The Sun Did It: Flares and Autoimmune Disease

Solar Flare Courtesy of NASA

It might seem like the wrong time of year to be writing about the pitfalls of sun and autoimmune disease, but not for me. I will explain. January and early February were a tough time for me.  I was in a flare.  It started with my eyes going from very dry to completely parched and always painful.  Putting drops in actually hurt my eyes they were so bad.  Then the symptoms cascaded from there…neurological symptoms, fatigue, joint pain, you name it. For those readers with autoimmune disease, you unfortunately know what I'm talking about.

I had assumed it was the cold weather that had kicked off my change in symptoms. The background: My husband and I had taken a trip around New Years to Florida.  He was lucky to be able to get off from work and we decided to take advantage of it.  I tend to feel better in warmer climates so it seemed like a good deal. While we were away I felt really good.  I had energy. My joints barely ached. We walked every morning.  My eyes generally felt good and I was able to read.  I started thinking about the future, as "a normal" healthy person.  Then, the day after we returned from sunny Florida to the cold Northeast, my flare began.  So it must have been the return to the cold I assumed. Right?

Well, it turns out that it was likely the opposite! When I saw my rheumatologist last week, I recounted what had happened over the previous weeks.  I was cursing the cold, dry, Northeast weather. Then I mentioned that I had been away somewhere warm before this all started.  He immediately started asking questions about where I had been and how much sun exposure I had gotten.  It so happens that he was willing to bet that it was most likely the sun that kicked off my flare.  I knew that patients with Sjogrens, Lupus, and other autoimmune diseases had to be especially careful in the sun, but I always regarded the cold as more dangerous since it caused me more immediate pain.

But no. The same sun that made me feel happy to be outside?  Well, it was getting my body ready to attack me at the same time.  The link between flares and the sun is not entirely surprising.  It turns out the sun and its UV rays can cause damage to our cell's DNA that starts a process by which inflammatory protein molecules called cytokines can activate causing a chain reaction leading to autoimmune exacerbation.  Making matters worse, like me many people with autoimmune disease take medications that can make them even more reactive to the sun.

This happened despite the fact that I am already very careful in the sun.  I wear a UPF 50 wide brim sun hat, beach cover up, high protection sun screen, and always sit under an umbrella if I go on the beach.  With all the precautions I took, I still managed to get red one day.  When I thought back, it was the one day that I strayed from just one part of my usual routine of making sure to be inside between the hottest hours of the day.  A big oops! But that's what I get for not being totally controlled and planned every minute.  I was having fun with my husband.  I wasn't thinking about having autoimmune disease and health challenges.  It is unfortunate with an illness like autoimmune disease, you can never completely let go -- whether its medications, sun protection, or just simply not overdoing it.   But the truth is that I would rather miss a few hours of fun and sun than have a flare any day.