Photodermatitis on the face, legs and hands: causes, how to treat

For most healthy people on the planet, exposure to the open sun does not cause any consequences other than tanning the skin. However, the skin of a fifth of the human population reacts inadequately to intense insolation. In everyday life, this condition is called an allergy to the sun, although in fact, sunlight, strictly speaking, cannot be classified as an allergen, which modern medicine understands as foreign proteins that cause an immune response in the body in the form of allergic reactions. Photodermatitis (photodermatosis) is an inflammatory structural change in the epithelial cells of the skin as a result of insolation, which acts as a provoking factor.

Acute and periodically recurring skin reaction caused by sun rays is becoming an increasingly common pathology that has been seriously studied not so long ago and at present the final verdict has not yet been made. But research in this area has already allowed us to draw a number of conclusions.

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Causes photodermatitis

People who cannot be in the open sun due to the so-called solar allergy should think about their health. An inadequate reaction to direct sunlight develops with insufficient melanin production, and its deficiency is provoked by various reasons. In addition, sometimes melanin is produced in sufficient quantity, and the skin is hypersensitive to ultraviolet radiation. In this case, it is worth thinking about the presence of phototoxic substances in the skin or on its surface. Such people should pay attention to the work of organs, the dysfunction of which contributes to intoxication of the body - the liver, kidneys, adrenal glands. Disturbances in the metabolic and immune processes contribute to the accumulation of substances (photosensitizers) in the skin that absorb light waves of the visible spectrum. They increase the toxicity of molecular oxygen, facilitating its transfer to a more energized state.

Many natural substances act as photosensitizers. Their accumulation in the skin as a result of metabolic disorders increases its sensitivity to ultraviolet radiation. These processes can be congenital, in which case ultraviolet intolerance manifests itself from childhood, and acquired. Most types of photodermatitis bother young people, some appear in adulthood and old age.

The most common acute form of photodermatitis is common sunburn. It occurs in absolutely healthy people under the influence of prolonged and intense insolation. Small children, pregnant women, albinos and natural blondes, lovers of solariums and tattoos are most susceptible to them. The risk of burns is increased by the presence of chronic diseases of internal organs, taking medications, and exposure of the skin to photosensitizers. In late spring and early summer, when solar activity is high and the body has not yet become accustomed to ultraviolet radiation, the likelihood of burns is greatest.

The aggressive impact of insolation can manifest itself in rashes - solar urticaria. For some individuals, this is enough to simply be exposed to direct sunlight for a short time. One-time situations are usually caused by the impact of some external (exogenous) factors. Such inflammations are also called photocontact dermatitis. Usually, the provocateurs are chemical substances of various origins that get on or into the skin and cause toxic (allergic) photodermatitis on those parts of the body that were exposed to sunlight.

Photosensitivity may be caused by oral contraceptives, medications belonging to many pharmacological groups. The most commonly used of these are: non-steroidal anti-inflammatory drugs, in particular aspirin and ibuprofen; tetracycline antibiotics; sulfonamides and drugs with antihistamine activity; barbiturates and neuroleptics; some cardiac and hypoglycemic drugs, cytostatics and diuretics; photosensitizers themselves and local agents for the treatment of skin problems.

Folk remedies and herbal preparations, cosmetics and perfumes containing vitamins A (retinoids, carotenoids), vitamin E, eosin, tar, resins, boric acid, mercury, lead, musk, phenol, essential oils of plants (rose, sandalwood, bergamot, nut, St. John's wort and others), medicinal herbs - nettle, St. John's wort, clover and some others; dill and parsley juice, celery, carrots, figs, citrus fruits - this is not a complete list of substances, the internal or external use of which causes hypersensitivity to sunlight. Hypersensitivity to sunlight in combination with furocoumarin-containing plants is called phytophotodermatitis, it is not so rare. A walk through a flowering meadow can be dangerous, especially in early summer. The pollen of the herbs blooming during this period contains furocoumarins, which, settling on the body under the influence of aggressive sunlight, can cause an allergic reaction.

