SUN SENSITIVITY - CAUSES and SOLUTIONS
Updated: 2 days ago
Doxycycline is the one most known for sun sensitivity in the Lyme world, but many other medicines carry this warning too. Some herbs, essential oils and plant juices can also make us burn more easily, and for some of us the reaction comes from our mast cells or an autoimmune condition. I've gathered the causes first, then the ideas that may help.
Short on time or energy? A quick-view graphic with the key points is at the bottom of this post.
Product links are under WHERE TO BUY.
WHAT CAN CAUSE SUN SENSITIVITY
DOXYCYCLINE AND OTHER TETRACYCLINES
- ILADS says doxycycline, started promptly after a known blacklegged tick bite, may prevent Lyme, and lists it as one choice for an erythema migrans (EM) rash, the classic Lyme rash. EM rashes show up mostly in summer (2018 study), so sun protection matters.
- In his 2008 Lyme treatment guidelines, Dr. Joe Burrascano told doctors to warn every patient on tetracyclines (like doxycycline and minocycline) that sunlight can affect their skin and eyes, and to teach them how to protect themselves.
- In a study of 858 adults treated with doxycycline for an EM rash, 1.9% had a sun reaction, ranging from itching and burning to mild, short-lived redness on sun-exposed skin. Women had it more often than men (2.7% vs 0.8%), 13 of the 16 people hadn't followed the advice to avoid the sun, and no one had lasting effects (2018 study).
- A phototoxic reaction shows up fast and looks like a bad sunburn. A photoallergic reaction comes on later and looks more like an eczema-type rash. Doxycycline can also cause nails to lift away from the nail bed after sun (photo-onycholysis, 2022 review).
- These reactions are caused mostly by UVA light, which passes through regular window glass. That means it can happen in the car or by a sunny window, any time of year (2022 review).
OTHER MEDICINES WITH A SUN WARNING
MedlinePlus gives each of these a sun warning:
- Doxycycline, minocycline and tetracycline
- Sulfamethoxazole and trimethoprim (Bactrim, Septra), a sulfa antibiotic
- Ciprofloxacin and levofloxacin (tanning beds and sunlamps too)
- Dapsone
- Many other medicines can do this too, including some water pills and NSAID pain relievers (2022 review). Ask your pharmacist to check everything you take.
HERBS, OILS AND PLANT JUICES
- St. John's wort: the NIH's NCCIH warns that large doses by mouth, or using it on the skin, could lead to serious skin reactions once you're out in the sun.
- Some citrus essential oils, especially bergamot, can cause burns or dark spots if your skin goes in the sun after using them.
- Plant juice plus sun (phytophotodermatitis): juice or sap from limes, lemons, grapefruit, figs, celery, parsley and parsnips has natural compounds (furocoumarins) that can cause a burn-like rash, even blisters, when that skin then gets sun. Redness usually shows up within 24 hours (2021 and 2023 reviews).
MAST CELLS (MCAS)
- Sunlight is on the list of mast cell triggers in my MCAS Education post.
- Solar urticaria is a rare kind of hives where light sets off the mast cells in your skin. Itching, redness and welts can show up within minutes of sun (2022 review).
- Of all the immune rashes set off by light, polymorphic light eruption (PLE) is the one seen most often (2021 review). Depending on the country, it affects anywhere from under 1% to over 21% of people, and it's more common the farther you live from the equator (2023 review).
LUPUS AND AUTOIMMUNE CONDITIONS
- Sensitivity to the sun is a lupus symptom, and skin lupus rashes usually show up after sun exposure (MedlinePlus). In lupus, UV light can also bring on flares in the rest of the body (2022 review).
- Lyme may be linked to autoimmune problems that start afterward. A 2025 Johns Hopkins study found new autoimmune arthritis in 1.67% of people within two years after Lyme, compared with 0.45% after the flu.
- Dr. Tania Dempsey explains that MCAS can help drive the development of autoimmune disease.
- If sun brings on rashes, a butterfly-shaped rash across your cheeks and nose, or flares, ask your doctor whether blood tests such as an ANA (antinuclear antibody) test make sense for you.
POSSIBLE SOLUTIONS
PROTECT YOUR SKIN AND EYES
- Avoid the sun when you can. That's the best protection when you're on a medicine that makes you sun sensitive (2022 review).
- Clothing: cover up with clothing, a wide-brimmed hat and sunglasses. Look for clothing labeled UPF 40 or higher, since UV can pass through the gaps in woven fabric (2022 review).
- Sunscreen: use a broad-spectrum (UVA and UVB) sunscreen, SPF 50, and put it on before you go out (2022 review). EWG suggests not chasing numbers higher than 50.
- Mineral sunscreen: EWG's 2026 Guide to Sunscreens names zinc oxide mineral sunscreen as its top pick. It suggests lotions or sticks over sprays, and avoiding oxybenzone, octinoxate and "fragrance" on the label. Fragrance-free is a good choice with MCAS, since Dr. Tania Dempsey sees perfumes and fragrances as typical mast cell triggers.
