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

For most of the practically healthy inhabitants of the world, exposure to the open sun does not cause any consequences other than sunburn on the skin. However, the skin of a fifth of the human population inadequately reacts to intense insolation. In everyday life, this condition is called an allergy to the sun, although in fact, sunlight, strictly speaking, can not be considered an allergen, by which modern medicine means alien proteins that cause the body's immune response in the form of allergic reactions. Photodermatitis (photodermatosis) - inflammatory structural changes in skin epithelial cells as a result of insolation, which acts as a provoking factor.

The acute and periodically recurrent skin reaction caused by sunlight is becoming an increasingly common pathology, which has received serious study not so long ago and at the present time the final verdict has not yet been passed to it. But research in this direction has already made it possible to draw a number of conclusions.

[1], [2]

Causes of the photodermatitis

People who can not be in the open sun because of the so-called solar allergy should think about their health. An inadequate reaction to the action of direct sunlight develops with insufficient production of melanin, and its deficiency is provoked by various causes. In addition, sometimes melanin is produced enough, and the skin is hypersensitive to ultraviolet light. In this case, it is worth considering the presence in the skin or on its surface of phototoxic substances. Such people should pay attention to the work of organs, the dysfunction of which contributes to intoxication of the body - liver, kidneys, adrenals. Violations of the process of metabolism and immunity contribute to the accumulation in the skin of substances (photosensitizers) absorbing light waves of the visible spectrum. They increase the toxicity of molecular oxygen, contributing to its transfer into a more energized state.

Many natural substances play the role of photosensitizers. Their accumulation in the skin as a result of metabolic disorders increases its sensitivity to ultraviolet radiation. These processes can be congenital, then the intolerance of ultraviolet is manifested from the very childhood, and acquired. Most types of photodermatitis disturb young people, some appear in mature and old age.

The most common acute form of photodermatitis is banal sunburn. They occur in absolutely healthy people under the influence of prolonged and intense insolation. Most susceptible to them are small children, pregnant women, albinos and natural blondes, lovers of tanning salons and tattooing. Increases the risk of burns, the presence of chronic diseases of internal organs, taking medications, skin photosensitizers. In late spring and early summer, when solar activity is high, and the body is not yet accustomed to ultraviolet, the probability of a burn is greatest.

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

Photosensitivity may be caused by oral contraceptives, drugs belonging to many pharmacological groups. The most commonly used of them: non-steroidal anti-inflammatory drugs, in particular aspirin and ibuprofen; antibiotics of tetracycline; sulfonamides and drugs with antihistaminic activity; barbiturates and antipsychotics; some cardiological and hypoglycemic drugs, cytostatics and diuretics; directly photosensitizers and local remedies for the treatment of skin problems.

Alternatives and phytopreparations, cosmetics and perfumes containing vitamins A (retinoids, carotenoids), vitamin E, eosin, tar, tar, boric acid, mercury, lead, musk, phenol, plant essential oils (pink, sandalwood, bergamot, nut, herbs of St. John's wort, etc.), herbs - nettle, St. John's wort, clover and some others; juice of dill and parsley, celery, carrots, figs, citrus - this is not a complete list of substances, internal or external application of which causes hypersensitivity to sunlight. Hypersensitivity to sunlight in combination with furokumarin-containing plants is called phytophotodermatitis, it is not so rare. Danger can be a walk through the flowering meadow, especially in early summer. Pollen blooming during this period of motley grass contains furokumariny, 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 frequency, then this condition is referred to as chronic photodermatitis. Most often, a polymorphic light rash occurs among them, the alleged cause is the development of a delayed response induced by insolation to an antigen. It is this relapsing disease that is most often considered an allergy to sunlight. Morphological forms of manifestations are various - hives, erosion, erythema.

Pulmonary pox Bazena and chronic actinic dermatitis (reticuloid) - with these diseases, insolation acts as a provocateur, the causes of their occurrence are not established.

Eczema and prurigo, provoked by sunlight, arise as a result of disruption of individual metabolic pathways of porphyrins and their derivatives, which accumulate in the bloodstream, as well as a deficiency of nicotinic acid.

