life.

If you’re ever unsure of what to do or avoid, it helps to remember these key considerations:

• Some medications — like hydrochlorothiazide, doxycycline and naproxen —can increase your sensitivity to the sun. Ask your healthcare provider if the medications you’re taking put you at risk for sun sensitivity.
• Use gentle, fragrance-free laundry detergent to help avoid irritation and reduce sun sensitivity.
• Don’t scratch, pick or itch your sunburns — trauma to your skin can increase inflammation and trigger a flare.
• You may have low vitamin D if you’re avoiding the sun. Ask your doctor if vitamin D supplements are right for you.
• Some indoor lighting, like fluorescent lights, can also trigger dermatomyositis flare-ups. Ask your employer or healthcare provider if a change in lighting or other workplace accommodations are possible.

“The sun is beautiful, but we still need to protect ourselves from sun damage and skin cancer,” says Dr. Fernandez. “When you’re living with a condition like dermatomyositis, you just have to be a little more cautious.”