Solar Urticaria

University Teaching Trust

Solar urticaria

Barnes Building Photobiology Unit 0161 206 4081

© G21082602W. Design Services, Salford Royal NHS Foundation Trust, All Rights Reserved 2021. Document for issue as handout. Unique Identifier: CS57(21). Review date: September 2023. What is solar urticaria? What causes solar urticaria? Urticaria (pronounced ur-tick- Everybody’s skin contains special This guide has been area) generally is a common skin immune (allergy) cells called mast written to help answer reaction that can affect about 2 in cells. These cells make a chemical some of your questions every 10 people at some time in called histamine. Histamine is their lives. Other common names involved in lots of the body’s about solar urticaria. for urticaria are “hives”, “nettle allergy reactions. Normally You may have been given rash” “wheals” and “welts”. sunlight has no effect on these cells but if someone has solar this guide because you Solar urticaria is a much rarer urticaria sunlight makes the mast type of urticaria that is caused have been diagnosed with cells release their histamine. It is by sunlight. Patients with solar the histamine that makes the skin solar urticaria or because urticaria have itchy or burning red, swollen and itchy. we think this might be the skin after they have been out in cause of your symptoms. the sun. They may notice pink or red patches which become Is solar urticaria serious? swollen and look like nettle Solar urticaria can be serious if stings. The patches can be of you expose large areas of the different shapes and sizes. If the body to sunlight (e.g sunbathing). patient comes out of the sun the Exposing large areas of your rash will disappear quite quickly skin to sunlight can make you (often within an hour). The skin feel light headed, sick and turn looks completely normal after pale. There have been reports of the rash has gone. one or two swimmers collapsing because they exposed a large Who suffers from solar area of their body to sunlight. urticaria? Solar urticaria is more common in women than men. It can start at any age but most people seem to develop it before the age of 40.

© G21082602W. Design Services, Salford Royal NHS Foundation Trust, All Rights Reserved 2021. Document for issue as handout. 1 Unique Identifier: CS57(21). Review date: September 2023. Is solar urticaria infectious? How will having solar What about other artificial How can solar urticaria be No. There is no risk of other urticaria affect me? light sources? treated? people catching solar urticaria If you have been diagnosed as Some patients with solar urticaria Sunscreens from you. having solar urticaria you may need to be careful around bright You will be provided with have to make changes to your artificial light sources. This sunscreens on prescription and Does having solar urticaria lifestyle which can be restrictive. can include the blue-ish lights these will help prevent the rash The doctor can prescribe anti- that dentists sometimes shine increase your risk of cancer? developing. Sunscreen should be histamine tablets which will into your mouth. You should applied as thickly and evenly as No. Experts think solar urticaria help to control the rash but you mention to your dentist that you possible and re-applied often. is more like an allergy. should also try to: have been diagnosed with solar urticaria. l Avoid the sun between 11am Anti-histamines Is solar urticaria hereditary? and 3pm The lights that some beauticians Anti-histamines block the effects use when applying artificial of histamine and will help to l Wear protective clothing No. Experts do not believe solar fingernails may also set your reduce the rash and itching. It is urticaria is hereditary. l Use a sunscreen that is SPF reaction off. best to take your anti-histamines 30 or above (UVB protection) regularly as prescribed by your You should not use a sun bed if and has four/five stars (UVA doctor. There are many different Can solar urticaria be cured? you have a sun allergy. protection). Remember types of antihistamine. Some No treatment will completely get to re-apply the sunscreen of the older types can cause rid of solar urticaria but by careful often. If you are visible light What about vitamin D? drowsiness but this is less likely sun avoidance, use of sunscreens sensitive you may need special Importantly, in order for people with the newer ones. You and anti-histamines the rash can be sunscreens to make enough Vitamin D may need to try different anti- reduced. Sometimes solar urticaria l Learn how much sunlight your themselves, they need a certain histamines until you find the ones can go away on its own but this skin can tolerate and keep amount of sun exposure. The sun that suit you best. does not happen very often. within that limit protection measures needed for people with solar urticaria mean l Make sure you introduce your Vitamin D deficiency is a real risk skin to sunlight gradually in and this does require treatment the spring with supplements if it occurs. Your vitamin D levels can be monitored through blood tests.