Erythropoietic and hepatic porphyria belong to the group of genetically determined diseases, are accompanied by photosensitivity, sometimes occur in very severe form, often manifest from the very birth. There are mild and latent forms that appear at a later age, which is facilitated by the intake of certain drugs that activate the enzymatic activity of aminolevulinate synthase (analgesics, barbiturates, glucocorticosteroids, NSAIDs). Late skin 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. Nevertheless, the inheritance of this form of porphyria can not be completely excluded either, since the patient's relatives have biochemical signs of the disease in the absence of a clinical picture, and in some family history, there are cases of the disease.

Another rare serious hereditary disease from a series of photodermatoses is pigmentary xeroderma, almost always sooner or later takes malignant course. It is assumed that the disease causes an enzymatic deficiency that prevents the recovery of DNA from skin cells damaged by insolation.

[3], [4], [5]

Risk factors

The risk factors for the intolerance of solar radiation are genetic predisposition to allergic diseases, metabolic disorders, immunodeficiency states, chronic diseases of internal organs, acute severe infections, drug therapy courses, periods of changes in the hormonal background - adolescent, pregnancy, menopausal, as well as tattooing, peeling, other cosmetic procedures, professional contact with toxic substances, bad habits, temporary stay in an unusually hot climate those chlorinated water, swimming in the sea at the time of algal blooms (usually in early summer).

[6], [7], [8], [9],

Pathogenesis

The mechanism of the development of photodermatitis has not yet been fully studied, some pathologies isolated into independent nosological units, still constitute a riddle for researchers.

Almost always there is a hereditary predisposition. For example, with a pigment xeroderm, genes are found in which mutations that cause enzymatic deficiency occur that do not allow the regeneration of the damaged DNA of skin cells by ultraviolet.

But the mechanism of the development of a special sensitivity to insolation with a light bullet Bazen is still in question, not even all medical scientists agree with the inheritance of this disease.

By the mechanism of development, a phototoxic and a photoallergic reaction is distinguished. 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 - scaling, swelling, vesicles and vesicles. Ultraviolet radiation, interacting with a photosensitizing substance, catalyzes the photochemical reaction with the formation of either free radicals or singlet oxygen, which cause damage to the structure of cardiomyocytes. The skin reaction is caused by the release of proinflammatory mediators (prostaglandins, histamine and arachidonic acid), the 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, ability to dissolve and form stable compounds. In the epidermal layer, keratinocytes die off, so-called sunburn cells, lymphocytic proliferation, degeneration of melanocytes and Langerhans cells, in addition, the blood vessels of the skin expand, and its surface layer swells. Skin cells undergo dystrophic changes and necrosis, then exfoliate.

In the second case, the reaction occurs upon repeated interaction with the ultraviolet. Drugs and other chemicals or products of their metabolism, absorbing sunlight, form photosensitive substances in the skin. With the repeated action of sunlight, immune mechanisms are activated in response to the antigens formed in the skin after the primary interaction. Externally, photoallergic reactions resemble a classic allergic reaction and are accompanied by severe itching, hyperemia, sloughing and proliferative processes in the epidermis.

Polymorphic light rash, 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 persons with impaired porphyrin metabolism, in other cases, patients had a positive test for passive allergens, which speaks of the development of photoallergies. In many patients, the causes of hives are not established.

Porphyria is a group of diseases caused by disorders in porphyrin metabolism, causing cumulation 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 hepatic - in liver cells (hepatocytes). The erased forms of the disease sometimes do not manifest themselves until some factor (taking certain drugs, puberty, pregnancy, etc.) will not trigger the development of the disease. In the pathogenesis of acquired porphyria, the stimulus to their development can be intoxication with lead salts, herbicides, insecticides, alcohol, liver disease. Porphyrins, accumulating in the skin, act as photosensitizers, and when insolation occurs, accelerated peroxidation of fatty components of cell walls, destruction of keratinocytes and damage to the surface of the skin.

