General: If a cream, ointment, perfume, etc. is causing a sun allergy, patients should discontinue using the product and symptoms will subside. If a medication is causing symptoms, a healthcare provider may recommend discontinuing the medication or altering the dose. However, if the medication cannot be discontinued or altered, a healthcare provider may recommend avoiding sun exposure until treatment is completed. Other treatments, including antihistamines, hydrocortisone, phototherapy, and/or PUVA may help relieve allergic symptoms.
Antihistamines: Oral antihistamines like diphenhydramine (Bendaryl®) have been used to treat hives and red, itchy skin. This medication is used most often in patients with polymorphous light eruption (PMLE) or solar urticaria.
Beta-carotene: Supplementation with oral beta-carotene has been used to treat sun allergy. This treatment is used most often in patients who have PMLE or actinic prurigo (hereditary PMLE). In sun-sensitive individuals, 25 milligrams of beta-carotene has been taken by mouth daily.
Hydrocortisone: Hydrocortisone cream has been applied to the affected area of skin to temporarily relieve itching. This medication is used most often in patients with PMLE or solar urticaria. Hydrocortisone 1% cream, which is available over-the-counter, has anti-inflammatory effects and relieves swelling and redness in addition to itching.
Phototherapy: Phototherapy, which involves gradually exposing the skin to increased levels of ultraviolet light, has also been used to treat sun allergy. This is typically used in patients who have PMLE or solar urticaria (hives). Phototherapy is performed at a healthcare provider's office. Patients are usually exposed to ultraviolet light five times per week for three weeks. Patients usually begin to develop a tolerance to sun exposure and allergic symptoms to sun exposure are reduced.
PUVA: PUVA is a combination of psoralen and ultraviolet light. PUVA may be performed if a patient is not responding to phototherapy. This is typically used in patients who have hereditary PMLE or classic PMLE. Psoralen, a compound found in many plants, makes the skin temporarily sensitive to ultraviolet light.
Sunscreen: Allergic patients who cannot avoid exposure should apply sunblock to the skin whenever they are outside. Patients should choose a sunblock with a sun protection factor (SPF) of 15 or higher. The sunblock should offer protection against both ultraviolet A (UVA) and ultraviolet B (UVB) rays. Allergic patients should also use sunblock that is formulated especially for the lips. Patients should choose lip sunblock with an SPF of 20 or more. Also, patients should look for products that are "PABA-free." PABA is a chemical that is found in many sunblocks, and it has been shown to cause irritation in sensitive patients.
Acupuncture: Acupuncture plus point-injection has been found beneficial for obstinate urticaria (hives). However, more research is needed to confirm these findings.
Needles must be sterile in order to avoid disease transmission. Avoid with valvular heart disease, infections, bleeding disorders or with drugs that increase the risk of bleeding (anticoagulants), medical conditions of unknown origin, and neurological disorders. Avoid on areas that have received radiation therapy and during pregnancy. Use cautiously with lung disease (like asthma or emphysema). Use cautiously in elderly or medically compromised patients, diabetics, or with history of seizures. Avoid electroacupuncture with arrhythmia (irregular heartbeat) or in patients with pacemakers.
Traditional or theoretical uses lacking sufficient evidence
Burdock: Traditionally, burdock has been used to treat hives. However, there is currently no available human evidence on its safety and effectiveness for this use.
Avoid if allergic to burdock or other plants of the Asteraceae/Compositae family (ragweed, chrysanthemums, marigolds, daisies). Avoid if history of dehydration, diabetes, heart disease, cancer, high blood pressure, or HIV. Stop use before surgeries/dental/diagnostic procedures. Avoid if pregnant or breastfeeding.
Chamomile: Although chamomile has traditionally been used to treat hives, scientific evidence is lacking. Currently, no human trials have evaluated the safety or effectiveness of chamomile for this use.
Avoid if allergic to chamomile or any related plants, such as aster, chrysanthemum, mugwort, ragweed, or ragwort. Stop use two weeks before surgery/dental/diagnostic procedures with bleeding risk, and do not use immediately after these procedures. Use cautiously if driving or operating machinery. Avoid if pregnant or breastfeeding.