And if a one-time situation is repeated with multiple periodicity, then such a condition is classified as chronic photodermatitis. Most often among them there is polymorphic light rash, the supposed cause is the development of a delayed response induced by insolation to some antigen. It is this recurrent disease that is most often considered an allergy to sunlight. Morphological forms of manifestations are varied - urticaria, erosion, erythema.

Bazin's light pox and chronic actinic dermatitis (reticuloid) - these diseases are also provoked by insolation, the reasons for their occurrence have not been established.

Eczema and prurigo caused by sun rays occur as a result of disruption of individual links in the metabolism of porphyrins and their derivatives, which accumulate in the bloodstream, as well as a deficiency of nicotinic acid.

Erythropoietic and hepatic porphyrias belong to a group of genetically determined diseases, are accompanied by photosensitivity, sometimes occur in a very severe form, and often manifest themselves from birth. There are mild and latent forms that manifest themselves at a later age, which is facilitated by taking certain drugs that activate the enzymatic activity of aminolevulinate synthase (analgesics, barbiturates, glucocorticosteroids, NSAIDs). Late cutaneous porphyria can be an acquired disease. It occurs in people with chronic alcohol intoxication, who have had hepatitis, who are in contact with hepatotoxic substances, gasoline. However, the inheritance of this form of porphyria cannot be completely excluded either, since the patient's relatives have biochemical signs of the disease in the absence of a clinical picture, and some family histories indicate cases of the disease.

Another rare severe hereditary disease from the photodermatoses series is xeroderma pigmentosum, which almost always sooner or later takes a malignant course. It is assumed that the disease is caused by enzymatic deficiency, which prevents the restoration of DNA of skin cells damaged by insolation.

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Risk factors

Risk factors for the development of intolerance to solar radiation are genetic predisposition to allergic diseases, metabolic disorders, immunodeficiency states, chronic diseases of internal organs, acute severe infections, courses of drug therapy, periods of hormonal changes - adolescence, pregnancy, menopause, as well as tattooing, peeling, other cosmetic procedures, professional contact with toxic substances, bad habits, temporary stay in an unusually hot climate, chlorinated water, swimming in the sea during algae bloom (usually at the beginning of summer).

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Pathogenesis

The mechanism of development of photodermatitis has not yet been fully studied; some pathologies, identified as independent nosological units, still pose a mystery to researchers.

Hereditary predisposition is almost always traced. For example, in xeroderma pigmentosum, genes have been identified in which mutations occur, causing enzymatic deficiency, which does not allow the regeneration of DNA of skin cells damaged by ultraviolet radiation.

But the mechanism for the development of special sensitivity to insolation in Bazin's light pox remains questionable; not even all medical scientists agree with the inheritance of this disease.

According to the mechanism of development, a distinction is made between phototoxic and photoallergic reactions. In the first case, toxic substances accumulated in the skin or applied to its surface, under the influence of sunlight cause symptoms similar to sunburn - peeling, swelling, blisters and vesicles. Ultraviolet radiation, interacting with a photosensitizing substance, catalyzes a photochemical reaction with the formation of either free radicals or singlet oxygen, causing damage to the structure of cardiomyocytes. The skin reaction is caused by the release of proinflammatory mediators (prostaglandins, histamine and arachidonic acid), general malaise is the result of the action of interleukins. Its severity depends on the amount of chemical substance in the skin or on the skin and such properties as absorption, metabolic, the ability to dissolve and form stable compounds. In the epidermal layer, keratinocytes die off, so-called sunburn cells are formed, lymphocyte proliferation, degeneration of melanocytes and Langerhans cells, in addition, the blood vessels of the skin expand, its surface layer swells. Skin cells undergo dystrophic changes and necrosis, then peel off.

In the second case, the reaction occurs with repeated interaction with ultraviolet light. Medicines and other chemicals or their metabolic products, absorbing sunlight, form photosensitive substances in the skin. With repeated exposure to sunlight, immune mechanisms are activated in response to antigens formed in the skin after the initial interaction. Externally, photoallergic reactions resemble a classic allergic reaction and are accompanied by severe itching, hyperemia, scaling and proliferative processes in the epidermis.