Statistics can only judge cases of photodermatitis, with which patients have not coped themselves and sought medical help. Often the symptoms take place within two to three days, these cases remain outside the medical field, so 20% of the population suffering from photodermatitis is clearly underestimated. Sun burns and not once have happened in almost everyone. Of course, more serious cases are usually recorded.

For example, an estimated 70% of all inhabitants of the planet are susceptible to the appearance of a polymorphous light rash. Women are more prone to this pathology, most often the disease is observed in the age group of people from 20 to 30 years. It is noted that after the thirtieth birthday in most patients (3/4), relapses appear less and less, and sometimes self-healing occurs.

Three hundred out of a hundred thousand people get sick with solar urticaria, men suffer three times less often than women. The main age of the sick from 30 years to 50. Usually, five years after the first manifestation of the disease, spontaneous regression occurs in about 15% of patients, another quarter - self-healing takes a decade.

Bazin's smallpox is a very rare disease, three cases are recorded from a million inhabitants of the planet. Manifests in childhood and adolescence, mainly in boys. Another predominantly male disease is the actinic reticuloid, middle-aged and elderly people are ill, whose skin has always inadequately reacted to insolation.

Pigment xeroderma is also rare enough - four cases per million population, has no sexual and racial preferences. Mostly sick members of the same family.

Porphyria is most common in northern European countries, where from a hundred thousand people sick from seven to twelve people.

Phototoxic reactions occur, some are estimated to be about twice as likely to be photorealgic, although there is no exact statistics on their prevalence.

[10], [11], [12], [13]

Symptoms of the photodermatitis

The first signs of sunburn become visible in subjects with more sensitive skin after only half an hour of staying under the scorching sun, with a more stable one in an hour and a half. In the open areas of the body there is hyperemia, a burning sensation, a tingling sensation. Later these patches begin to itch, it is painful to touch them, not only with hands, but also with a jet of cool shower. The first night after receiving the burn will not bring rest - it usually hurts to lie, the temperature may rise, symptoms of general malaise may appear. With severe burns, there are swelling, blisters, vomiting, hyperthermia, severe thirst. Usually the acute condition lasts no more than two or three days. In severe cases, seek medical attention.

Phototoxic reactions according to clinical manifestations resemble the picture of ultraviolet burn. They develop for several hours or days after a single insolation, usually after systemic drug therapy or internal use of photoactive chemicals. To interact with sunlight, for example, tricyclic antidepressants, the appearance of gray-blue pigment spots on the skin, antibiotic tetracycline and fluoroquinolone series, furocumarine-containing and some other substances - nail damage. Phototoxic reactions are often similar to late cutaneous porphyria, manifested as lichenoid rashes, telangiectasias. Sometimes, after sloschivaniya surface of the epidermis, changes the color of affected areas of the skin.

Photoallergic reactions occur more often after external medicinal and other chemicals are used. According to the symptoms, these species are similar to skin manifestations of allergy - hives, papular and eczematous rashes, with the formation of serous crusts, peeling, with characteristic intense itching. Rashes appear about a day or two after the repeated ultraviolet irradiation. They are localized, mainly in areas that were open to exposure to sunlight, but sometimes spread to those parts of the body that were under the clothes.

Phototoxic dermatitis is characterized by more precise boundaries of rashes, their resolution is usually accompanied by hyperpigmentation of the skin. Photoallergic - outwardly have fuzzy fuzzy boundaries, the presence of pigmentation is not observed.

Symptoms of solar urticaria is a scattering of small blisters of pink or reddish color, which are very much itchy. Hives appear quickly enough, often enough to stay in direct sunlight for a few minutes. If you stop accessing sunlight to the affected areas of the skin, rashes can go away quickly without any treatment.

Photocontact dermatitis from contact with plants-photosensitizers (phytophoto-dermatitis) occurs in the form of bands, zigzags, bizarre patterns, consisting of their spotted, erythematous or bubble rashes on the hands, face, legs, and any parts of the body that could come into contact with plants. Appears usually the next day, it itches strongly or moderately, it can be confused with traumas (scuffs, abrasions). Inflammatory phenomena quickly pass by themselves, the pigmented spots in their place can persist for a longer time.

