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 cancerskin cancer. The American Cancer Society estimates there will be 59,940 new cases of melanomamelanoma, 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 pressurehigh 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 with."

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.