Methotrexate and sun exposure: Hi I'm looking for a... - PMRGCAuk

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Methotrexate and sun exposure

Dance62 profile image
34 Replies

Hi I'm looking for a bit of advice. I'm going to Croatia on Thursday for a pre-surgery holiday and have just been reading about the link between Methotrexate and photosensitivity. Everything I've read seems to suggest covering up completely from head to foot which seems a bit extreme. I always use factor 50 and would like to think I'm reasonably sensible.

Does anyone else have experience/advice about this? I'm not planning to lie in the sun for hours, but will definitely want to swim.

I'm on 20mg Methotrexate a week.

Any advice would be very welcome as always. Thank you.

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Dance62 profile image
Dance62
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34 Replies
SheffieldJane profile image
SheffieldJane

I do not know about Methotrexate and exposure to the sun in particular but my daughters and grandchildren live in Australia and they protect themselves from the harmful rays as a matter of routine and habit. They use factor 50 sunscreen and wear hats. They go in the sea a lot and wear pretty swimwear with sleeves and the boys wear rash vests. A surfing session and they wear full cover up wet suits. The boys’ daddy runs a clinic for skin cancer. He removes dodgy moles all the time.

It’s a good habit, although we were never raised that way. I was warned about Pred and sun exposure once. I would err on the side of caution. I have heard that Croatia is truly beautiful. Look after yourself.

Dance62 profile image
Dance62 in reply toSheffieldJane

Thank you 😊

Dinahmite profile image
Dinahmite in reply toSheffieldJane

Hello. I'm wondering how and where to get hold of pretty swimwear with sleeves. Enjoy your holiday.

Telian profile image
Telian in reply toDinahmite

You can get pretty rash vests with matching shorts on line from well known out door makes ie Billabong, O’Neill etc. Have a browse. I would think you should easily get them where you are going to as well. Good luck! Have a good safe holiday.

Dinahmite profile image
Dinahmite in reply toTelian

Thank you.

Croft9232 profile image
Croft9232 in reply toDinahmite

Also Lands End have fantastic pieces of swimwear especially for mature ladies. Online only.

Dinahmite profile image
Dinahmite in reply toCroft9232

Thanks. On it!

SheffieldJane profile image
SheffieldJane in reply toDinahmite

A general Google search throws up other ideas like Boden. Modest swimwear is becoming more usual. Hides my sins also. 🙂

Dinahmite profile image
Dinahmite in reply toSheffieldJane

Yes. Mine too!

piglette profile image
piglette

Your skin may become very sensitive to sunlight while you’re taking methotrexate. This can cause a reaction that looks and feels like sunburn.

To reduce the chance of this side effect, stay out of bright sun, use a high factor sunscreen and wear clothes that protect you from the sun.

Dance62 profile image
Dance62 in reply topiglette

Thank you for the advice

PMRpro profile image
PMRproAmbassador

I don't think that everyone develops it but Factor 50 and looking for shade is a good idea.

Personally I find the extra heat of being in direct sun too uncomfortable with PMR - that was without MTX - bear in mind that that can add 10-15 degrees to the temperature you feel so that mid 20s C can feel more like 40C, Croatia tends to get weather similar to Italy as it progresses west to east and it hasn't been fabulous here yet - the wettest first 4 months of the year since 1951!! It is a bit early to get a reliable forecast yet - the Med and mountains make forecasting difficult. At present it is low 20s in the north, mid-20s further south, with showers and possibly thunderstorms so probably quite humid as well which makes it feel hotter too.

Where are you going?

Dance62 profile image
Dance62 in reply toPMRpro

Brac Island, quite near split. Forecast we've seen says it'll be roughly mid 20s which is usually fine for me.

Thank you for the advice 😊

PMRpro profile image
PMRproAmbassador in reply toDance62

Have a lovely time! My niece flew out to Gran Canaria a couple of days ago - their forecast is worse than for where I live!!!!