To contact photodermatitis is also a keyfob, which arises in places where the perfume is applied to the exposed insolation of the skin. It is manifested by prolonged hyperpigmentation of its surface.

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

The most common places for rashes are the décolleté zone, the forearm. Manifests in the spring with the first bright sun, then the skin gets used to insolation and the rashes pass. And at first rashes can appear on the face and neck, then these parts of the body get used to the sun radiation - the rashes are passing, but appear in other places, when the clothes become more and more light and open. By the middle of summer the rash disappears, as the skin gets used to insolation, but a year later with the first intense sun rays the rashes appear again.

Solar summer pruritus (prurigo) usually manifests in the puberty period after prolonged insolation. The photodermatitis on the face is localized, mainly the middle of the face is affected, the red border of the lips is affected, especially the lower lip (edematous, compacted with exfoliating crusts) suffers. The rash is localized in the décolleté zone, on the hands, especially up to the elbow, other exposed parts of the body. Most often these are red papules outlined by erythema, over time they merge into plaques surrounded by papules. Rashes are itchy, cracked and crusted. On the lesions, the skin becomes covered with pigment spots that appear on the sites of the healed plaques,

Eczema caused by ultraviolet radiation is characterized by a symmetrical arrangement on the surface of the skin, which is unprotected from insolation. There is photodermatitis on the face, the skin of the neck and the occipital part, the outer side of the hands that are open for ultraviolet almost all year round, sometimes the surface of the lower leg and forearms are affected. Eczematous spots consist of papules or vesicles, with fuzzy blurred boundaries, their forms are variable. During periods of exacerbations, the affected skin swells, mucus secretions appear, the surface of the spots becomes covered with crusts, erodes, itchs. High probability of secondary infection.

Steady face erythema, caused by insolation, has a characteristic shape resembling a purple butterfly, clearly delineated by a brownish border. In this place there is a small swelling, burning and itching. It can spread to other open areas of the skin, the arms to the elbow and the skin of the hands outside are often affected. Periodically peeling off with the formation of serous crusts, it inflames in the form of small itchy nodules, it can slightly rise above the surface of healthy skin. With a decrease in solar activity in the cold season, the rashes disappear, leaving no traces behind them. General condition of the patient during the exacerbation without changes.

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

In patients with late cutaneous porphyria, the most common of its other species, the seasonality of exacerbations is clearly traced - from May to August. It can be of two types. The first belongs to sporadic (acquired) types of the disease. Among them, professional photodermatitis is often associated with intoxication during production activities. The second is hereditary.

Manifests after 40 years - on the body emptied blisters, small and large, densely filled with a clear liquid, sometimes - with an admixture of blood or unclear, 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, crusts peel off, leaving pale purple traces on the skin, or retracted scars, first inflamed and pink-red, then replaced by a darker skin, later on these places the pigmentation disappears and white spots remain. In the progressing stage on the skin, you can see all the stages of the process - from fresh blisters to scars and depigmentation. Over time, patients even in the period of remission on the skin are left traces in the form of pigmented and atrophied areas, later the skin acquires a yellowish hue, becomes denser and, at the same time, brittle and easily traumatized.

Actinic reticuloid also more often affects men older than middle age, suffering from sunny eczematoid dermatitis. In the open areas of the body appear rashes, the skin under which thickens and thickens. Eruptions can remain in the cold season, but under sunlight the condition worsens.

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

In adolescence, there are symptoms that allow suspected smallpox. At the expiration of 0,5-2 hours after the skin gets into direct sun rays on the skin of the face and the outside of the hands, papular rash is emptied, in the place of which small blisters with a crater in the middle are formed, after their opening there are bloody crusts. The rash is very itchy. The crusts begin to fall a week later and by the end of the second week all the face and skin on the back surface of the brush is covered with small pockmarks. The progressing stage may be accompanied by symptoms of general malaise, exfoliation of the nails.