Polymorphic light eruption, the pathogenesis of which has not yet been studied, is presumably a delayed photoallergic reaction.

Several pathogenetic links have been identified in the development of solar urticaria. It can develop in individuals with porphyrin metabolism disorders; in other cases, patients had a positive test for passive allergens, indicating the development of photoallergy. In many patients, the causes of urticaria remained unidentified.

Porphyria is a group of diseases caused by disorders in porphyrin metabolism, causing their accumulation and excessive excretion through the urinary system or intestine. In erythropoietic variants of the disease, porphyrins and their derivatives accumulate in blood cells (erythrocytes and normoblasts), in liver variants - in liver cells (hepatocytes). Latent forms of the disease sometimes do not manifest themselves in any way until some factor (taking certain drugs, puberty, pregnancy, etc.) triggers the development of the disease. In the pathogenesis of acquired porphyria, the stimulus for their development can be intoxication with lead salts, herbicides, insecticides, alcohol, liver disease. Porphyrins, accumulating in the skin, act as photosensitizers, and insolation causes accelerated peroxidation of the fatty components of cell walls, destruction of keratinocytes and damage to the skin surface.

Statistics can only judge cases of photodermatitis that patients could not cope with themselves and sought medical help. Often the symptoms disappear within two or three days, these cases remain outside the field of view of doctors, so 20% of the population suffering from photodermatitis is clearly an underestimate. Sunburns and more than once happened to almost everyone. Of course, more serious cases are usually registered.

For example, polymorphic light rash affects, according to estimates, about 70% of all inhabitants of the planet. Women are more prone to this pathology, the disease is most often observed in the age group of people from 20 to 30 years. It is noted that after the age of thirty, most patients (3/4) have relapses less often, and sometimes self-healing occurs.

Solar urticaria affects three people out of a hundred thousand, men are affected three times less often than women. The main age of those affected is from 30 to 50 years. Usually, five years after the first manifestation of the disease, spontaneous regression occurs in about 15% of patients, and in another quarter, self-healing takes a decade.

Bazin's light pox is a very rare disease, three cases per million inhabitants of the planet are registered. It manifests itself in childhood and adolescence, mainly in boys. Another predominantly male disease is actinic reticuloid, which affects middle-aged and elderly people whose skin has always reacted inadequately to insolation.

Xeroderma pigmentosum is also quite rare - four cases per million population, has no gender or racial preferences. Mostly, members of one family are affected.

Porphyria is most common in northern European countries, where seven to twelve people out of a hundred thousand inhabitants suffer from it.

Phototoxic reactions are estimated to be approximately twice as common as photoallergic reactions, although there are no precise statistics on their prevalence.

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Symptoms photodermatitis

The first signs of sunburn become noticeable in subjects with more sensitive skin after half an hour of exposure to the scorching sun, and in an hour and a half with more resistant skin. Hyperemia appears on exposed areas of the body, and a burning and tingling sensation is felt. Later, these areas begin to itch, and it is painful to touch them, not only with your hands, but also with a stream of cool shower. The first night after receiving a burn will not bring rest - it is usually painful to lie down, the temperature may rise, and symptoms of general malaise may appear. With severe burns, swelling, blisters, vomiting, hyperthermia, and intense thirst appear. Usually, the acute condition lasts no more than two or three days. In severe cases, it is necessary to seek medical help.

Phototoxic reactions resemble ultraviolet burns in their clinical manifestations. They develop over several hours or days after a single insolation, usually after systemic drug therapy or internal use of photoactive chemicals. For example, tricyclic antidepressants are characterized by the appearance of gray-blue pigment spots on the skin, tetracycline and fluoroquinolone antibiotics, furocoumarin-containing and some other substances - nail damage. Phototoxic reactions are often similar to late cutaneous porphyria, manifested as lichenoid rashes, telangiectasia. Sometimes, after peeling of the epidermis surface, the color of the affected skin areas changes.