Dance62 profile image
Dance62 in reply toPMRpro

Thank you 😊 we are certainly having some weird weather this year. Hope it gets better where you are soon.

PMRpro profile image
PMRproAmbassador in reply toDance62

I take exception when my daughter in Fife, Scotland has better weather than I do in northern Italy!!!!

HelenDaisy profile image
HelenDaisy in reply toPMRpro

That’s very interesting. Is that why I’m always so wretched hot? Even in the winter! Summer becomes unbearable to me.

PMRpro profile image
PMRproAmbassador in reply toHelenDaisy

Many people find their temperature control flies out the window when PMR comes in! Pred makes it worse for me.

It was a nightmare when my husband was alive, he was a cold soul anyway but when he was ill he wanted the heating on full blast. He had the small room, had the radiator on as long as the central heating was on and then a small electric radiator when it wasn't on or enough. I had to almost strip to go in his room, it was like the tropics! He, on the other hand, wouldn't come in my room as it was "too cold". At 22C ...

HelenDaisy profile image
HelenDaisy in reply toPMRpro

That’s like us! My husband used to be the hot one. Since his cancer treatment he’s lost weight and is always cold. I was always cold but now I’m opening windows and sweating all year round. Summer can be purgatory! Is it PMR or pred or both?

PMRpro profile image
PMRproAmbassador in reply toHelenDaisy

Identical situation - OH had cancer at 41, pre me having PMR. In the hottest summer Scotland had had ... I very quickly got a new bed, an IKEA one with two single 80cm mattresses and single duvets so I could have a summerweight one and he had an extrawarm winter one!! I'd realised I only slept well in Germany where beds are fairly standard like that, no double duvets and mattresses.

Well his demands would have tried me anyway - rooms at 25C plus were hell for me! I think it can be either or both - I suffered even more during the 5 years I had PMR without pred and then pred added to it in some ways though calmed it down in others. Now I am down to 7mg pred I actually feel colder - this May has been appallingly cool and very wet, I still have the heating on in the mornings up here in the mountains. It is usually off long before the end of April.

HelenDaisy profile image
HelenDaisy in reply toPMRpro

I've enjoyed our cool spring, but it's warming up now. Interesting about the cancer: my PMR arrived due to the stress of his diagnosis. He's thankfully fine now 5 years down the road. I was hoping I would be too, but just upped yesterday to 7.5mg for a flare.

PMRpro profile image
PMRproAmbassador in reply toHelenDaisy

It was probably 10 years later the PMR first turned up - after a load of stressful events, his illness, job changes, house moves while children were still trying to complete school exams, difficult house sales, I was in Scotland, he was in England, didn't sell the house but rented it out (to our benefit in the end). I didn't really think it was that bad at the time but in retrospect the 20 years before PMR had been what could fairly be described as INTERESTING!!!

Understanding22 profile image
Understanding22 in reply toPMRpro

V interested to read this as I developed GcA in 2020 then got PMR and when I look back I realise how stressful life had been. After a house move last year I feel I am only recovering now. Just want to relax and be permanently on holiday. Yes my body temp regulator has gone haywire. Cannot stand the heat now and have noticed in last few days how being in the sun affects me. My face feels burning and goes red whereas in the past I could tolerate and my skin went brown.

HeronNS profile image
HeronNS

I believe Croatia is roughly the same latitude as where I live, Nova Scotia, and we're advised as a general rule to stay out of direct sun between 10 am and 3 pm local time during this time of year.

Tealblue2 profile image
Tealblue2

I definitely struggled with it last summer. We went to Lanzarote and in the first day I went completely bright red - but was using my normal sunscreen. I ended up buying a rash vest and cap and wearing those in the pool and sitting in the shade the rest of the time

I had only just started using it at that point and don’t know whether you would develop more immunity to it once the body has developed tolerance to it

Noni71 profile image
Noni71

I’ve never had a problem with sun and methotrexate. I use factor 50 but took no other precautions. I didn’t sit in full sun all day but I did swim and walk without any negative effects at all. This was in Majorca in the mid/late 20s

krillemy profile image
krillemy

I am on 20 mg as well. I have no problems with the sun. I use a little factor 30 on exposed areas but I do sunbathe. Have a nice holiday!