Detoxification therapy (cleansing): Detoxification has been suggested as a possible treatment for hives. However, there is currently no scientific evidence of its safety or effectiveness for this use.
In cases of illness, the various forms of detoxification should be used under professional guidance. See specific monographs for precautions and warnings associated with modalities of detoxification.
Ephedra: Traditionally, ephedra has been used to treat hives. However, there is currently no evidence on the safety and effectiveness of ephedra for this use.
Thousands of toxicity reports exist on ephedra, including over 100 deaths. Avoid if history of high blood pressure, abnormal heart rate, heart attack, stroke, seizure, eating disorders, anxiety, prostate disease, mental illness, kidney disease, stomach ulcers, heart disease, eye disease, depression, diabetes, thyroid disease, or sleep problems. Avoid if pregnant or breastfeeding.
Kudzu: Traditionally, kudzu has been used to treat hives. However, there is currently no scientific evidence on the safety and efficacy of this use.
Use cautiously with anticoagulants/anti-platelet agents, blood pressure lowering agents, hormones, antiarrhythmics, benzodiazepines, bisphosphonates, diabetes medications, drugs that are metabolized by the liver's cytochrome P450 enzymes, mecamylamine, neurologic agents, and methotrexate. No well-designed studies on the long-term effects of kudzu are available. Avoid if allergic or hypersensitive to Pueraria lobata or members of the Fabaceae/Leguminosae family (like peas, peanuts, soybeans, and lentils). Avoid if pregnant or breastfeeding.
Moxibustion: There is limited evidence suggesting that moxibustion may help treat hives. Additional research is needed to evaluate the safety and efficacy of moxibustion for this use.
Use cautiously over large blood vessels and thin or weak skin. Avoid with aneurysms, any kind of "heat syndrome," heart disease, convulsions (seizures) or cramps, diabetic neuropathy, extreme fatigue and/or anemia, fever, inflammatory conditions, over allergic skin conditions or ulcerated sores or skin adhesions. Avoid areas with an inflamed organ, contraindicated acupuncture points, face, genitals, head, inflamed areas in general, nipples, and skin adhesions. Use cautiously in patients who have just finished exercising or taking a hot bath or shower. Use cautiously with elderly people with large vessels. Not advisable to bathe or shower for up to 24 hours after a moxibustion treatment. Avoid if pregnant or breastfeeding.
Peppermint oil: Historically, peppermint has been used to treat hives. Further research is needed to determine whether peppermint is safe and effective for this use.
Avoid if allergic or hypersensitive to peppermint or menthol. Peppermint is generally considered safe in non-allergic adults when taken in small doses. Use cautiously with G6PD deficiency (low levels of an enzyme called glucose-6-phosphate dehydrogenase) or gallbladder disease. Menthol, which makes up part of peppermint oil, is generally considered safe in non-allergic adults. But, doses of menthol greater than one gram per kilogram of body weight may be deadly in humans. Avoid if pregnant or breastfeeding.
Probiotics: Although probiotics have been suggested as a possible treatment for hives, there is insufficient scientific evidence on its safety and efficacy for this use.
According to scientific studies in humans, probiotics are generally considered safe and well tolerated. Avoid if allergic or hypersensitive to probiotics. Use cautiously if lactose intolerant.
If possible, patients who are allergic to sunlight should minimize or avoid exposure to the sun. Patients should wear hats with brims, sunglasses, and protective clothing when outside to minimize exposure. An umbrella or parasol may also be beneficial in sensitive patients.
Allergic patients who cannot avoid exposure should apply sunblock to the skin whenever they are outside. This is because ultraviolet rays are able to penetrate clothing. Patients should choose a sunblock with a sun protection factor (SPF) of 15 or higher. The sunblock should offer protection against both ultraviolet A (UVA) and ultraviolet B (UVB) rays. Also, patients should look for products that are "PABA-free." PABA is a chemical that is found in many sunblocks, and it is know to cause irritation in sensitive patients.
Allergic patients should also use sunblock that is formulated especially for the lips. Patients should choose lip sunblock with an SPF of 20 or more.
Patients should not use tanning beds because they may trigger an allergic reaction.
Antihistamines like diphenhydramine (Bendaryl®) have been used to help prevent or reduce allergic reactions to sunlight.