Lupus Photosensitivity: Fluorescent Lighting Can Intensify Symptoms and Trigger Flares

Most people are aware of the importance of protecting their skin from the damaging effects of the sun. We accept that the sun’s UV rays cause premature aging, skin damage, and increase our risk of developing skin cancer.

While a good percentage of us are diligent about protecting our skin while basking in direct sunlight, we feel protected from the effects of UV radiation while indoors.

A significant number of people don’t have that peace of mind. Indoor lighting can trigger the uncomfortable symptoms of photosensitivity, an unusually strong reaction to UV radiation. For those living with photosensitivity, fluorescent lights can cause a significant amount of pain and discomfort.

There are numerous health conditions, or medications used to treat various disorders, that can trigger photosensitivity. More than two-thirds of those diagnosed with lupus find that fluorescent lights can make their symptoms worse. To reduce the risk of triggering symptoms, many people living with lupus are protecting themselves by filtering indoor light.

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Understanding the Discomfort of Photosensitivity

Photosensitivity has many potential causes. Most often, the abnormal reaction to sunlight is caused by an interaction between a reactive compound and the sun’s UV rays. Medications, perfumes, and even sunscreens are common triggers for photosensitivity.

The uncomfortable skin reactions associated with photosensitivity can also be caused by chronic health conditions. The following symptoms of photosensitivity can appear within minutes or days of UV exposure:

  • An intense burn after limited exposure
  • Itching, stinging, or burning skin
  • Skin rashes or hives
  • Oozing blisters
  • Skin discolorations, lumps, or spots

Reactions to ultraviolet light can be minimized by wearing UV-blocking sunscreens, protective clothing, and avoiding exposure. When photosensitivity is triggered by a medication, the adverse reactions commonly subside once the medication has cleared the system.

Understanding the Basics of Lupus

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Lupus is a complex autoimmune disorder. The immune systems of people living with lupus create antibodies that do not differentiate between potentially threatening invaders and healthy cells. Those diagnosed soon learn that their own immune system is continuously engaged in an internal assault on their body.

While there is no cure for lupus, the condition is manageable. The goal of lupus treatment is to minimize the frequency and severity of disease activity and keep the immune system from attacking healthy joints and organs. Medications and lifestyle modifications can dramatically improve disease outcome.

Photosensitivity is Problematic for Lupus Patients

Like many other chronic health conditions, lupus can run through cycles of activity and remission. A period of disease activity that intensifies symptoms is commonly referred to as a flare. Minimizing the frequency and severity of lupus flares helps keep the immune system from attacking healthy tissues.

A report published in the Journal of the American Academy of Dermatology finds that 83 percent of lupus patients have some form of photosensitivity. In addition to triggering uncomfortable skin reactions, UV exposure can also make the many symptoms of lupus worse and trigger flares. Those living with lupus may find that UV light exposure can cause:

  • Fever
  • Fatigue or weakness
  • Increased Joint Pain
  • Flu-like symptoms
  • Skin rashes or hives
  • A sensation of skin tightness
  • Malar rash across the nose and cheeks (butterfly rash)
  • Headaches and dizziness

How UV Exposure Triggers Lupus Flares

Abnormal light sensitivity is considered both a symptom of the disorder and a trigger for disease activity. The photosensitivity commonly associated with lupus is triggered by the autoimmune response to skin cell death. In those with lupus, cells are more susceptible to UV-induced damage.

When the skin cells of lupus patients are exposed to UV rays, preprogrammed cell death, a process called apoptosis, occurs more frequently than in the skin of those who do not have lupus. Because of the immune system dysfunction, dead cells are not cleared from the body efficiently.

As a result, cell proteins interact with the immune system and trigger inflammation. That’s why doctors commonly advise lupus patients to consider the following recommendations:

  • Using a broad-spectrum sunscreen and reapplying every two hours to exposed skin
  • Wearing clothing that provides maximum protection
  • Using a UV filtering umbrella while outdoors and wearing a wide-brimmed hat
  • Tinting car windows (may require doctor authorization)
  • Covering fluorescent fixtures and halogen bulbs with filters that block UV radiation

It may also be helpful to know that there are several types of lupus. Systemic lupus is marked by inflammation of the joints, skin, and kidneys, while the effects of cutaneous lupus are limited to skin activity. All types can be affected by fluorescent lights.

Fluorescent Bulbs Contribute to UV Exposure and Lupus Symptoms

The fluorescent bulbs commonly used to illuminate our environment emit more UV radiation than you might realize. Within the bulbs of fluorescent fixtures, electrical energy interacts with gasses to create ultraviolet rays. The phosphorous coating on the bulb absorbs the UV rays and transforms the ultraviolet energy into visible light.

