WebMD Ask the Pharmacist

Summer Skin Care: Ask the Pharmacist

June 22, 2010. Pharmacist Heather Free, PharmD, answers questions about sun exposure and skin care.

Question:

Can medicines cause sun sensitivity?

Answer:

There are several medications that can lead to photosensitivity, or sun sensitivity. Photosensitivity appears similar to sunburn and usually occurs within 24 hours of exposure to the sun while taking photosensitivity medications.
Avoiding sun exposure and tanning beds is recommended for protection while using these medications. Apply sunscreen SPF 30 or higher with UVA and UVB protection every few hours if you will be exposed to the sunlight. Some common medications that can lead to photosensitivity include, but are not limited to:

Antibiotics: ciprofloxacin, levofloxacin, tetracycline, doxycycline, minocycline, TMP-SMX
Antihistamines: diphenhydramine
Antidepressants: amytriptyline, desipramine, doxepin, imipramine, nortriptyline, trazodone
Malaria medications: quinine, chloroqine, hydroxychloroquine
Chemotherapy medications: 5-fluorouracil, vinblastine, dacarbazine
Disease-modifying agents (rheumatoid arthritis/lupus): dapsone, hydroxychloroquine, methotrexate, sulfasalazine
Cardiac/blood pressure medication: amiodarone, nifedipine, quinidine, diltiazem, furosemide, hydrochlorothiazide
Diabetic medications: chlorpropamide, glyburide
Nonsteroidal anti-inflammatory medications: naproxen, piroxicam, ibuprofen
Acne medications: isotretinoin (Accutane)
Oral contraceptives

Before taking your medications or spending time in the sun, consult your pharmacist to find out if your medication(s) can lead to photosensitivity.

Question:

Please tell me if any of the following meds come with a warning to stay out of the sun: oxybutynin, sertraline, Vytorin, Neurontin, and Suboxone. Thank you in advance. What a great thing you all do.

Answer:

The medications that you listed have not been reported to exhibit any sun-sensitivity side effects. However, it is important to continue to check with your local pharmacist to make sure this doesn’t change. In addition, it is always important to use sunscreen when out in the sun, whether your medications are known to increase sensitivity or not.

Question:

Do photosensitive antibiotics cause blurred vision when you have been out in the sun?

Answer:

The reaction to photosensitivity is similar to sunburn. The medication makes you more susceptible to burning when exposed to UV rays. There should not be any interference with your vision. If there is, you should consult your local pharmacist about the particular antibiotic that you are taking to see if there is a vision-related side effect associated with the medication.

Question:

I am taking Adipex-P. Can suntanning cause a reaction with this medication?

Answer:

Not with this particular medication, but it is still important to practice sun safety by wearing sunscreen and preventing sunburns.

Question:

Does levothyroxine or lovastatin cause a reaction to sun exposure? I break out with something that looks like hives, but only when I’m in the sun. I am also taking Femara, calcium, vitamin E, vitamin C, niacin, and fish oil.

Answer:

The medications that you have listed are not sun-sensitive. Therefore, you should not see a reaction to the sun. However, niacin can cause redness to the skin because of its own skin flushing properties. Exposure to the sun can enhance this side effect. But this doesn’t mean that it is a sun-sensitive product. Be sure to practice sun-safe behaviors by applying sunscreen and not staying in the sun too long.

Question:

Is there a medication for high blood pressure that is not sun-sensitive?

Answer:

Separate from the issue of sun sensitivity, there are so many choices of blood pressure medication that can be examined in order to make sure the correct product(s) has been selected for you. But we do not want to completely change your therapy if it is working for you.
There may be another drug in the same class as the one you are currently taking that is less sun-sensitive and that can be just as effective for treatment. Be cautious in changing drug classes entirely. Work with your health care professional and your pharmacist to find the right treatment for you.

Question:

Can I go out in the sun while taking 875 mg dose of amoxicillin?

Answer:

Yes. Amoxicillin is one of the antibiotics that is not sun sensitive.

