If you feel like remembering to apply sunscreen is the least of your worries with hidradenitis suppurativa (HS), take note: People with HS have a higher risk of certain types of skin cancer — specifically, nonmelanoma cancers.
“Squamous cell carcinoma (SCC) is considered the most common complication arising in long-standing HS,” noted the authors of a 2021 study. Parts of the body that have been repeatedly damaged by HS lesions might be more vulnerable to cancer.
That’s why it’s essential to regularly use sunscreen and find other ways to stay safe in the sun without complicating your skin care routine or your life. This article offers some simple tips to stay on track with sun safety and help prevent other problems down the road.
People with HS, also known as acne inversa, use various oral and topical medications to keep their symptoms under control. Their regimen may also include over-the-counter (OTC) lotions, creams, and cosmetics. Unfortunately, some of these treatment options and products make skin more vulnerable to ultraviolet light. This chemically induced sun sensitivity can lead to premature aging and skin cancer.
For example, birth control pills that contain estrogen list photosensitivity as a potential side effect, as do nonsteroidal anti-inflammatory medications (NSAIDs) like ibuprofen. Drugs such as adalimumab (Humira), a biologic that’s approved by the U.S. Food and Drug Administration (FDA) to treat HS, may be associated with an increased risk of certain skin cancers, making sunscreen use extra important.
“I got a call from my doctor and dermatologist, and they came to an agreement that I should start adalimumab (Humira). I’ve been super emotional about it,” one myHSteam member shared. “I feel as if I won’t be able to have much of a life being on it, and I say that because of the lowered immune system, and I won’t be able to be in the sunlight a lot. (I’m also allergic to sunscreen).”
HS is sometimes treated with biologics that aren’t specifically approved for the condition, such as infliximab (Remicade). Infliximab works similarly to adalimumab, so it carries the same sun-safety concerns. It’s important to ask your doctor if you need to take extra sun-safety measures when starting a new biologic.
In addition, it’s important to be aware that retinoids prescribed for acnelike forms of HS can make skin photosensitive. Aside from prescriptions, various OTC skin care products contain retinoids, so it’s crucial to read labels and know what you’re putting on your skin.
Doctors also advise taking extra caution in the sun when using products with alpha or beta hydroxy acids or hydroquinone. If you’re purchasing a product that claims to brighten skin or reduce wrinkles or breakouts, there’s a good chance it contains one of these active ingredients.
Wearing sunscreen is crucial for everyone, no matter your skin tone. In the United States, HS disproportionately affects African Americans and people who are biracial , according to a 2017 study in JAMA Dermatology. (The study defined ”biracial” as ”white and African American.”) Some people may assume that sunscreen is needed only for light complexions, but the melanin that makes skin look darker provides an SPF of just 6 or 7. Dermatologists recommend an SPF of at least 30 to protect against sun exposure.
Also, keep in mind that the sun’s potential dangers exist even in cold temperatures, especially if you’re participating in an activity in which ultraviolet rays can reflect off snow or ice, like skiing or sledding.
According to the Skin Cancer Foundation, although skin cancers occur less frequently among members of nonwhite racial ethnic groups, they tend to have worse outcomes. This is because they’re more likely to be diagnosed with skin cancer at later, less-treatable stages.
Talk to your doctor about your skin cancer risk and ways to protect yourself. Along with wearing sunscreen diligently, you can watch out for unusual moles or growths. It’s important to check for dangerous melanomas, which are more likely to develop in less obvious locations, like between the fingers and toes.
People with HS may hesitate to use sunscreen on skin that’s sensitive or affected by HS lesions. If you’re worried about how commercial sunscreen could affect your skin condition, you have plenty of options. For example, you can try sunscreens that block ultraviolet radiation with natural minerals like zinc oxide.
To avoid layering any creams or lotions on your skin, you can opt for sun-protective clothing. Similar to sunscreen being labeled with an SPF, sun-protective clothing is rated with an ultraviolet protection factor (UPF). While a typical cotton shirt has a UPF of about five, certain clothing brands are designed to provide UPF 30 or more. These protective, lightweight garments can help you stay cool and covered and free you from slathering or spraying another product on your skin. Pair sun-protective clothing with sunglasses and a wide-brimmed hat to shield your whole body from harmful rays.
In addition to wearing sun-protective clothing, you can reduce your risk of skin cancer by following safe habits, like avoiding peak sun hours (between 10 a.m. and 3 p.m.) and seeking shade.
Understanding your family history can give you and your health care provider special insight into your personal risk of skin cancer. Studies show that in the general population, squamous cell carcinoma — the type of skin cancer that’s more prevalent in people with HS — is strongly linked to family history. That means if your parents or siblings have had any type of skin cancer, you may be at greater risk.
Having a skin disease like HS and a family history of skin cancer may put you at increased risk, so it’s important to talk with your dermatologist. They can help you understand your risk factors and the best ways to protect yourself, such as performing skin checks at home in between doctors’ visits. If you see a new mark that looks different from others or changes quickly, don’t hesitate to follow up with your dermatologist and ask for a closer look.
On myHSteam, the social network for people and their loved ones living with hidradenitis suppurativa, more than 34,000 members come together to ask questions, give advice, and share their stories with others who understand life with HS.
Has your health care provider discussed your risk of skin cancer? How do you balance sun safety with your HS treatment? Share your experience in the comments below, or start a conversation by posting on your Activities page.