Migraine Drugs and the Risk of Sun Sensitivity

Some drugs used to treat migraine and other conditions increase the risk of sun sensitivity. This side effect is called photosensitivity. It can occur with all kinds of drugs, regardless of how they are taken. Drugs that are put on the skin (like creams), as well as drugs taken by any other method (like by mouth or injection), can all lead to a reaction.^1,2

Types of photosensitivity

Photosensitivity can impact people in different ways. It can also vary from drug to drug. There are 2 types of photosensitivity:^1,2

• Photoallergy – This can occur days after a person is exposed to sunlight or radiation
• Phototoxicity – This usually occurs a few hours after exposure

Phototoxicity is more common. It has to do with the ingredients of the drug itself and how the drug and skin are impacted by the sun’s light or other forms of radiation. Drugs that are phototoxic tend to show this pattern across most people who take them.^1,2

On the other hand, a photoallergy is an allergic reaction. Not everyone will have the same allergic response to a certain drug. This means it is possible that only a few of the many people taking a drug have this side effect.^1,2

What do the reactions look like?

Photoallergies often cause a widespread, red rash. The rash may be itchy, and blisters may be present.^1,2

Phototoxic reactions can also be red and itchy. However, they usually occur in areas directly exposed to the sun rather than the entire body. A phototoxic reaction is often described as a bad or exaggerated sunburn.¹

All types of photosensitivity reactions can also increase the risk of future skin cancers.²

Which drugs cause sun sensitivity?

There are many drugs that can cause photosensitivity reactions. Some of these are used in migraine treatment, while others may be used for different issues. Several drugs that commonly cause reactions include:^1,2

• Antibiotics like ciprofloxacin, doxycycline, and tetracycline
• Antidepressants like paroxetine and sertraline
• Antifungals like flucytosine and griseofulvin
• Antihistamines like cetirizine, diphenhydramine, and loratadine
• Calcium channel blockers like amlodipine and nifedipine
• Cholesterol-lowering drugs like statins, including simvastatin and atorvastatin
• Diuretic drugs like hydrochlorothiazide, furosemide, and chlorthalidone
• Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, naproxen, and celecoxib
• Oral contraceptive drugs and estrogens
• Retinoids like acitretin and isotretinoin
• Sulfonamide drugs like acetazolamide and sulfasalazine
• Sulfonylurea drugs like glipizide or glyburide
• Certain ingredients in cosmetic products

This is not a complete list of all drugs that can cause sun sensitivity. Talk with your doctor about all drugs you take, including over-the-counter drugs and supplements. They can help best determine your risk and the next best steps.

Do you need to stop treatment?

The way photosensitivity is treated can vary in each situation. For some, the drug causing the reaction may need to be stopped. However, it is possible for a person to react to a drug 1 time but not the next time they use it. Because of this, having a photosensitivity reaction does not mean a person will always have to stop a drug entirely.^1,2

In some cases, the drug may be necessary, so treatment might involve avoiding the sun and radiation as much as possible. Sometimes, a reaction may be severe enough that additional drugs, like corticosteroids, are needed.^1,2

How can you reduce your risk of a reaction?

If you are taking a drug that often causes sun sensitivity, there are steps you can take to reduce your risk of having a reaction:^1,2

• Stay in the shade as much as possible
• Wear sun-protective clothing and a wide-brimmed hat
• Wear sunscreen that is at least 15 SPF, through 30 SPF is ideal
• Avoid other sources of ultraviolet radiation, like tanning beds

Even when it is not obviously sunny outside, these steps are important. The sun’s rays can reflect off of other things like water, snow, or sand and lead to a reaction.^1,2

Work with your doctor to determine what drugs you take may lead to sun sensitivity. It is also important to practice good prevention methods and seek treatment if you have a photosensitive reaction. Together, these steps can help you and your doctor monitor your health for any long-term issues.