The most dangerous disease caused by the reaction of hypersensitivity to sunlight is the pigment xeroderma. Pigmentation begins to appear at an early age, even before the year, because the disease is hereditary. First, there are many erythematous eruptions, inflammation is replaced by the appearance of pigment spots on open areas of the body, primarily on the face, then they darken, warts and papillomas appear, ulcers and skin atrophy. This disease itself will not pass, so early diagnosis and treatment will help ease the condition of the patient, improve the quality and duration of his life.

These are the main types of photodermatitis and diseases accompanied by photosensitization. If the rash appears periodically, you should always consult a doctor and be examined. Photodermatitis in a child may indicate the presence of any skin disease accompanied by photosensitivity, however, mainly they are manifestations of sunburn or polymorphous light rash, and parasites can also cause an inadequate response to sunlight. If you know that you overdid it with a walk in the sun, then this is a normal reaction. Baby skin is sensitive to sunlight. If the child does not tolerate ultraviolet radiation, it is necessary to consult a doctor.

The stages of photodermatitis correspond to any manifestations of skin reactions. Progressing - the first stage, when there are rashes in response to insolation, itching, burning, soreness. Then the appearance of a new rash stops, the old still holds and bothers - this is a stationary stage, indicating a fracture in the direction of regression. Then, the healing of the skin surface or regression of the disease begins. If you take care of the skin from a new intense insolation, then perhaps more photodermatitis will not bother you.

Complications and consequences

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

Solar burns by themselves pass without a trace, however, over time, a new growth may occur on the burn site. The most terrible of which is black cancer or melanoma, the role of burns in the occurrence of which is in one of the first places.

Pigment xeroderma almost always has a malignant course.

Frequent cases of acute photodermatitis can lead to a chronic process. In addition, such a reaction to sunlight can talk about the development of chronic pathologies of internal organs, avitaminosis, hemochromatosis, metabolic disorders, the presence of autoimmune processes and collagenoses. Therefore, if sensitivity to the sun's rays becomes your constant companion, you need to find out its cause.

[14], [15], [16], [17]

Diagnostics of the photodermatitis

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

Sample for allergens and more specific tests for serum iron, vitamins B6 and B12, and others at the physician's discretion may be prescribed. The histological examination of the skin samples confirms the type of photodermatitis. Changes in epidermal and dermal cells characteristic of phototoxic reactions (premature keratinization and vacuolar degeneration of skin cells, epidermal blisters, intracellular edema, superficial lymphocytic infiltrates with neutrophils) differ from those in photoallergic reactions (exudative inflammation of the epidermis, focal parakeratosis, movement of lymphocytes in epidermis, perivascular and interstitial lymphocytic infiltration of the skin with predominance of histiocytes and eosinophils).

Often a consultation of other specialists is required: hematologist, gastroenterologist, allergologist-immunologist, rheumatologist.

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

[18], [19], [20], [21]

Differential diagnosis

Differential diagnosis is carried out with the purpose of establishing a specific type of photosensitization: solar urticaria, eczema, prurigo; photodermatitis, induced by drugs, plants, toxic substances; differentiation of them with symptoms of metabolic or autoimmune pathologies - lupus erythematosus, porphyria; other skin diseases - relapses of atopic or seborrheic dermatitis, erythema multiforme and others.

[22], [23], [24], [25]

Treatment of the photodermatitis

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

With sunburns, blisters, drugs with dexpanthenol (provitamin B5), in particular in aerosol form - Panthenol, are of great help  . Touching the inflamed skin is painful, in addition, lack of contact reduces the risk of infection. When applied to the surface of the skin, the active ingredient is quickly absorbed by its cells, where it is converted into pantothenic acid, which is an essential component for the normalization of metabolic processes and cellular renewal. Promotes the formation of endogenous corticosteroids, acetylcholine, thereby reducing pain and inflammatory symptoms. It is applied to the damaged skin from one to several times a day, it is not recommended to spray on the face skin. It is usually well tolerated, but occasionally it can cause allergies. Panthenol is used in pediatric practice, as agreed with a doctor, it can be used to treat the skin and during pregnancy.

