Fun in the sun should always start with sunscreen, especially if you have lupus. Since the sun can cause lupus to flare up, either right away or days later, it’s extra important to protect your skin.
“The best thing with lupus is to kind of go into vampire mode. Never let the sun touch your skin, even for a second,” says Steven Daveluy, MD, FAAD, associate professor and program director of dermatology at Wayne State University.
Sunscreen can go a long way in protecting your skin. Here’s what to consider so you can choose the right sunscreen and enjoy your time outdoors.
There are two main types of sunscreen: physical and chemical.
Physical sunscreens, which have titanium dioxide or zinc oxide as an active ingredient, block the sun’s harmful ultraviolet radiation from hitting your skin. These sunscreens will block the most amount of light from the skin, including UVA (which causes signs of aging), UVB (which causes skin cancer), and visible light.
“UVA tends to be the one that’s more of a problem for people with lupus,” Daveluy says.
Any sunscreen labeled “broad spectrum” will protect you from both UVA and UVB, but physical sunscreens, or sunblock, do this really well.
“The downside to them is that sometimes they can be more difficult to apply, so some of those physical sunscreens can be thicker or some can leave more of a white color on the skin,” says Lindsay Strowd, MD, FAAD, associate professor of dermatology at Wake Forest School of Medicine.
To avoid the ghostly look, you could try a tinted physical sunscreen, especially if you have darker skin. As a bonus, the iron used to create the tint actually adds sun protection.
Chemical sunscreens work not by blocking the sun’s light, but by absorbing it. This type of sunscreen protects you from some UVA and most UVB, but not from visible light.
“The upside to chemical sunscreens is they can be much easier to apply,” Strowd says. “So sometimes they are a much thinner type of sunscreen and feel cosmetically nicer on the skin.”
Some sunscreens have a combination of physical and chemical sunscreen ingredients.
“The most important thing is finding a sunscreen that you are comfortable using every day. This often means trying out different sunscreens to see how they feel on your skin,” Daveluy says.
What SPF Is Best?
Shoot for sunscreen with an SPF of at least 45, but higher is better.
“We used to say SPF 30 was good. That was based on testing done in the lab,” Daveluy says. “But now we know that no one puts their sunscreen on as thick as they do when testing, so we're not getting the same level of protection that they see in testing.”
Strowd usually recommends that her patients “shoot for a higher SPF sunscreen because that way if you don't put it on quite as thick as they do when they test it, you're still going to get a higher SPF rating than if you use a lower SPF sunscreen.”
Lotion, Stick, or Spray?
The method of applying sunscreen -- lotion, stick, spray -- doesn’t matter, but if you use a spray sunscreen be sure to rub it in. Strowd even suggests spraying your skin twice. This is because the spray doesn’t cover your skin evenly and it can be hard to tell where you’re covered. The bottom line for any method is to put it on, and put it on thick.
The bottom line, Strowd says: “Whichever one you feel like you're going to be most consistent with applying is the one that I would prefer.”
Don’t forget your lips. You can wear lip balm with SPF or just put regular sunscreen on your lips. Daveluy advises avoiding lip balm without SPF because it can magnify the sun’s rays.
Make It a Habit
You should wear your sunscreen every day, regardless of the weather or the season.
Strowd says to put it on 10 or 15 minutes before you head outdoors. That gives your skin time to absorb it so you’ll be protected from the minute you step outside.
Even 5 or 10 minutes in the sun without protection can cause a lupus flare up. Think of it like brushing your teeth, Strowd says, something you do automatically.
Ultraviolet rays shine right through clouds. So you still need sunscreen on overcast days, and even when you're in the car or indoors by a window.
“Glass filters some (ultraviolet rays) but it doesn't filter all of it,” Strowd says. “So you have to be careful and make sure you're protected even if you're inside.”
Be sure to reapply sunscreen at least every 2 hours when you’re out in the sun. If you’re swimming, moving, or sweating you’ll need to reapply more often. But even if you’re not, the sun breaks down the sunscreen within 2 hours of being outside.
More tips from Strowd and Daveluy:
- Keep a small bottle of sunscreen in your purse or backpack so you always have some on hand.
- Don’t stash sunscreen in your car. If your car heats up, your sunscreen’s ingredients can break down and stop working.
- Also use other ways of protecting your skin from the sun. Wear a wide-brimmed hat, look for shade or carry an umbrella for instant shade, and avoid outdoor activities between 10 a.m. and 4 p.m., when the sun is most intense.
“You can use the shadow rule if you aren't sure,” Daveluy says. “If your shadow on the ground is longer than your height, the sun is low and less intense. But if your shadow is short, the sun is overhead and intense.”
Clothing with UPF protection is also another way to layer on protection. Strowd says, “It’s quite easy now to find high-neck, long-sleeve shirts that provide relatively high protection against the sun, but they're still made in a way that makes them fairly breathable and relatively easy to wear even in the hot, sunny, summer weather.”