Drug-Induced Sun Sensitivity in Fibromyalgia/Chronic Fatigue Syndrome

Sunburnt woman
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I've never heard of fibromyalgia or chronic fatigue syndrome causing sun sensitivity (although it wouldn't surprise me - we can be sensitive to just about everything.) But now, I've discovered that we can become photosensitive because of our medications.

You may have noticed photosensitivity on those long side effects lists. I take five separate drugs that have the potential to cause it, and now I'm getting a really good look at how not pleasant it can be!

What drugs can cause sun sensitivity? Here's a list of the ones that are most common for us:

  • Tricyclic antidepressants: Elavil (amitriptyline,) Sinequan (doxepin,) Norpramin (desipramine,) and more;
  • SSRIs: Celexa (citalopram,) Lexapro (escitalopram,) Paxil (paroxetine,) and more;
  • Anti-Inflammatories: Motrin (ibuprofen,) Relafen (nabumetone,) Anaprox/Aleve (naproxen,) and others;
  • Antihistamines: Zyrtec (cetirizine,) Claritin (loratadine,) Benadryl (diphenydramine,) and others;
  • Antivirals: Zovirax (acyclovir,) Symmetrel (amantadine);
  • Anticonvulsants: Neurontin (gabapentin,) Lyrica (pregabalin,) and others;
  • Flexeril (cyclobenzaprine,) a muscle relaxant;
  • Sedative/Hypnotics: Ambien (zolpidem,) Sonata (zaleplon,) Librium (chlordiazepoxide,) Xanax (alprazolam.)

Other drugs that can cause it include oral contraceptives, corticosteroids, diabetic drugs, antipsychotics, heart medications, antibiotics, and cancer drugs.

The drugs I take that can cause it are Zyrtec, Flexeril, Relafen, Plaquenil (hydroxychloroquine,) and methotrexate. (Plaquenil is for my autoimmune thyroid disease and methotrexate is for my autoimmune arthritis.)

However, I've been on most of those drugs for years and hadn't had a problem. The methotrexate is the newest, so I'm pretty sure either it's the culprit, by itself, or it's working with the other drugs to cause the reaction.

My Experience

I don't spend much time in the sun. In fact, I spend a lot more time trying to avoid it! This summer, I've had two instances where I found myself outside and unable to avoid direct sunlight for long periods.

The first time, I started having this odd sensation: it was like little pinpricks randomly around my arms. At first, I thought it was starting to rain, but no one else felt it. Then it started to feel like hot little nerve zings and I knew it was just my body's latest weirdness. It went away, though, and I didn't think much of it.

At least, I didn't think much of it until one day last week. I was on vacation with my family and sitting on a lovely Oregon beach, with lots of sunscreen on, and before long I felt those little pinpricks again. This time, they started out hot and worked up to rather painful. It didn't stop until about 36 hours after I was out of the sun, and it left behind red, swollen, intensely painful areas.

I'm of Irish descent and skin doesn't get any whiter than mine.

I know sunburns intimately. This was no sunburn.

I did get burned in a couple of places where I'd neglected sunscreen - around the base of my neck and just below one sleeve. Those areas felt like a normal sunburn - they were red and hot, and they hurt when touched.

But the other places, primarily the tops of my feet and the backs of my hands, were incredibly puffed up and had pinpricks of fire dancing all over them continuously. The only thing that helped was soaking them in cold water, but once I took them out they heated and swelled up again and the pain was back.

I did some research and soon realized this was pretty typical of photosensitivity, and more specifically, phototoxicity. (It's different from photoallergy. You can learn more about both here: Medications and Sun Sensitivity.)

The treatment for sun sensitivity is to stop taking the medication or avoid the sun. I know I'll be opting for the second, since that's pretty much what I do anyway, and I enjoy being in far less pain that I'd be without the meds. It'll take some work and a little extra planning, but believe me, it'll be worth it if I can avoid that kind of pain.

I'm already thinking about needing long summery pants instead of shorts and capris, and lightweight, long-sleeved shirts. A big hat seems like a must. I'll also probably have to haul around a lawn chair we have that came with an attachable umbrella. And - gasp - maybe even enclosed shoes, which terrifies me because I have extreme heat sensitivity in my feet and prefer them bare. But we do what we have to do, don't we?

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