Pain Medication and the Sun

By H. Rand Scott, MD — Medical Director, Newport Pain Management Reviewed and updated October 2026

Believe it or not, sun and some medications don't mix. Many prescription and over-the-counter pain relievers can cause a skin reaction when you go into the sun. This is called photosensitivity, and living in Orange County makes it worth knowing about.

Reactions can range from an itchy, scaly, hive-like rash to swelling and blisters that look like a bad sunburn out of proportion to how long you were out. Long-term consequences of repeated photosensitive reactions can include premature skin aging, increased skin cancer risk, cataracts, and blood vessel damage.

• Phototoxic reactions — the more common type. The drug absorbs UV light and directly damages skin cells. Looks and feels like an exaggerated sunburn, usually within hours of exposure.
• Photoallergic reactions — the immune system reacts to a drug-plus-UV combination. Shows up as an itchy, red, sometimes bumpy rash 24 to 72 hours after exposure.

• NSAIDs — ibuprofen, naproxen, piroxicam, ketoprofen (topical gel is a common culprit)
• Antibiotics — tetracyclines (especially doxycycline), fluoroquinolones (ciprofloxacin, levofloxacin), sulfa drugs
• Antidepressants — tricyclics (amitriptyline, nortriptyline), some SSRIs
• Diuretics — hydrochlorothiazide, furosemide
• Heart medications — amiodarone (particularly notorious)
• Diabetes drugs — sulfonylureas (glipizide, glyburide)
• Retinoids — isotretinoin, tretinoin
• Some antifungals — griseofulvin, voriconazole
• Certain anti-seizure medications — carbamazepine, phenytoin
• St. John's wort — an herbal often overlooked

Before starting any prescription or over-the-counter medicine, ask your pharmacist directly: "Does this cause photosensitivity?" They have the answer at their fingertips and it takes 30 seconds. Don't assume an over-the-counter remedy is safe — many aren't.

• Use a broad-spectrum sunscreen with SPF 30 or higher — SPF 50+ during peak hours
• Apply daily to any exposed skin, including the back of the neck, ears, and hands (three of the most-missed spots)
• For best protection, apply liberally to dry skin 15 minutes before going out, then reapply every 2 hours — sooner after swimming, physical activity, heavy sweating, or towel-drying
• Use a water-resistant formulation if you'll be swimming or sweating heavily
• Avoid or limit sun exposure between 10 AM and 4PM, when UV is strongest
• Wear a wide-brimmed hat and tight-weave clothing whenever practical
• Use sunscreen even under a self-tanner
• Wear sunglasses with UV protection — some medications sensitize the eyes as well as the skin

1. Get out of the sun and cover the affected skin.
2. Cool compresses and aloe can help mild reactions.
3. An over-the-counter antihistamine (loratadine, cetirizine) may help itching.
4. Call your prescribing physician — do not stop critical medications on your own, but let us know so we can review alternatives.

Questions about your medications? Call Newport Pain Management at (949) 759-8400.

This article is for general education and is not a substitute for individual medical advice.