Photoallergic reactions often occur after external use of medicinal and other chemical substances. In terms of symptoms, these types are similar to skin manifestations of allergy - urticaria, papular and eczematous rash, with the formation of serous crusts, peeling, with characteristic intense itching. The rash appears approximately a day or two after repeated ultraviolet irradiation. They are localized mainly in areas that were exposed to sunlight, but sometimes they spread to those parts of the body that were under clothing.

Phototoxic dermatitis is characterized by clearer boundaries of the rash, its resolution is usually accompanied by hyperpigmentation of the skin. Photoallergic - externally have blurred unclear boundaries, the presence of pigmentation is not observed.

Symptoms of solar urticaria include a rash of small, pink or reddish blisters that itch a lot. Urticaria appears fairly quickly, often after just a few minutes of direct sunlight. If you stop exposing the affected areas to sunlight, the rash may go away fairly quickly without any treatment.

Photocontact dermatitis from contact with photosensitizing plants (phytophotodermatitis) appears in the form of stripes, zigzags, bizarre patterns consisting of spotted, erythematous or vesicular rashes on the hands, face, legs, any parts of the body that could come into contact with plants. It usually appears the next day, itches strongly or moderately, can be confused with injuries (abrasions, abrasions). Inflammatory phenomena quickly pass by themselves, figured pigment spots in their place can remain longer.

Contact photodermatitis also includes keychain photodermatitis, which occurs in places where perfume is applied to skin exposed to sunlight. It manifests itself as long-term hyperpigmentation of its surface.

Polymorphic light rash is the most common chronic form of photodermatosis and is manifested by a red itchy rash in the form of nodules merging into spots of different sizes, sometimes there are eczematous and lichen-like spots. Polymorphism is manifested in a variety of rash forms, however, the histological specificity of any of them is a compaction localized around the vessels of the upper and middle layers of the skin, mainly lymphocytic, in which T-cells predominate. A particular patient is characterized by any one type of rash.

The most common places for rashes are the décolleté area and forearms. It manifests itself in the spring with the first bright sun, then the skin gets used to insolation and the rash goes away. Moreover, at first the rash may appear on the face and neck, then these parts of the body get used to solar radiation - the rash goes away, but appears in other places when clothing becomes lighter and more open. By mid-summer the rash disappears, as the skin gets used to insolation, but a year later with the first intense sun rays the rash appears again.

Summer solar prurigo usually manifests itself in puberty after prolonged insolation. Photodermatitis is localized on the face, mainly the middle of the face is affected, the red border of the lips is affected, the lower lip is especially affected (swollen, thickened with peeling crusts). The rash is localized in the décolleté area, on the arms, especially up to the elbow, and other exposed parts of the body. Most often, these are red papules outlined by erythema, over time they merge into plaques surrounded by papules. The rashes itch, crack and become covered with crusts. In the affected areas, the skin is covered with pigment spots that appear in places of healed plaques,

Eczema caused by ultraviolet radiation is characterized by a symmetrical location on the skin surface unprotected from insolation. Photodermatitis is located on the face, skin of the neck and the back of the head, the outer side of the hands, which are exposed to ultraviolet radiation almost all year round, sometimes the surface of the shins and forearms is affected. Eczematous spots consist of papules or vesicles, with unclear blurred boundaries, their shapes are variable. During periods of exacerbation, the affected skin swells, weeping discharge appears, the surface of the spots becomes covered with crusts, erodes, and itches a lot. There is a high probability of secondary infection.

Persistent erythema of the face caused by insolation has a characteristic shape resembling a purple butterfly, clearly outlined by a brownish border. In this place, slight swelling, burning and itching are noticeable. It can spread to other exposed areas of the skin, most often the arms up to the elbow and the skin of the hands on the outside. Periodically peels off with the formation of serous crusts, becomes inflamed in the form of small itchy nodules, and can slightly rise above the surface of healthy skin. With a decrease in solar activity in the cold season, the rash disappears, leaving no traces. The general condition of the patient during the exacerbation period is unchanged.

One of the symptoms of lupus erythematosus can also be photodermatitis on the face, resembling a butterfly in outline.