Dance62 profile image
Dance62 in reply tokrillemy

Thank you, that's really encouraging!

Pixix profile image
Pixix

not much help. As we didn’t go to Croatian til early September. I burn very easily, & use factor 50, but my weakness is that I forget to re-apply it regularly. Whoops. Croatia is beautiful, enjoy. So pretty, lovely & friendly, too. We used to snorkel a lot, & I loved swimming, we had t-shirts with factor 40 protection built in, & I wore long shorts, & a bandana on my head…a lot of people forget head protection in the sea/pool! Hats fall off, you can tie a bandana onto your head! Have fun, S x

S4ndy profile image
S4ndy

Just check out Amazon, they have some rash vests and long sleeved swimwear. Next day delivery too so you will get them prior to your hols. Croatia is on my list of places I want to visit, have a great time x

Knit11 profile image
Knit11

I have been taking 20 mg. Methotrexate and gave up going to the beac,, where I am used to walk a lot. However, I went on a trip to Croatia, Austria and Hungary and we hiked in Plitvice Lake Park and walked in pretty cities. I put 50 suntan lotion and wore an Under Armour long sleeve shirt that rejects heat. But even that is not necessary. My rheumatologist said that I only need to be mostly in the shade with suntan lotion. Essentially, the med makes one more susceptible to burn from the sun. I interpret this as using common sense while still enjoying life. Have a wonderful trip! It's a great place to explore.

AtopicGuy profile image
AtopicGuy

Using factor 50, wearing a wide-brimmed hat and covering up as much as possible are good ideas. Try to avoid the mid-day sun, when the UV is strongest. Swim in the morning, late afternoon, or evening, when the water temperature allows, only taking short dips. Shade is better than direct sunlight, but UV is scattered from the whole sky, so don't be fooled into thinking it is anywhere near safe: the only place with little UV is under cover.

The body's immune system is constantly repairing sun damage. The greatest problems come when it is overwhelmed by the strength and/or duration of exposure; that is when the damage builds up, so spread things out. All things in moderation.

MrsNails profile image
MrsNails

Hi l’ve taken Methotrexate for many years, l’ve been off it for 18months.

I’m a Celt with dark hair but fair skin, when l was on MTX ~ l found l caught the sun more easily but more evenly!

Always had half an hour in the morning without sunscreen for my Vitamin D

But generally wore a 3/4 length sleeves & trousers or maxi dresses but very fond of the shade of late anyway!

Take it steady to see if you can tolerate any warm weather we have before you go away. We’re heading to Norway!

Have a good time!

PMRCanada profile image
PMRCanada

I am on 15mg MTX weekly and was away on a winter vacation in sunny, hot Puerto Vallarta, Mexico last Feb. I wore 50 spf sunscreen and was in the shade and sun throughout my vacation with no problems. We swam, walked, etc. and no issues except the day prior to us leaving when I developed a PMLE related rash.

I had developed PMLE (polymorphous light eruption), basically an allergic reaction to the sun, 5 years prior to developing PMR. So my first exposure to the sun each year usually results in a bumpy, itchy rash. This usually only lasts a few days, then I’m fine the rest of the season.

A sun lover my whole life, I am now more diligent about using sunscreen and being in the shade, however having a pool usually means sun exposure in the summer. So I do try and slowly work up my time in sun by sitting out 15-20 minutes in the morning as to adjust each summer.

Of note I’ve never had the bright red sunburn related to taking MTX and sun exposure, in the 2.5 years I’ve been on MTX (and the first year I was on 25mg weekly).

Enjoy your holiday!

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