Looking Fit 02/2005: Feeling Sensitive?

Feeling Sensitive?
Get A Refresher Course In Photosensitivity

by Judie Bizzozero

Every salon professional knows that the Golden Rule of tanning is Don’t burn. It’s a mantra that should be reinforced to each and every customer, each and every time they enter the tanning salon. However, there are instances where a customer may have a photosensitive reaction to ultraviolet light and think it’s a sunburn. Every salon employee should be trained to deal with the issue of photosensitivity in order to avoid it happening at all.

Photosensitivity is a physical reaction that occurs in varying degrees to a certain portion of the population. It occurs when different drugs or medical conditions react with ultraviolet light to cause the body to become more sensitive regarding the skin’s acceptance of ultraviolet light.

The chemical may enter the skin several ways—orally, topically or parenterally (not through the digestive tract)— but must be present when the skin is exposed. Compounds that cause photosensitivity usually are cosmetic or therapeutic in nature. Sometimes the chemical changes that occur reduce the skin’s ability to defend or heal itself. Some medications specifically are designed to enhance the immune system or reduce the immune response. There also are medical conditions that cause a similar response.

Hopefully, a tanning customer will be aware of any medical condition and have been told by his or her physician to be careful of sun exposure. However, it is the salon owner’s responsibility to inform the client that ultraviolet light is the same whether it is emitted from the sun or from a tanning unit.

There are a number of reactions that can occur from mixing certain medications with ultraviolet light. The reaction is almost the opposite of putting sunscreen lotion on the skin. For example, an SPF 8 lotion is formulated to allow a person to remain in the sun for eight times as long without burning. In the case of a photosensitizing agent, the individual only may be able to be out in the sun for onefourth the time he or she normally can before getting erythema or sunburn.

It also is important to note that certain drugs are more photosensitizing than others. For example, Tetracycline, Thiazide and anti-cancer drugs such as Interferon top the list as most likely to cause a severe reaction.

Salon operators must be aware of the fact that each individual is different and there are varying portions of the population that will react to any given medication or product.

Additional points to consider are formulation, metabolism, elimination factors and photochemical reactivity, as well as the method of administration. Factors associated with radiation include the special irradiance of the ultraviolet source, dose and rate of delivery, number and frequency of exposure, and the timing of the radiation relative to the presence of the chemical in the body. Refer to a list of photosensitizing drugs and agents on page 86 of this issue. While this list is comprehensive, it does not list the newer medications in the market. If you have any concerns, have your customers consult with their doctor or pharmacist to see if they can withstand UV exposure—indoors or outdoors.

The clinical features of photosensitization reactions vary with the chemical and the individual. Skin eruptions tend to occur in areas of greatest exposure. In the event of an injury developing from overexposure to ultraviolet light in a tanning facility, medical advice or attention should be sought immediately. Tanning facilities that are regulated by state law are required to submit a written report of the incident within five working days.

In the incidence of a photosensitive reaction, exposure to ultraviolet radiation should be stopped at once. For mild sunburn, cool compresses should be kept on the affected area until the pain subsides. Soaking with Aveeno Oilated oatmeal, cold cream and other bland medications are fine for mild sunburns. Do not use any anesthetic ointment with the word “caine” in it, as this could cause a severe allergic reaction. If an eye injury is incurred, immediately refer the client to either an emergency room or ophthalmologist—not an optometrist or optician.