If you have well-controlled eczema thanks to topical moisturizers, prescription medications, and good identification and management of triggers, you may also be thinking about how summer will affect your skin and how you can give your skin that natural-looking sun-kissed glow — in a safe way. Self-tanners may indeed be one option, even when you have eczema. “Self-tanner can be a great way to get color, but there are several potential drawbacks that all patients should be aware of, some of which are specific to eczema patients,” says S. Tyler Hollmig, MD, the director of dermatologic surgery and the director of laser and cosmetic dermatology at the University of Texas at Austin. “Patients with eczema really need to have their skin in prime, treated condition in order to tolerate self-tanner, and for best appearance,” he says. RELATED: How to Build a Smart Skin-Care Routine When Managing Eczema
How Does the Sun Affect Eczema-Prone Skin?
As the Skin Cancer Foundation says, “there is no such thing as a safe or healthy tan.” That’s because sun (ultraviolet, or UV, light) exposure increases your risk of a variety of skin cancers. This applies to people who have eczema, but there’s a caveat. “In general, sunlight in moderation can be very helpful for eczema. When you look at rates of eczema throughout the U.S. and world, research shows there is less eczema in populations that live closer to the equator,” says Jonathan Silverberg, MD, PhD, MPH, an associate professor of dermatology at the George Washington University School of Medicine and Health Sciences in Washington, DC. In addition, phototherapy — that is, using UV light — is one treatment for eczema, notes the NEA. “We do not entirely understand the mechanism here, but certain wavelengths of UV light are thought to suppress cutaneous immune cells in a way that reduces inflammation and flaring,” Dr. Hollmig explains. Still, dermatologists do not suggest that people with eczema get a sunburn. Phototherapy treatment is used in a controlled and skin-safe way in the dermatologist’s office. For instance, there is minimal risk of skin cancer, and side effects like redness or burning are not common, according to NYU Langone Health. RELATED: 8 Ways to Avoid Eczema Flare-Ups in the Summer
Using Self-Tanner When You Have Eczema
As someone with eczema, you might be a pro at reading labels on your skin-care products. You’re not only looking for words like “gentle,” “fragrance-free,” or “designed for sensitive skin” — you’re also reading the ingredients list. “The challenges faced with self-tanners may really apply to a variety of personal-care products, in that there are certain ingredients that are notoriously irritating in patients with sensitive skin or atopic dermatitis,” says Silverberg. Self-tanners are leave-on products, and so there may be an increased risk that the ingredients in the formula, like preservatives, will cause irritation. The main active ingredient in self-tanners is dihydroxyacetone (DHA), an FDA-approved additive that reacts with amino acids in the outer layer of skin to produce that sun-kissed glow, according to a review in the Journal of the American Academy of Dermatology from September 2018. There is not much data on DHA and eczema. But in Hollmig’s experience, DHA can irritate your skin, as well as cause allergic contact dermatitis, especially in those prone to eczema. When choosing a self-tanner, know that your product will contain DHA, as that’s the active ingredient that changes your skin tone. Still, you can take a few precautions. One, look for a product that is labeled safe for sensitive skin. Products that have fewer additives (such as fragrances and preservatives) or a shorter list of ingredients, as well as those that contain additional moisturizers (such as shea butter, aloe, glycerin, and vitamins E and B5) can decrease the risk of irritation and promote a healthy skin barrier. If you are getting a spray tan, you can ask the salon what type of product they use — in general, the advice and cautions on at-home bottled self-tanners applies to a spray tan. Some products that meet the aforementioned criteria are Coola Organic Sunless Tan Dry Oil Mist ($46, Dermstore.com), Supergoop! Healthy Glow Sunless Tan Broad Spectrum Sunscreen SPF 40 ($38, Sephora.com), and Josie Maran Juicy Mango Argan Liquid Gold Self-Tanning Body Oil ($39, Sephora.com). As Hollmig explained, it’s important that skin is in its best shape prior to application. Dry skin or rough scaly patches will take up self-tanner unevenly, resulting in blotchy areas. Make sure that prior to application, you have been sticking to a consistent moisturizing routine. RELATED: Photos of the 7 Different Types of Eczema
Before Trying a Self-Tanner, Test Your Skin
Overall, the likelihood of skin reacting to self-tanners is low, but if you have sensitive skin or have had adverse reactions to products in the past, be more careful applying something new, including self-tanner, suggests Silverberg. He recommends doing a “repeat open-use test.” Here’s how to do it:
Apply the product (in this case, your self-tanner of choice) on a one- to two-centimeter area of the skin at the crease of the elbow.Repeat once or twice per day for a couple of weeks.Watch for a reaction, such as redness or irritation.
“If you react on your arm, you may have avoided a full-body flare-up. If it was well tolerated, it’s reasonable to step up application and use it on the other parts of your body,” says Silverberg. There is still no guarantee you won’t react, but it’s less likely. He also suggests purchasing a smaller, travel-size of the product (if available) so that it’s less of an initial investment. RELATED: Common Eczema Myths You Shouldn’t Believe
One Last Thing on Using a Self-Tanner When You Have Eczema
In general, self-tanning products are not a replacement for sunscreen with SPF. In other words, that faux tan won’t guard your skin from the harmful UV and UVB rays from the sun. To do that, reach for a sunscreen with at least SPF 30, the Skin Cancer Foundation recommends. Apply sunscreen 30 minutes before going out in the sun, and every two hours after that, or after you swim or sweat. Doing so can help reduce your risk of skin cancer, as well as slow signs of skin aging, such as the development of wrinkles, discolorations and sagging, and increases skin cancer risk, notes the American Academy of Dermatology (AAD). SPF is important for everyone, but people with eczema may have an additional reason to use SPF: Eczema may make your skin more vulnerable to the effects of the sun, notes the NEA. Overall, plan to continue to use sunscreen regularly when you’re outside in the summer and year-round. “SPF can and should be applied right on top of a fake tan,” says Hollmig. RELATED: How to Identify, Prevent, and Treat a Sunscreen Allergy
