By Ara Jamasbi, pediatric resident at CHOC
Living in Southern California, we are lucky to experience beautiful sunny weather practically year round. While we’re all aware of the dangers of sunburns, there are other skin reactions to the sun to be mindful of as well.
Photosensitivity is abnormal or adverse skin reactions to the sun. and If your child develops a sunburn reaction, swelling, or intense itching after limited exposure to sunlight or shows a rash or scarring in a sun exposed area (ie. face, V of neck), they may actually have photosensitivity.
Polymorphous light eruption, also known as “sun allergy” or “sun poisoning” is the most common photosensitivity. It occurs 1-2 days after intense sun exposure. It may range from small red dots to clear fluid-filled dots (vesicles), eczema-looking dry patches, large plaques/papules, or target-like lesions. The commonly involved areas include the face, neck, arms and hands where there was sun exposure. In children, it starts as dry patches on the face with red small dots, with severe itching. Lesions disappear in 1-2 weeks spontaneously if no further sun exposure occurs.
Solar urticaria is another type photosensitivity characterized by itching and redness usually after about 30 min or less of sun exposure. After several hours, the skin returns to normal. The cause is unclear, but antihistamines, corticosteroids and limited sun exposure have all been beneficial.
Phytophotodermatitis occurs when UV light reacts with certain chemicals on the skin. These chemicals can come from common foods such as limes, carrots, parsley and celery. The rash typically appears 24 hours after the exposure, and can take weeks to months to completely resolve. It may appear as a red itchy rash, but sometimes may even blister. It is usually in the pattern of exposure to the food causing the reaction, such as spattering or drips from a squeezed lemon
Don’t forget basic sunscreen practices. It is important to use a water-resistant, broad spectrum sunscreen (protecting against both UVA and UVB rays) with SPF 30 or higher. The higher the SPF, the more protection, with SPF 50 giving maximal protection. Sunscreen should be applied 15-30 minutes before going outside and re-applied every two hours, but more often if the child is swimming or sweating. Throw away sunscreen that is older than three years or passed the expiration date. Don’t forget to put sunscreen on often-forgotten areas such as the tops of the feet, ears and back of the neck and scalp.