Education & Training: Photosensitivity Part 2

Last month we discussed the subject of photosensitivity and how it relates to indoor tanning. All salon operators and employees should be well educated about photosensitivity, which 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. This month we take a closer look at the differences between the two types of photosensitive reactions— phototoxic and photoallergic.

Photoallergic reactions usually occur due to substances applied to the skin, but can be caused by substances ingested or injected. The reaction is the result of UV light structurally changing the substance and, in turn, causing the skin to produce antibodies, resulting in allergic reaction.

The symptoms typically appear as eczema-like skin conditions, but also can present as lesions or hives. Symptoms usually appear on exposed areas of the body, but can spread to nonexposed areas as well. Symptoms usually appear 24 hours to several days later, and the recovery period often is slower than that of phototoxic reactions.

It is important to note that photoallergic reactions are not dependent on the amount of substance applied, ingested or injected. These reactions require prior or prolonged exposure to the substance and do not occur during the initial exposure to the substance. After the initial exposure period, continued exposure to the substance, even in small amounts, will cause a photoallergic reaction. They are more common in adults than children. Reactions can occur due to chemically related substances by cross-sensitivity or cross-allergenicity.

Phototoxic reactions are more common than photoallergic reactions and are caused by substances that can be ingested, applied to the skin or injected. A phototoxic reaction occurs when the substance absorbs energy from UV light and releases the energy into the skin. This energy causes skin cell damage or death. The reaction usually occurs quickly—within seconds to hours after exposure. The symptoms usually appear only on the parts of the body that were exposed and present as a sunburn/erythema, with pain, blistering, hyperpigmentation and peeling. Phototoxic reactions can occur on first exposure to a substance and usually do not show cross-sensitivity.

The clinical features of photosensitive reactions vary with the chemical and the individual. Be aware that it can be difficult to distinguish between the two types of reactions and a substance or medication is capable of producing both reactions.

Skin eruptions tend to occur in areas of greatest exposure. In the event of injury resulting from overexposure to ultraviolet light in a tanning facility, medical advice or attention should be sought immediately. In the incidence of a photosensitive reaction, exposure to ultraviolet radiation should be stopped at once.

Tanning facilities that are regulated by state law are required to submit a written report of the incident within five working days.

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 an emergency room or ophthalmologist.