Treatment of Photosensitivity

Immediate Management

The American Academy of Dermatology recommends discontinue all photosensitizing medications immediately if drug-induced photosensitivity is suspected, including tetracyclines, fluoroquinolones, NSAIDs, thiazide diuretics, cardiovascular medications, and antidepressants 1
Avoid psoralen-containing plants and foods for at least 2 hours before any sun exposure, as recommended by the British Journal of Dermatology 2

Apply broad-spectrum sunscreen with SPF ≥30 to all exposed skin areas, including hands and face, as recommended by the American Academy of Dermatology 3, 1
Wear protective clothing, such as long-sleeved shirts, long pants, and broad-brimmed hats, to prevent sun exposure 1
Avoid sun exposure between 10 AM and 4 PM when UV radiation is most intense, as recommended by the American Academy of Dermatology 1
Use UV-blocking window films in vehicles if driving during peak hours, as recommended by the American Academy of Dermatology 3

No sunlight exposure for 24 hours after PUVA treatment, as recommended by the American Academy of Dermatology 3
Wear UVA-blocking protective eyewear during and after PUVA treatment, as recommended by the British Journal of Dermatology 2
Shield nipples/areolae with broad-spectrum sunscreen or zinc oxide paste during PUVA treatment, as recommended by the American Academy of Dermatology 3
Cover recent skin cancer sites or surgical scars completely during PUVA treatment, as recommended by the American Academy of Dermatology 3
Be aware that PUVA erythema peaks at 96 hours or later, requiring treatment intervals of at least 2-3 days, as recommended by the British Journal of Dermatology 2

Perform monthly skin examinations during active phototherapy, as recommended by the American Academy of Dermatology 5
Annual full-body skin examinations by a dermatologist are recommended for all patients with chronic photosensitivity, as recommended by the American Academy of Dermatology 1
Encourage patient self-examination for new or changing lesions, as recommended by the American Academy of Dermatology 1

Narrowband UVB is preferred over PUVA in children due to its superior safety profile and ease of administration, as recommended by the American Academy of Dermatology 4
Phototherapy is appropriate for children with refractory disease unresponsive to topical measures, as recommended by the American Academy of Dermatology 4
Address psychosocial factors, as phototherapy equipment can appear intimidating to younger patients, as recommended by the American Academy of Dermatology 4
Long-term consequences of childhood phototherapy are unknown, though increased non-melanoma skin cancer risk has been reported with PUVA in pediatric psoriasis, as reported by the American Academy of Dermatology 4

Do not use topical calcineurin inhibitors concurrently with phototherapy, as recommended by the American Academy of Dermatology 4
Do not underestimate the delayed nature of PUVA erythema, which may not peak until 96 hours post-treatment, as recommended by the British Journal of Dermatology 2