Patients with late cutaneous porphyria, the most common of its other types, clearly show seasonal exacerbations - from May to August. It comes in two types. The first belongs to sporadic (acquired) types of the disease. Among them, professional photodermatitis associated with intoxication during industrial activities is often encountered. The second is hereditary.

It manifests itself after 40 years - blisters appear on the body, small and larger, densely filled with a transparent liquid, sometimes with an admixture of blood or cloudy, later they wrinkle, open and dry up. In their place, serous or serous-hemorrhagic crusts are formed. This process takes one and a half to two weeks, the crusts peel off, leaving pale purple marks or retracted scars on the skin, at first inflamed and pink-red, then replaced by darker skin, later the pigmentation disappears in these places and white spots remain. In the progressive stage, all stages of the process can be seen on the skin - from fresh blisters to scars and depigmentation. Over time, even during remission, patients have traces of pigmented and atrophied areas on the skin, later the skin acquires a yellowish tint, becomes denser and, at the same time, fragile and easily injured.

Actinic reticuloid also most often affects men over middle age who have suffered from solar eczema-like dermatitis. Rashes appear on exposed areas of the body, the skin underneath thickens and hardens. The rash may persist during the cold season, but the condition worsens under the sun's rays.

Professional photodermatitis associated with sun exposure and fresh air manifests itself as increased hyperpigmentation and peeling of the skin on exposed areas of the body. Specific appearance is typical for such professions as sailors, fishermen, builders, agricultural workers, welders.

In adolescence, symptoms appear that allow one to suspect smallpox. After 0.5-2 hours of exposure of the skin to direct sunlight, a papular rash appears on the skin of the face and the outside of the hands, in the place of which small blisters with a crater in the middle form, after they open, bloody crusts remain. The rash is very itchy. The crusts begin to fall off after a week, and by the end of the second week, the entire face and skin on the back of the hand are covered with small pockmarks. The progressive stage may be accompanied by symptoms of general malaise, peeling of the nails.

The most dangerous disease caused by a hypersensitivity reaction to sunlight is xeroderma pigmentosum. Pigmentation begins to appear at an early age, even before the age of one, since the disease is hereditary. At first, many erythematous rashes appear, inflammation is replaced by the appearance of pigment spots on exposed areas of the body, primarily on the face, then they darken, warts and papillomas appear, ulcers and skin atrophy. This disease will not go away on its own, so early diagnosis and treatment will help alleviate the patient's condition, improve the quality and duration of his life.

These are the main types of photodermatitis and diseases accompanied by photosensitivity. If the rash appears periodically, you should definitely see a doctor and get examined. Photodermatitis in a child may indicate the presence of any skin disease accompanied by photosensitivity, however, these are mainly manifestations of sunburn or polymorphic light rash, and the presence of parasites can also cause an inadequate reaction to sunlight. If you know that you have overdone it with a walk in the sun, then this is a normal reaction. Children's skin is sensitive to sunlight. If the child does not tolerate ultraviolet radiation at all, you should consult a doctor.

The stages of photodermatitis correspond to any manifestations of skin reactions. Progressive is the first stage, when rashes appear in response to insolation, itching, burning, pain. Then the appearance of a new rash stops, the old one still holds on and bothers - this is a stationary stage, indicating a turning point towards regression. Then the healing of the skin surface or regression of the disease begins. If you protect your skin from new intense insolation, then photodermatitis may not bother you anymore.

Complications and consequences

The photosensitivity reaction is accompanied by severe itching, so the most common complication is infection of the inflamed skin due to scratching.

Sunburns themselves disappear without a trace, however, over time, a new growth may appear at the site of the burn. The most terrible of which is black cancer or melanoma, the role of burns in the occurrence of which is one of the first places.

Xeroderma pigmentosum almost always has a malignant course.

Frequent cases of acute photodermatitis can lead to the process becoming chronic. In addition, such a reaction to sunlight can indicate the development of chronic pathologies of internal organs, vitamin deficiency, hemochromatosis, metabolic disorders, the presence of autoimmune processes and collagenoses. Therefore, if sensitivity to sunlight becomes your constant companion, it is necessary to find out its cause.

