How Autoimmune Patients Can Stay Healthy in the Sun, Water, and on Summer Vacation
Summer brings with it time spent outdoors, vacations that tempt us to eat foods that aren’t good for us, and exposure to chlorine in swimming pools—to name just a few seasonal threats. People with autoimmune diseases need to be especially careful of summertime-related dangers. Take sun exposure, for example. Autoimmune sun sensitivity occurs in such disorders as systemic and cutaneous lupus erythematosus (SLE and CLE), dermatomyositis, and occasionally Sjögren’s syndrome. This can lead to a lupus sun rash, skin problems in people with other autoimmune diseases, or even trigger a flare-up of illness.
In this blog post, we’ll talk about summertime threats to autoimmune health and what you can do to decrease these warm-weather autoimmune triggers.
Autoimmune Sun Rash
Autoimmune sun rash and other skin problems can occur when you venture outside for too long. Lupus and sun sensitivity is especially common. Up to 93% of lupus patients have what scientists call a photosensitivity to the sun. This is a change in the skin that makes it more vulnerable to sun damage. Sometimes called sun allergy, photosensitivity is an immune reaction triggered by sunlight. It can cause an exaggerated sunburn, itchy sores, or blisters on skin that has been exposed to the sun.
It doesn’t just affect those with lupus. Half of people with dermatomyositis also have sun sensitivity. Dermatomyositis is an inflammatory autoimmune disease. People who have this disorder suffer from muscle weakness and a violet or red skin rash. There are also a lot of anecdotal reports of people with Sjögren’s syndrome suffering from bad effects after sun exposure. Sjögren’s syndrome is an autoimmune disorder that is characterized by dry eyes and a dry mouth.
When people with autoimmune photosensitivity are exposed to the sun, they might sunburn more easily even when they have had only moderate exposure to sunlight. Even worse, in some people large amounts of sun exposure can cause flare ups of autoimmune disease or make skin rashes worse. However, in some people, a small amount of sun exposure can actually make them feel better. In the case of psoriasis, sun exposure may improve the rash that accompanies the disease.
Vitamin D and Autoimmune Disease
With certain autoimmune diseases, sun exposure is a Catch-22 situation. You might be sensitive to the sun but you also need your daily allotment of this “sunshine vitamin.” That’s because healthy vitamin D levels are critical for people with autoimmune problems. A lot of my patients with autoimmune disorders are low or deficient in vitamin D. This vitamin is linked to both the development and severity of autoimmune disorders like rheumatoid arthritis, lupus, and multiple sclerosis.
Work with an autoimmune specialist to get your vitamin D levels tested. We like our autoimmune patients to have vitamin D levels of 60 to 70 ng/mL. If you can’t go out into the sun due to an autoimmune sun rash or another issue with autoimmune sun sensitivity, then you will need to use vitamin D supplements to get your levels up that high. It’s best to work with an autoimmune doctor who specializes in functional medicine to test your levels and work on the proper vitamin D dosage for you.
If you don’t have photosensitivity, continue to get healthy amounts of sunshine.
Factors That Worsen Sun Sensitivity
A few factors can make you sunburn more easily, whether or not you have an autoimmune disease. For example, some medications can lead to photosensitivity.
Medications that cause sun sensitivity:
• Antibiotics (including “sulfa” drugs, quinolones and tetracyclines)
• Antihistamines (including diphenhydramine, or Benadryl)
• Certain antifungal drugs
• Non-steroidal anti-inflammatory drugs (NSAIDs like ibuprofen and naproxen)
• Oral contraceptives (birth control)
• Oral diabetes drugs (sulfonylureas)
• Tricyclic antidepressants
Foods and a dietary supplement that increase sun sensitivity:
• St. John’s wort, used for depression, anxiety, and PMS
• Wild carrots
Fragrances and essential oils that make you more likely to get sunburned:
• Bitter orange
• Lemon verbena
What Is The Difference Between Photosensitivity and Photoallergy?
Photoallergy is slightly different than photosensitivity. With photoallergy, a person exposed to the sun can react to a lotion applied on the skin, a medication taken orally, or other substances. Ultraviolet rays change that lotion or medication into something new. This causes the body to recognize it as foreign and triggers an immune response. Photoallergy occurs over a few days or over time rather than the first time you use it. It’s more like an itchy rash rather than the bad sunburn seen with photosensitivity.
Best Ways To Protect Yourself from the Sun
If you think your body can handle it, you can expose your skin to the sun for ten minutes per day so that you can replenish vitamin D levels. At that point—or before if you’re extremely sensitive or are afraid of getting an autoimmune sun rash—apply a safe, non-toxic, healthy sunscreen. Environmental Working Group (EWG) offers a safe sunscreen guide that is an excellent resource.
Zinc oxide and titanium dioxide are two ingredients considered safe. But many sunscreens contain potential endocrine-disrupting toxins such as oxybenzone, octinoxate, octisalate, octocrylene, homosalate, and avobenzone, which are all absorbed by the body after just one use. Studies also found these chemicals on the skin and in the blood weeks after they were no longer used. In addition, scientists have detected many sunscreen ingredients in breast milk and urine. Even titanium dioxide and zinc oxide can cause skin allergy or asthma-related concerns when inhaled. So opt for a lotion sunscreen and avoid sprays.
You can also stay out of the sun when the rays are strongest. According to Johns Hopkins University, the sun is strongest between 10 a.m. and 4 p.m.