© G21082602W. Design Services, Salford Royal NHS Foundation Trust, 2 All Rights Reserved 2021. Document for issue as handout. 3 Unique Identifier: CS57(21). Review date: September 2023. Desensitisation or UV Hardening or toughening Example Monday treatment Some people with solar urticaria Mrs Smith knows her I don’t want to expose too much of my skin, Sometimes the resistance of your may be able to increase the solar urticaria rash just my arms and face so I wore jeans and a skin to the effects of the sun resistance of their skin at home. usually appears after t-shirt. I went outside in the sun for 5 minutes. can be increased by ultraviolet This involves going out side for going outside for half I went back indoors and waited to see if my light. This is done in a hospital short periods in the spring to an hour. Mrs Smith has rash appeared…..thankfully it didn’t. department and will involve build up your resistance. been toughening her visiting the hospital three times You might find the time is as skin in the spring and Wednesday a week for about 5 weeks in the short as a few minutes at first this is her diary: Today I went out in the sun for 10 minutes. I spring. but you may be able to gradually covered myself up after that so I didn’t catch any It involves gradually exposing build this up to longer times. You extra sun and waited. My rash still didn’t appear. your skin to a little more will have to be careful not to ultraviolet light every visit to try overdo it, but as you understand Friday to build up your skins resistance. more about how much light I decided to go outside for 20 minutes, and then The effects of desensitisation are triggers your rash you will be I went back inside. After half an hour my rash lost in the winter so you will have able to judge how long to stay started and I felt itchy. to build up your resistance again out. in the spring. The effects of hardening are lost Saturday in the winter so you will have to I went back out in the garden for 10 minutes and build up your resistance again in my rash didn’t appear. I will keep trying to go out the spring. We have included an for 10 minutes so that my skin can get used to it. example of how you might try to toughen your skin in the spring. Wednesday I went out in the sun for 10 minutes and still no rash. I will try 20 minutes again on Friday.

Friday Went out in the sun for 20 minutes….no rash!

© G21082602W. Design Services, Salford Royal NHS Foundation Trust, 4 All Rights Reserved 2021. Document for issue as handout. 5 Unique Identifier: CS57(21). Review date: September 2023. Other Treatments Notes Some hospitals may offer other These treatments are not more specialised treatments for available everywhere and might solar urticaria. They include: not suit every patient with solar urticaria. Treatments can have Plasmapheresis side effects so you and your A blood purification procedure doctor should weigh up the used to treat several autoimmune benefits against the side effects diseases. It has been shown to decide whether and what type to work in some cases of solar should be prescribed in your case. urticaria.

Intravenous immunoglobulin Contact us therapy The Photobiology Unit can be Involves giving injections of a contacted on: sterile purified antibody called immunoglobulin G. 0161 206 4081 or by e-mail: Afamelanotide Photobiology.Salford@srft. Is a treatment currently nhs.uk undergoing medical trials. It involves an implant of a hormone that makes your skin tan without having to go in the sun. This can help protect your skin and reduce the severity of solar urticaria.

Omalizumab Is a monoclonal antibody treatment that is showing high efficacy in many patients with solar urticaria.

© G21082602W. Design Services, Salford Royal NHS Foundation Trust, 6 All Rights Reserved 2021. Document for issue as handout. 7 Unique Identifier: CS57(21). Review date: September 2023. © G21082602W. Design Services Salford Royal NHS Foundation Trust All Rights Reserved 2021 This document MUST NOT be photocopied University Teaching Trust Information Leaflet Control Policy: Unique Identifier: CS57(21) Review Date: September 2023

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