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Diagnostics photodermatitis

To determine the causes of the patient's skin hypersensitivity to sunlight, a multifaceted examination of his body is carried out. After an interview and a thorough examination, the patient is prescribed blood tests - general, biochemistry, testing for autoimmune diseases, for the content of porphyrins in blood plasma and urine, clinical urine analysis, phototesting, skin photoapplication tests.

Allergen tests and more specific analyses may be prescribed – serum iron levels, vitamins B6 and B12, and others at the doctor’s discretion. Histological examination of skin samples allows confirming the type of photodermatitis. Changes in the cells of the epidermis and dermis characteristic of phototoxic reactions (premature keratinization and vacuolar degeneration of skin cells, subepidermal blisters, intercellular edema, superficial lymphocytic infiltrates with neutrophils) differ from those in photoallergic reactions (exudative inflammation of the epidermis, focal parakeratosis, lymphocyte migration into the epidermis, perivascular and interstitial lymphocytic infiltration of the skin with a predominance of histiocytes and eosinophils).

Often, consultation with other specialists is required: hematologist, gastroenterologist, allergist-immunologist, rheumatologist.

Instrumental diagnostics are prescribed depending on the suspected diagnosis, mainly this is an ultrasound examination of internal organs, however, other examination methods can also be used.

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Differential diagnosis

Differential diagnostics is carried out to establish a specific type of photosensitivity: solar urticaria, eczema, pruritus; photodermatitis induced by drugs, plants, toxic substances; differentiating them from symptoms of metabolic or autoimmune pathologies - lupus erythematosus, porphyria; other skin diseases - relapses of atopic or seborrheic dermatitis, erythema multiforme, etc.

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Treatment photodermatitis

Acute photodermatitis, as well as relapses of polymorphic light rash after stopping insolation, often pass on their own within two to three days. To speed up the healing process, relieve itching, and prevent secondary infection, external anti-inflammatory, antiseptic, and regenerating agents are usually used.

In case of sunburn and blisters, preparations with dexpanthenol (provitamin B5) are very helpful, in particular, in aerosol form – Panthenol. Touching the inflamed skin is painful, in addition, the absence of contact reduces the risk of infection. When applied to the skin surface, the active ingredient is quickly absorbed by its cells, where it turns into pantothenic acid, which is a necessary component for normalizing metabolic processes and cellular renewal. It promotes the formation of endogenous corticosteroids, acetylcholine, thereby reducing pain and inflammatory symptoms. It is applied to damaged skin from one to several times a day, it is not recommended to spray it on the skin of the face. It is usually well tolerated, but can occasionally cause allergies. Panthenol is used in pediatric practice, with the consent of a doctor, it can be used to treat the skin during pregnancy.

The combination of dexpanthenol with the antiseptic miramistin makes Pantestin gel even more effective. A wide range of antimicrobial action provides protection against bacteria and fungi. Miramistin also potentiates the anti-inflammatory and regenerative properties of pantothenic acid. The skin surface is treated once or twice a day.

If skin rashes are accompanied by exudation, use products with a drying effect, such as Salicylic-zinc ointment (Lassar paste), which absorbs exudate, reduces inflammation and prevents infection. The components of the paste (salicylic acid and zinc) are not absorbed into the systemic bloodstream when applied locally and act directly at the site of application, eliminating unpleasant symptoms fairly quickly.

Methyluracil ointment has an anti-inflammatory effect, accelerates the healing process and restoration of the skin surface.

You can treat the inflamed surface with Olazol spray, which contains sea buckthorn oil, antiseptics and analgesics, especially if there is a suspicion of infection. This product is applied to the skin once or twice a day.

If you are not allergic to honey, Amprovisol spray, which contains propolis and vitamin D, glycerin and menthol, will disinfect the surface, help relieve inflammation and unpleasant sensations of burning and pain.

These products are not used on large surfaces, and do not allow them to come into contact with the eyes. Do not spray directly onto the face, first shake the can, squeeze the product onto the palm of your hand, then carefully transfer it to the inflamed areas of the skin on the face.