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

If skin rashes are accompanied by exudation, use drying agents, for example,  salicylic zinc ointment  (Lassar paste), absorbing exudate, reducing inflammation and preventing infection. The components of the paste (salicylic acid and zinc), when applied locally, are not absorbed into the systemic circulation and act directly at the site of application, quickly eliminating unpleasant symptoms.

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

You can treat the inflamed surface with Olazole spray   containing sea-buckthorn oil, antiseptics and analgesic, especially if there is a suspicion of infection. This tool is applied to the skin once or twice a day.

If there is no allergy to honey, spray  Amprovisol,  which contains propolis and vitamin D, glycerin and menthol, disinfects the surface, helps relieve inflammation and unpleasant sensations of burning and pain.

These funds do not apply to large surfaces, do not allow them to hit the eye. Directly on the person do not spray, first, shaking the can, squeezing the product out onto the palm of your hand, then carefully transferred to the inflamed skin on the face.

Use non-prescription medicines without prescribing a physician to relieve the symptoms of photodermatitis with caution. After all, even the safest means can aggravate the condition, causing an allergic reaction in addition. In case of complications or severe form of lesion, you should always seek medical help. You may need systemic therapy, oral administration of antihistamines, glucocorticosteroids externally and orally. Hormonal drugs are very effective, however, they have many side effects and should not be used without medical advice.

If photodermatitis is a symptom of a disease, then treat it primarily. Treatment is prescribed by a doctor, different medications and individual treatment regimens are used. Almost always, diuretics, vitamins (group B, ascorbic acid, vitamin E), iron-containing preparations, physiotherapy are included in the treatment.

Different procedures and methods of influence are used, sometimes their combination. The choice of method depends on the patient's condition and disease. Electroprocedures can be prescribed: D'Arsonval currents, ultrathonotherapy, electrophoresis with calcium chloride, antihistamine drugs, prednisolone. Local effects of magnetic waves, electric current of high frequency, galvanic current, laser radiation help quickly to get rid of symptoms, raise immunity and improve blood circulation. However, a stable therapeutic effect will bring not only treatment in the period of exacerbation, but also in the period of remission occurring in the cold season.

Alternative treatment

To help yourself or a loved one, to relieve the condition of the skin after an unsuccessful stay in the sun can be with the help of improvised means.

An easy anesthetic, as well as antiseptic and anti-inflammatory effect has cooled tea leaves. Compresses from moistened gauze gauzes can be applied to skin areas covered with a rash.

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

A similar effect can have fresh cabbage leaves, slightly repulsed and attached to the inflamed skin, the washed plantain leaves can be applied to the inflamed areas immediately, even outside the city, at the first signs of sun damage to the skin.

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

First aid means for acute photodermatitis include applying to the skin the juice of aloe or colanchoe, egg protein, honey, sour cream or kefir, raw potato juice, apple cider vinegar. Treated with improvised means of the affected skin repeatedly. Once the applied substance dries the treatment is repeated. In this case, individual patient tolerance should be considered. In addition, alternative agents are used at moderate burn levels or until large blisters appear. By the way, honey and potatoes can prevent them from appearing, but you need to lubricate the skin immediately at the first signs of a sunburn.

Solar dermatitis can be treated with ointment from equal parts of honey and juice of colanchoe. However, it must be insisted in the refrigerator for a week before use, therefore it is impossible to carry ointment to the first aid. Unless, having an anamnesis chronic photodermatitis, it can be prepared in advance.

You can prepare an ointment from cranberry juice with vaseline, mixing them in equal parts. She lubricate the rashes several times a day. Ointment has the ability to remove the inflammatory process, puffiness, and also - moisturize and soften the skin, help to quickly get rid of peeling.

Herbal treatment of photosensitivity phenomena is also effective. In addition to the above compresses, you can take in the broth and infusions of herbs. For example, mix in equal parts the flowers of marigold, chamomile and plantain leaves. A liter of boiling water is taken 300-400 grams of phytmixture, brewed in a glass jar and insisted for an hour. Drink like tea several times a day for half a cup.

