Sun Allergy

Q. I am 29 and in the past 3 years, I have developed cellulitis from exposure to the sun. The exposure does not have to be extensive; one day in the sun (winter or summer) will do it. After the initial exposure, it seems to take less and less exposure to generate a reoccurrence. I get bumps on my arms, face, back and sometimes legs. I have been on birth control pills for 10 years. I am also extremely susceptible to strep bacteria. (As a child I had strep throat numerous times a year, scarlet fever etc.) On at least one occasion last year after developing a serious rash covering my entire arms, back and face (on a vacation to Florida) I developed a strong case of strep. What can be done? Do I have to avoid the sunlight forever? Is there a way to prevent this? I have tried to treat it with Benadryl, aloe, etc. I use SPF 30 sun block and apply it liberally. Until this began, I never had any trouble with exposure to the sun even on trips to Aruba where the sun is especially strong.

A.What you are describing sounds more like a type of sun allergy (photoallergy). There is a different term used if the skin lesions are raised and appear swollen with surrounding redness: Solar Urticaria (a type of Hives).

I am not aware that sun exposure in of itself can cause strep cellulitis (a bacterial skin infection). However, after the skin is damaged such as after a sunburn blister breaks, bacteria can penetrate the broken skin which may then lead to a cellulitis. There are certain drugs that can lead to excessive sun sensitivity including certain antibiotics and diuretics, amongst others. There is a rare disorder called porphyria that can cause sun sensitivity, which can be checked by a 24 hour urine test.

Unfortunately, there is no cure for the above condition. The best advice is to try to avoid the sun. When unable to stay out of the sun, I agree with #30 sun block, wear a hat, long sleeves, etc. If you do get a rash, topical steroids and oral Motrin may be helpful. Also, antihistamines such as Atarax may be helpful. You may consider seeing a dermatologist, but I'm not sure he/she will have much else to offer. Good Luck.