Use over-the-counter medications without a doctor's prescription to relieve photodermatitis symptoms with caution. After all, even the safest remedy can worsen the condition, causing an additional allergic reaction. In case of complications or severe forms of damage, it is imperative to seek medical help. Systemic therapy, oral use of antihistamines, glucocorticosteroids externally and internally may be required. Hormonal drugs are very effective, however, they have many side effects and should not be used without a doctor's recommendation.

If photodermatitis is a symptom of a disease, it is treated first. Treatment is prescribed by a doctor, various drugs and individual treatment regimens are used. Diuretics, vitamins (group B, ascorbic acid, vitamin E), iron-containing drugs, and physiotherapy are almost always included in treatment measures.

Various procedures and methods of influence are used, sometimes their combination. The choice of method depends on the patient's condition and disease. Electrical procedures may be prescribed: d'Arsonval currents, ultratonotherapy, electrophoresis with calcium chloride, antihistamines, prednisolone. Local exposure to magnetic waves, high-frequency electric current, galvanic current, laser radiation helps to quickly get rid of symptoms, raise immunity and improve blood circulation. However, a lasting therapeutic effect will be brought not only by treatment during the period of exacerbation, but also during the period of remission, which occurs in the cold season.

Folk remedies

You can help yourself or a loved one and alleviate the skin condition after an unsuccessful stay in the sun using improvised means.

Cooled tea leaves have a mild anesthetic, as well as antiseptic and anti-inflammatory effect. Compresses from gauze scraps soaked in it can be applied to areas of skin covered with a rash.

Cooled infusions of celandine, oak bark, juniper, calendula flowers or chamomile can also be used for such compresses. They will help reduce itching, swelling, and irritation.

A similar effect can be achieved with fresh cabbage leaves, lightly beaten and applied to inflamed skin; washed plantain leaves can be applied to inflamed areas immediately, while still outside the city, at the first signs of sun damage to the skin.

You can make compresses from a gruel of grated cucumber or raw potatoes.

First aid for acute photodermatitis includes applying aloe or Kalanchoe juice, egg white, honey, sour cream or kefir, raw potato juice, and apple cider vinegar to the skin. Treat the affected skin with improvised means repeatedly. As soon as the applied substance dries, repeat the treatment. The patient's individual tolerance should be taken into account. In addition, folk remedies are used for moderate burns or before large blisters appear. By the way, honey and potatoes can prevent their appearance, but the skin should be lubricated immediately at the first signs of sunburn.

Solar dermatitis can be treated with an ointment made from equal parts of honey and Kalanchoe juice. However, before use, it must be infused in the refrigerator for a week, so the ointment cannot be considered a first aid remedy. Unless, if you have a history of chronic photodermatitis, you can prepare it in advance.

You can make an ointment from cranberry juice and Vaseline, mixing them in equal parts. Apply it to the rash several times a day. The ointment has the ability to relieve inflammation, swelling, and also moisturize and soften the skin, helping to get rid of peeling faster.

Herbal treatment of photosensitivity phenomena is also effective. In addition to the above compresses, you can take decoctions and infusions of medicinal herbs internally. For example, mix equal parts of calendula flowers, chamomile and plantain leaves. Take 300-400 g of herbal mixture per liter of boiling water, brew in a glass jar and leave for an hour. Drink like tea several times a day, half a glass at a time.

You can drink tea from fresh dandelion flowers. Brew it in the proportion - 100 g of flowers per 500 ml of boiling water. You can drink it after 10 minutes. This remedy is suitable for the beginning of summer. When sunbathing outside the city during this period, you can take dandelions with you in case of photodermatitis.

Later, cornflowers bloom; tea made from these flowers also has anti-inflammatory and antipruritic properties, and also has a pleasant taste.

The infusion of the succession promotes the production of endogenous steroid hormones, which, having anti-allergic properties, will help the body overcome photodermatitis. It is brewed at the rate of: a tablespoon of the herb per 200 ml of boiling water, infused for a quarter of an hour in a water bath, then left to stand for ¾ of an hour at room temperature. Strain, add boiled water to the original volume and drink three to four times a day, half a glass at a time. Do not brew for future use, the infusion should be fresh.