You can drink tea from fresh dandelion flowers. Brew it in the proportion of 500ml of boiled water take 100g of flowers. After 10 minutes you can drink. This tool is suitable for early summer. Taking sun baths outside the city during this period, you can take dandelions with you in case of photodermatitis.

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

The infusion of alternation promotes the production of endogenous steroid hormones, which, having anti-allergic properties, will help the body to overcome photodermatitis. Brew it from the calculation: a tablespoon of herbs for 200ml of boiling water, insist for a quarter of an hour in a water bath, then ¾ hours stand at room temperature. Filter, add boiled water to the original volume and drink three to four times a day for half a cup. Do not brew any more, the infusion should be fresh.

For large areas of the lesion, baths are added with the addition of infusion from calendula, lime, chamomile, string. Brew a mixture of these herbs in equal proportions. The infusion is made stronger, at least 300-400 g of the mixture per three-liter jar, which is wrapped in a blanket and left for three hours.

A mixture for taking baths can be prepared from equal parts of chamomile flowers, valerian root, celandine grass, St. John's wort, sage and kipreya. On a liter of water take five tablespoons of the mixture, boil with boiling water and puff for 10 minutes in a water bath. Slightly cool, strain and add to the bath.

Baths are taken first daily, for 15-20 minutes, without wiping, and lightly soaking water on the body with a soft towel. In two weeks you can do baths every other day. After a one-month course, you need a break for the same time.

[26], [27], [28], [29],

Homeopathy

Treatment with homeopathic preparations of diseases with accompanying photosensitivity of the skin should be carried out by a professional, in this case, the patient may recover. Used in this case, almost the entire arsenal of homeopathic medicines, the doctor will prescribe the most likely drug, corresponding to the constitutional type of patient.

Symptomatic agents prescribed for photodermatitis are Hypericum perforatum, Hypericum perforatum, Camphora, Cadmium sulphuricum, Iron sulfate (Ferrum sulphuricum). The latter drug can be prescribed in the case of solar eczema or hives, if the patient also has helminths. Quinine sulfate (Chininum sulphuricum) is prescribed for different types of rashes on sensitive skin to patients with anemia. With itchy chronic photodermatoses recurring in the summer, Apis or Bee honey can be prescribed (Apis mellifica).

In acute photodermatitis and sunburn, Sodium (Natrium carbonicum), Cynthar flies (Cantharis), Amylenum nitrosum, Arnica montana are prescribed.

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

Catalysts of tissue respiration and metabolic processes Coenzyme compositum and Ubiquinone compositum are for injection, but it is possible to use them orally as a drinking solution. Dosed individually depending on the cause and extent of the lesion, as well as the presence of concomitant diseases, the duration of the course is determined by the doctor. They can be used concomitantly with other drugs.

External it is also possible to apply homeopathic ointments: cream Irikar, ointment Fleming DN, Utrika DN, Sanodermas Edas-202. Ointments are applied a thin layer on the affected skin areas two to three times a day.

Prevention

Prevent sunburn and the emergence of photosensitization reactions is not too difficult, it is enough to observe some precautions: protect the skin from exposure to sunlight with the help of a dress from natural fabrics of light tones and applying photo-protective creams.

Even absolutely healthy people are advised to limit their stay in the open sun, especially at the beginning of the warm season up to 10-15 minutes. Take sun baths in the morning to 11 hours and in the evening after 16. The rest of the time must be in a diffused shadow. After bathing in any pond, it is necessary to dry the skin with a towel, since the drops of water left on the skin increase the risk of sunburn.

In the hot season it is necessary to increase the consumption of still fresh water, in the daytime - not to drink alcohol.

Going to the beach or out of town, consider the possible reaction with ultraviolet, making up your menu. Do not use perfume and decorative cosmetics, especially in which are aniline dyes, retinoids, eosin, anti-aging cosmetics, skin care products containing salicylic or boric acid, photo-protective creams with paraaminobenzoic acid.

People taking medications should consider possible photosensitivity and observe precautions on sunny days.

[30], [31], [32], [33],

Forecast

Most types of photodermatitis are not dangerous, while observing certain rules of behavior in the sun, it is quite possible to avoid unpleasant consequences.

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