Question:

I accidentally left my daughter's amoxicillin prescription in the car over the weekend. The temperature was mildly warm and the directions say to keep refrigerated. Will it hurt to give her this medication without being refrigerated?

Answer:

I would need to know more information to answer this question for you. How long was the medication in the car? Was it overnight and approximately what temperature was it? Is it humid in the area? Did the medication change color? All of these questions can help to determine whether the medication is still safe to administer to your child.
Most importantly, check with your prescription health insurance to see if they cover a new prescription for damaged medications. If they do and the medication is affordable, have your pharmacist call the health care professional for a new prescription.

Question:

I was wondering if some medications have the side effect of increased bruising. Recently I have been bruising very easily, bruises all over my body.

Answer:

Medications that can increase blood-thinning properties tend to increase the risk of bruising. There are several prescription medications that can increase this risk, including warfarin, heparin, and Plavix. Over-the-counter aspirin can also have the same effect. There is much caution and monitoring while on these medications.
You should consult your local pharmacist to discuss your current medication profile and your increased bruising. Based on your pharmacist’s advice and if the bruising worsens, you should then consult your health care provider to make sure it is actually your medication, and not a separate condition, that is causing the bruising.

Question:

How many cc's are in an mL?

Answer:

1 cc (cubic centimeter) is equal to 1 mL (milliliter). Both measurements related to volume.

Question:

Can you use a tanning bed while on penicillin and prednisone?

Answer:

There are some antibiotics that can cause sun-sensitive reactions. Penicillin is not on the list for sun sensitivity. You are also safe with the prednisone. Ask your pharmacist before leaving the pharmacy counter if any of your medications can cause skin irritation or increase the risk of sunburn.

Question:

How can pharmacy staff accommodate pediatric patients who take compounded medications?

Answer:

This is a difficult question to answer. Compounding used to be more popular than it is now. Pharmacists were trained to compound in school, and any nearly pharmacist could prepare medication for you in this way. Now many pharmacy schools have compounding training available, but do not require the course.
A compounded medication is a product that a pharmacist makes on an individual basis because it is not commercially provided. Pharmacists need to make sure the ingredients can remain stable in the mixture and that they will provide proper treatment for the patient’s condition. Recipes for compounds are not standard, so sometimes the pharmacist has to conduct research to obtain a recipe for the compounded medication that your physician has prescribed. Many chain pharmacies do not have pharmacist that are trained to compound. If you need a compounded prescription, they should be able to direct you to another pharmacy to suit your need
There are community pharmacies available that specialize in compounding. But you want to do some research. Check with your local children’s hospital to see if they have an outpatient pharmacy that will fill your prescription. If they do not, see if they can recommend a local pharmacy that is able to compound the medication for you.

Question:

I recently noticed that the skin on my arms is white and blotchy. I am on metformin, lisinopril, and HCTZ. Today, I was in the sun and became very itchy. Is it my meds? I have been on these medications for almost a year.

Answer:

Some of your medications can cause you to be a bit sun-sensitive. This means that you may want to reduce the amount of sun you are exposed to and use a higher SPF, reapplying it every 1-2 hours you spend in the sun.

Question:

What drugs have a negative effect on the skin's ability to tan?

Answer:

Tanning is not a medically recommended habit. If a tanned appearance is important to you, look into using self-tanning products. There isn’t a drug that will block your tan. However, there are plenty of medications that can accelerate or increase the risk of burning.

Question:

What medications do you advise people to avoid the sun while taking?

Answer:

There is a long list of medications that maintain sun-sensitive properties. Please see my previous answer that included a shortened listing of some of these medications.
Many pharmacies label the medication bottle with sun-sensitivity warnings. If not labeled, be sure to ask your pharmacist if your prescriptions can increase your risk of sunburn.

Question:

What is the recommended SPF to use for summer?