For large affected areas, take baths with the addition of infusion of calendula, linden, chamomile, and string. Brew a mixture of the named herbs in equal proportions. The infusion is made stronger, no less than 300-400 g of the mixture per three-liter jar, which is wrapped in a blanket and left for three hours.

A bath mixture can be prepared from equal parts of chamomile flowers, valerian root, celandine herb, St. John's wort, sage and fireweed. Take five tablespoons of the mixture per liter of water, brew with boiling water and simmer for 10 minutes in a water bath. Cool slightly, strain and add to the bath.

Baths are taken daily at first, for 15-20 minutes, without drying, but slightly blotting the water on the body with a soft towel. After two weeks, you can take baths every other day. After a month's course, a break of the same length is necessary.

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Homeopathy

Treatment of diseases with accompanying photosensitivity of the skin with homeopathic preparations should be carried out by a professional, in this case the patient's recovery is possible. In this case, almost the entire arsenal of homeopathic medicines is used, the doctor will most likely prescribe a drug that corresponds to the constitutional type of the patient.

Symptomatic remedies prescribed for photodermatitis include St. John's Wort or Hypericum (Hypericum perforatum), Camphor (Camphora), Cadmium Sulfate (Cadmium sulphuricum), and Ferrous Sulfate (Ferrum sulphuricum). The latter may be prescribed for solar eczema or urticaria if the patient also has helminths. Quinine Sulfate (Chininum sulphuricum) is prescribed for various types of rashes on sensitive skin in patients with anemia. For itchy chronic photodermatoses that recur in the summer, Apis or Honey Bee (Apis mellifica) may be prescribed.

For acute photodermatitis and sunburn, prescribe Soda (Natrium carbonicum), Spanish fly (Cantharis), Amyl nitrite (Amylenum nitrosum), and Arnica (Arnica montana).

To relieve drug intoxication, detoxify the body, strengthen the immune system, improve cellular respiration and renewal, restore trophism and lost functions, complex oral homeopathic drops Lymphomyosot, Psorinokhel N can be prescribed.

Catalysts of tissue respiration and metabolic processes Coenzyme compositum and Ubiquinone compositum are intended for injections, but they can be used orally as a drinking solution. They are dosed individually depending on the cause and degree of damage, as well as the presence of concomitant diseases, the duration of the course is determined by the doctor. They can be used simultaneously with other drugs.

Externally, you can also use homeopathic ointments: Irikar cream, Fleming DN ointment, Utrika DN, Sanoderm Edas-202. The ointments are applied in a thin layer to the affected areas of the skin two to three times a day.

Prevention

Preventing sunburn and photosensitivity reactions is not too difficult; it is enough to take some precautions: protect your skin from exposure to sunlight by wearing suitable clothing made of natural fabrics in light colors and applying sunscreen creams.

Even absolutely healthy people should limit their time in the open sun, especially at the beginning of the warm season to 10-15 minutes. Take sunbaths in the morning before 11 am and in the evening after 4 pm. The rest of the time it is necessary to be in the shade. After swimming in any body of water, it is necessary to dry the skin with a towel, since drops of water remaining on the skin increase the risk of sunburn.

In hot weather, it is necessary to increase the consumption of still clean water; during the daytime, do not drink alcoholic beverages.

When going to the beach or out of town, consider the possible reaction to ultraviolet radiation when planning your menu. Do not use perfumes and decorative cosmetics, especially those containing aniline dyes, retinoids, eosin, anti-aging cosmetics, skin treatments containing salicylic or boric acid, sunscreen creams with para-aminobenzoic acid.

People taking medications should be aware of possible photosensitivity and take precautions on sunny days.

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Forecast

Most types of photodermatitis are not dangerous; if you follow certain rules of behavior in the sun, you can avoid unpleasant consequences.

The prognosis for recovery in the vast majority of cases is quite favorable.