Foods that Protect Against Sunburn
There are also foods and drinks that may make you less sun sensitive. These shouldn’t be relied upon completely to protect against sun damage. Eat these foods but use a healthy sunscreen, too:
• Blueberries – A rich source of antioxidants that fight off the free radicals that cause sun damage to the skin. Also a good source of vitamin C, a collagen-building nutrient that can stop wrinkles caused by sun exposure. Check out this delicious July 4th treat that features blueberries, “Red, White and Blue Berry Bars.”
• Carrots and leafy greens – Contain high levels of beta-carotene, a carotenoid that protects against sun damage.
• Cauliflower – Contains histidine, an amino acid that may protect against the sun.
• Green tea – Protects the skin from ultraviolet radiation thanks to one of its main components, EGCG.
• Salmon and flaxseed – Rich in omega-3 fatty acids, which are anti-inflammatory and may shield the skin from ultraviolet rays.
• Watermelon and tomatoes – Have high levels of the carotenoid lycopene, which can act as a natural sunscreen.
Beware of Chlorine
Splashing around a swimming pool or soaking in a hot tub on cooler summer evenings are fun things to do at this time of year. However, swimming pools and hot tubs are usually disinfected with chlorine. This chemical is linked to asthma in swimmers. And it may have other toxic effects. One study found that DNA damage to blood cells known as lymphocytes was greater in swimming pool lifeguards compared to controls.1 Chlorine is also linked to chronic fatigue and autoimmune disease.
The best ways to avoid chlorine exposure:
• Change the disinfecting system on your hot tub or swimming pool. For example, use a chemical-free, salt-water based disinfecting system rather than chlorine.
• Rinse before and after you go swimming to reduce the amount of chlorine that lingers on your skin.
• Swim in the great outdoors. Lakes, rivers, and the ocean are especially refreshing and you get the benefit of connecting with nature. Plus, when you walk around outdoors barefoot, you’re stepping on dirt or sand, which is known as “grounding” or “earthing.”
- There are a lot of benefits of grounding. Stepping barefoot on the ground can cause your body to make more antioxidants.2 Research has shown that grounding can improve physical function and energy, significantly decrease fatigue, tiredness, and pain, and uplift a depressed mood.3 What’s more, it can reduce pain in people with lupus and other autoimmune diseases.4
- Take care not to swallow lake or river water. Some fresh water reservoirs can contain parasites (as can chlorinated swimming pools). Same goes for when you’re out hiking or backpacking. Make sure to carry your own water, use a good water filter, or boil your water for five minutes before drinking or using it to brush your teeth.
How to Eat Healthy While Traveling
Many autoimmune conditions benefit from dietary restrictions. Whether it’s gluten, dairy, soy, or something else, these can be critical for staying well. But let’s face it, on summer vacations you’re faced with a lot of dietary temptations and you don’t have the conveniences of home. Falling off the wagon with your food restrictions could send you into an autoimmune flare. Since healthy foods for autoimmunity aren’t readily available, how can you eat healthy on vacation? Here are some tips to eat well, stay on your healthy diet, and prevent a flare.
• Plan ahead for success. That means planning your menu before you leave for vacation. Bring your own healthy snacks on vacation. Make a trip to the grocery store once you arrive to load up on foods that work for you.
• Most people take better care of their health when they are at home following their usual routines. You can recreate your routines even while on vacation. Plan time for exercise, sleep and meals.
• Eat healthy snacks before your blood sugar drops and you get hungry. That way you won’t be craving foods that can harm you. If you have to choose a restaurant at the last minute when you’re “hangry,” you’re more likely to pick the first place that catches your eye. And that place might be a pizza parlor, bakery, or fast food joint.
• Research in advance which restaurants serve the kind of meals you can safely eat. Patronize restaurants that serve organic and gluten-free food. That way it will be easier to stick with your grain-free or gluten-free diet.
• Reach out for positive support ahead of time. Let family members know your health goals for your vacation so they understand and can support you. That way they won’t pressure you to join them in a meal or activity that could send you into a downward spiral.
Don’t Let Autoimmunity Hold You Back from Summertime Fun
Even if you’re dealing with an autoimmune illness, you can have a great time on vacation or enjoying the sun and water outdoors. Sunshine is great for most people but people with autoimmune sun rash should take special precautions. Work with an autoimmune doctor to test and boost your vitamin D levels if you can’t venture out in the sun. Certain foods can protect against sun damage and taste great, like my Red, White and Blue Berry Bars. Spend time swimming outdoors and avoid exposure to chlorine and sunscreen toxins when possible. Finally, plan ahead to maintain your daily routines and your healthy eating plan while on vacation.
We wish you a healthy and happy summer vacation!
1. Kianmehr M, Mottaghy Shahri MR, Afsharnia M, Rohani Z, Ghorbani M. Comparison of DNA damages in blood lymphocytes of indoor swimming pool lifeguards with non-lifeguards athletes. Mutat Res Genet Toxicol Environ Mutagen. 2019;837:29-33.
2. Sinatra ST, Oschman JL, Chevalier G, Sinatra D. Electric Nutrition: The Surprising Health and Healing Benefits of Biological Grounding (Earthing). Altern Ther Health Med. 2017;23(5):8-16.
3. Chevalier G, Patel S, Weiss L, Chopra D, Mills PJ. The Effects of Grounding (Earthing) on Bodyworkers’ Pain and Overall Quality of Life: A Randomized Controlled Trial. Explore (NY). 2019;15(3):181-190.
4. Oschman JL, Chevalier G, Brown R. The effects of grounding (earthing) on inflammation, the immune response, wound healing, and prevention and treatment of chronic inflammatory and autoimmune diseases. J Inflamm Res. 2015;8:83-96.