Answer:

It is recommended that you use products that contain both UVA and UVB protection, with an SPF of at least 30. You might find yourself paying more money for a higher SPF that may not be as effective as it claims.
Watch out for combination products that also contain bug spray. The chemicals in bug spray should not be applied to the body as often as sunscreen.

Question:

Is it still true that you shouldn't take medicines with milk?

Answer:

Most medications work best if taken with water. There are certain foods that can affect the absorption of medication. It is important to ask your pharmacist about taking medication with or without food with every new prescription you begin.

Question:

What is a good OTC treatment for eczema?

Answer:

Over-the-counter treatments for eczema include anti-itch products that contain diphenydramine or hydrocortisone, and moisturizing lotions, such as Cetaphil, Eucerin, Aquaphor, and their generics.
For more severe cases, over-the-counter regimens may need to be supplemented with a stronger steroid cream. Seek medical advice if over-the-counter treatments do not help to control your symptoms or your lesions become worse.

Question:

Can adult sunscreen lotion cause a rash on children?

Answer:

Children’s sunscreen has the right amount of ingredients to protect a child’s skin. It also doesn’t have the perfumes and alcohols that can be found in adult products, ingredients which can increase irritation to the skin and lead to rashes.
If you are looking to utilize one product for the whole family, I recommend using a baby’s or a child’s sunscreen product. The formulation has less chemicals and will still have the correct SPF protection for everyone.

Question:

Is there any OTC method of removing freckles from your face?

Answer:

There is not a product to eliminate freckles. However, if you have sunspots or darker areas that have developed later in life after sun exposure, there is a prescription-strength bleaching cream that can be used to reduce the color.
Whether it is freckles or sunspots, it is important to have the discoloration checked out to make sure it is not an early sign of skin cancer. A dermatologist can aid in a skin cancer screen, which takes about 15-20 minutes. The doctor can also assist with getting you a prescription for bleaching cream if the discoloration is not cancerous.

Question:

I was given TR 1.75% liquid for the cysts that I get on my nose. Can you tell me what it is? The directions seem quite scary.

Answer:

Unfortunately, I am not familiar with this product. I would need more information to give you a better response. However, I would take the product to your local pharmacist and gather more information about what you are applying to face.
It is very important to understand all you can about your medications, acknowledging the risks and the benefits, to be sure that a certain medication is right for you. Medications come with guidelines describing how and what they are to be used for, how they should be stored, any possible side effects, contraindications, etc. But ultimately, every experience with any medication is very individualized. It is important to understand your medication and how it can affect you, whether positively or negatively.

Question:

How can I keep my hair and skin oil-free in the summer?

Answer:

Oily hair is a natural production. If you wash your hair frequently it causes your body to produce more oil. The less you wash it, the more the production slows down.
Ways to absorb body oil is to use baby powder. Just use a small amount at the roots and pat the white color out. Some hair salons have colored hair powder that can be used if you do not like the white powder.
As for the face or skin, a light lotion that is less greasy should be applied as a moisturizer. There are also face towelettes that can be used to blot the face and eliminate oil and perspiration.

Question:

What is generally meant when the MD says take a prescription 2 times a day? Twice in 24 hours or twice during normal awake hours?

Answer:

Typically it is best to take these kind of medications every 12 hours. The flexibility of the frequency of dosage depends on the medication. Check with your local pharmacist to understand the importance of the timing of your medication.

Question:

I would like to know about suntanning pills? Are they safe? Do they work? Thank you.

Answer:

Suntanning pills do not work. Also, sun tanning pills are not approved by the FDA. The Dietary Supplement Health and Education Act passed by the United States Congress in 1994 allows the marketing of products as a "dietary supplement" without the approval of any government agency. The labeling for these products must include a disclaimer saying that they have not been approved by the FDA and are not intended to diagnose, treat, cure, or prevent any disease. If a question about safety arises, the burden of proof is on the FDA, not the manufacturer.

Question:

What does "half-life" mean for a drug?

Answer:

Half-life is a measurement of the amount of time it takes the body to clear half the medication from the body.
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