Photosensitivity is a common adverse reaction that occurs with a wide range of medications, many of which are not used to treat with any dermatologic conditions. Photosensitivity is categorized into two mechanisms: phototoxic and photoallergic reactions. Phototoxic reactions are a result of the absorption of ultraviolet A or ultraviolet B radiation by a drug or its metabolites. This leads to the generation of reactive oxygen species which can damage cellular components of skin. This can resemble or present similarly to exaggerated sunburns. Photoallergic reactions, on the other hand, are immunologically mediated and are not as common. They typically involve delayed hypersensitivity mechanisms, resulting in eczematous, pruritic lesions, and may impact more than just the sun exposed areas.
Some common medications that are associated with photoxicity include tetracyclines, fluoroquinolones, thiazide diuretics, sulfonamides, amiodarone, NSAIDs, and phenothiazines. Photoallergic reactions can be seen with sulfonamides, certain NSAIDs, and some antipsychotic agents. Such reactions can significantly impact patient adherence and their overall quality of life. It is thus essential to proactively identify patients at risk for photosensitivity reactions and help counsel on preventative measures. This can include the use of sunscreen, typically SPF 30 or higher, wearing protective clothing, and minimizing sun exposure during peak UV radiation hours. Patients should also be counseled on the early signs of photosensitivity reactions and how to report any unusual skin changes.
Although these photosensitivity reactions may not be as common as some other adverse events, it can still have a significant clinical impact, particularly in patients using chronic therapies or those with repeated sun exposure. Additionally, it may deter patients from properly adhering to their medication regimen, which can in turn, impact their overall health. The counseling of these medications and their potential for photosensitivity reactions are thus salient in improving patient outcomes.
Drucker AM, Rosen CF. Drug-induced photosensitivity: culprit drugs, management and prevention. Drug Saf. 2011;34(10):821-837. doi:10.2165/11592070-000000000-00000
Gonzalez H, Ferguson J. Phototoxic and photoallergic reactions. Clin Dermatol. 2001;19(4):469-473. doi:10.1016/S0738-081X(01)00168-6
Lim HW, Arellano-Mendoza MI, Stengel F. Photodermatoses: an update on diagnosis and treatment. Am J Clin Dermatol. 2016;17(4):315–334. doi:10.1007/s40257-016-0196-z
Photosensitivity is a common adverse reaction that occurs with a wide range of medications, many of which are not used to treat with any dermatologic conditions. Photosensitivity is categorized into two mechanisms: phototoxic and photoallergic reactions. Phototoxic reactions are a result of the absorption of ultraviolet A or ultraviolet B radiation by a drug or its metabolites. This leads to the generation of reactive oxygen species which can damage cellular components of skin. This can resemble or present similarly to exaggerated sunburns. Photoallergic reactions, on the other hand, are immunologically mediated and are not as common. They typically involve delayed hypersensitivity mechanisms, resulting in eczematous, pruritic lesions, and may impact more than just the sun exposed areas.
Some common medications that are associated with photoxicity include tetracyclines, fluoroquinolones, thiazide diuretics, sulfonamides, amiodarone, NSAIDs, and phenothiazines. Photoallergic reactions can be seen with sulfonamides, certain NSAIDs, and some antipsychotic agents. Such reactions can significantly impact patient adherence and their overall quality of life. It is thus essential to proactively identify patients at risk for photosensitivity reactions and help counsel on preventative measures. This can include the use of sunscreen, typically SPF 30 or higher, wearing protective clothing, and minimizing sun exposure during peak UV radiation hours. Patients should also be counseled on the early signs of photosensitivity reactions and how to report any unusual skin changes.
Although these photosensitivity reactions may not be as common as some other adverse events, it can still have a significant clinical impact, particularly in patients using chronic therapies or those with repeated sun exposure. Additionally, it may deter patients from properly adhering to their medication regimen, which can in turn, impact their overall health. The counseling of these medications and their potential for photosensitivity reactions are thus salient in improving patient outcomes.
Drucker AM, Rosen CF. Drug-induced photosensitivity: culprit drugs, management and prevention. Drug Saf. 2011;34(10):821-837. doi:10.2165/11592070-000000000-00000
Gonzalez H, Ferguson J. Phototoxic and photoallergic reactions. Clin Dermatol. 2001;19(4):469-473. doi:10.1016/S0738-081X(01)00168-6
Lim HW, Arellano-Mendoza MI, Stengel F. Photodermatoses: an update on diagnosis and treatment. Am J Clin Dermatol. 2016;17(4):315–334. doi:10.1007/s40257-016-0196-z