Amanda Greene, 43, stashes a tube of sunscreen in her purse and car so that she can reapply it throughout the day -- as frequently as some women touch up their makeup. Using sun protection is second nature for Greene, who was diagnosed with lupus (SLE) at 15 and is photosensitive.
"I use it from head to toe 365 days a year, whether it's gray or sunny," says Greene, a Los Angeles lupus advocate. "Some women reapply lipstick -- I reapply my SPF. It's part of living with lupus."
About 1.5 million Americans have lupus (systemic lupus erythematosus, or SLE), the most common form), according to the Lupus Foundation of America. The majority, 90%, are women, who usually develop the disease between ages 15 and 44. African-American, Hispanic, and Asian women have a higher risk. Eliza Chakravarty, MD, assistant professor of medicine in the division of immunology and rheumatology at Stanford University School of Medicine, sheds light on a disease you might not know much about.
Women who have lupus need to take certain precautions managing their beauty regimens to avoid aggravating symptoms of the disease. WebMD talked to three lupus experts to determine the smartest steps you can take to protect your skin and look good at the same time.
Depending on the type of lupus you have, different recommendations may apply. You should talk to your lupus specialist about your individual concerns.
Getting the Proper Sun Protection
"There's a tremendous amount of confusion about sunscreens," says Andrew G. Franks, Jr., MD, director, Skin Lupus and Autoimmune Connective Tissue Disease Center and clinical professor of dermatology and medicine (rheumatology) at New York University School of Medicine. "Patients with lupus need to avoid ultraviolet [light]. We want them to be sun-conscious and sun-educated."
"It's very important, whether you're photosensitive or not," he says. You may not get a rash after UV exposure, but there could be an increase in auto-antibody production, which can create disequilibrium in the status of your lupus.
Franks recommends using the highest SPF, but emphasizes that sunscreen is not a substitute for taking common-sense precautions like sun avoidance or wearing sun-protective clothing. He says the current numbers only delineate UVB protection, but there is a star system in development that will spell out UVA protection.
"The key is to find a nonirritating, extremely broad-spectrum sunscreen to wear everyday," says Noelle Sherber, MD, dermatologist in private practice in Baltimore. Her top recommendation is La Roche Posay's Anthelios SX Daily Moisturizing Cream SPF15: "The active ingredient, Mexoryl SX, is uniquely effective due to its spectrum of UV protection that fills a gap in other chemical sunscreens in the short UVA range. The formula is gentle and moisturizing."
Although no other brand incorporates Mexoryl, sunscreens with added antioxidants provide an additional layer of defense, Sherber says.
For women with tumid lupus, a rare type of skin lupus that makes a person sensitive to sunlight, Sherber recommends sunscreens containing titanium dioxide and zinc oxide that reflect light. For touch-ups during the day, she recommends keeping a powder with sunscreen handy.
Sherber also recommends donning sun-protective clothing, especially to protect the chest area. "Your basic white T-shirt only has SPF 4," she says. You can buy clothing that has built-in SPF protection or use products that are designed to wash SPF into your clothing.