While the UV radiation from fluorescent lights is generally considered safe, the effects can be detrimental to the health of those living with lupus. Consider the following observations:

  • A report in the early 1980s suggested fluorescent lights induce symptoms in lupus patients
  • A 1985 report confirmed that fluorescent lights emit significant levels of UVB and UVC rays
  • A 1992 report documented that lupus patients reported increased joint pain, rash, and fatigue after fluorescent light exposure
  • This same 1992 report confirms that participating patients were not affected by fluorescent lights covered with a UV-blocking light diffuser

 

Skin damage accumulates when skin does not have enough time to recover from UV exposure. It can take 30-48 hours for skin to recover from the effects of UVA, and 24-30 hours to recover from UVB exposure for those with normal skin. The recovery processes are believed to take longer for those with lupus.

 

Minimizing UV Exposure Could Reduce the Risk of Lupus Complications

The frequency and severity of lupus flares vary by the immune system function of the individual. Since those susceptible to UV-triggered immune system activity are at an increased risk of significant physical damage, anything that can be done to decrease your exposure is beneficial to your overall health. Just a few of the many potential complications of lupus can include:

  • Kidney Damage – kidney failure is one of the leading complications associated with lupus
  • Nervous System Involvement – the effects on the nervous system can increase the risk of strokes, seizures, and memory difficulties
  • Blood Disorders and Cardiovascular Disease – people with lupus are more prone to anemia, blood vessel damage, unusual bleeding, and blood clots
  • Respiratory Issues – an increased risk of developing inflammation in the lining of their chest cavity (pleurisy) and pneumonia
  • Joint Damage – immune system activity can cause arthritis. Arthritis in people with lupus commonly affects the joints of the hands, knees, shoulders, feet, and elbows

 

Accommodating Lupus Photosensitivity in the Workplace

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If you suspect that fluorescent lights are aggravating your condition, you may question your ability to continue working. It’s important to know that you don’t need to be afraid to ask your employer for help. Patient rights and employer responsibilities are clearly defined by the Americans with Disabilities Act. By law, accommodations cannot be denied unless they cause undue hardship for the business.

Most employers are more than happy to accommodate health-related requests. They understand that their cooperation protects employee wellness and workplace productivity. If you are photosensitive, consider asking your employer to reduce your indoor UV exposure with one or more of the following suggestions:

  • Covering windows with UV-blocking shades
  • Covering windows with a UV-blocking film
  • Moving your desk away from windows
  • Using lamps with incandescent bulbs
  • Installing UV-blocking fluorescent light filters

 

Depending on where you work, an informal request may be all that is needed to get the ball rolling. Some companies will require accommodations be formally requested through their human resources department. Either way, you may be asked to provide documentation, and possibly accommodation suggestions, from your healthcare provider.

 

Minimizing the Impact of Fluorescent Light with Protective Filters

Although working can be difficult with any chronic health condition, filtering workplace fluorescent lights can help minimize the frequency and severity of lupus flares. In addition to being beneficial to those with lupus, coworkers could also benefit. Fluorescent lights are also known to contribute to a significant number of health issues including migraine, tension headaches, photophobia, and digital eye strain for those who are sensitive.

 

 The first full day under them I didn’t feel as horribly bad as I had been by late morning all other days. My eyes aren’t as strained. No headache! My rashes are much less. Some lesions are actually healing now. I don’t seem to swell as much in my joints at the end of the day. My life is still a daily struggle, but at least I can have a better chance of working full time in my office. It’s all the little things that make a big difference. THANK YOU!!!”

 

 ~ Beth L, Software Engineer and Lupus Patient

 

While there are plenty of companies that offer fluorescent light filters, many filters do not provide UV protection. For Fluorescent lighting covers and tube filters that block symptom-triggering UV radiation, visit Make Great Light. Our fluorescent light filters are the most advanced in the industry, blocking 99% of UVA rays and completely blocking UVB rays. Make Great Light Fluorescent light filters are an affordable indoor light sensitivity solution.

 

Additional Sources:

https://www.sciencedirect.com/topics/medicine-and-dentistry/photosensitivity

https://www.cdc.gov/lupus/basics/diagnosing.htm

https://pdfs.semanticscholar.org/dd5a/7396d4a63ead508bdaee772b2be74edac9c6.pdf

https://www.webmd.com/lupus/lupus-photosensitivity-uv#1

https://www.lupus.org/resources/research-on-photosensitivity-among-people-with-lupus

https://www.everydayhealth.com/lupus/

https://www.medicalnewstoday.com/articles/323059.php

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