- Windows: since UVA passes through regular glass, cover up in the car and sit back from sunny windows when your skin is sensitive.
- Wash plant juice off: if you've handled limes, lemons, celery or parsnips, wash your hands and skin before going in the sun. Gloves help when you're working with these plants (2021 review).
IF YOU REACT
- Call your doctor if you get a bad sunburn, blisters or swelling while on a medicine with a sun warning. Don't stop a Lyme medicine on your own.
- Antihistamines: non-sedating antihistamines are often used for solar urticaria and to ease PLE itching. In a 2025 survey of 112 people with solar urticaria, most said they helped only a little, not at all, or made things worse, though they worked better in milder cases. A prescription shot (omalizumab, Xolair) brought complete control for about a third of those who tried it. My MCAS solutions post has more mast cell ideas to go over with your doctor.
- Cool compresses can ease the pain and itch of a plant juice burn (2021 review).
- Aloe: NIH's NCCIH says research suggests aloe gel on the skin may help burns heal faster and ease burn pain. It occasionally causes burning, itching or a rash.
FROM THE INSIDE
- Astaxanthin: I've called it an "internal sunscreen." In a small 2018 trial of 23 healthy people, astaxanthin raised the amount of UV it took to redden the skin and helped UV-exposed skin hold onto moisture. The trial was paid for and run by a company that sells astaxanthin products. Carotenoids, the family astaxanthin belongs to, were among the best-supported supplements in a 2025 review of 47 human studies on sun protection.
- Polyphenols: these plant compounds were also among the best-supported in that 2025 review. Studies so far are small and short.
OTHER OPTIONS LYME-LITERATE DOCTORS AND RESEARCH POINT TO
- Polypodium leucotomos (a fern extract): in a 2026 trial of 50 healthy volunteers, it raised the amount of UVA needed to redden the skin by 26%. It was also one of the best-supported in the 2025 review.
- Nicotinamide (also called niacinamide, a form of vitamin B3): in the same 2026 trial, it also raised that amount by 26%. Neither one lowered signs of UVA damage to DNA.
- Gradual spring sun for PLE: for milder PLE, a 2021 review says broad-spectrum sunscreen plus slowly building up sun exposure in early spring may be enough. Talk with your doctor first, and skip this while on a medicine with a sun warning.
BEFORE YOU START
- Read the warning on each bottle.
- St. John's wort can weaken many medicines. Ask your doctor first if you take any.
- Go over any new supplement with your doctor, especially during treatment.
MY EXPERIENCE
- I've gotten sunburned while on doxycycline, and it happens pretty fast.
- I keep an aloe product on hand for sunburn, since aloe is a top remedy.
- I believe my doctor had me use astaxanthin at one point, though I don't remember much about it.
- I buy lots of unscented products.
WHERE TO BUY
Buy products on Fullscript for a 25% discount
These mineral sunscreens are EWG VERIFIED:
Buy here (Babo Botanicals Sheer Zinc Mineral Sunscreen Lotion SPF 30, Unscented: zinc oxide):
Buy here (Babo Botanicals Super Shield Mineral Sunscreen Lotion SPF 50: zinc oxide, fragrance free):
Buy here (Babo Botanicals Daily Sheer Mineral Sunscreen Fluid SPF 50: zinc oxide, fragrance free):
Buy here (Babo Botanicals Daily Sheer Tinted Mineral Sunscreen Fluid SPF 50: zinc oxide, fragrance free):
Astaxanthin product suggestions are in my Astaxanthin post (linked above).
MORE RESEARCH WITH MIXED RESULTS
- Omega-3: omega-3s were among the supplements looked at in the 2025 review, but the strongest evidence was for polyphenols, carotenoids and polypodium.
- Polypodium for solar urticaria: in the 2025 survey, only a few people had tried it, and it didn't bring much improvement.
RELATED POSTS
NON TOXIC PRODUCTS
EYES AND VISION
HEAT INTOLERANCE
SOURCES
ILADS, Lyme Disease Basics for Providers (updated 2026)
Dr. Joe Burrascano, Advanced Topics in Lyme Disease (2008, older source, still worth reading)
Velušček et al., doxycycline sun reactions in bull's-eye rash patients, BMC Infectious Diseases (2018, older source, still worth reading)
Di Bartolomeo et al., drug-induced photosensitivity, Frontiers in Allergy (2022)
MedlinePlus, Doxycycline (2026)
MedlinePlus, Minocycline (2026)
MedlinePlus, Tetracycline (2026)
MedlinePlus, Co-trimoxazole (2025)
MedlinePlus, Ciprofloxacin (2026)
MedlinePlus, Levofloxacin (2026)
MedlinePlus, Dapsone (2017, older source, still worth reading)
NIH NCCIH, St. John's Wort (2025)
Mansilla-Polo et al., phytophotodermatitis review, Photodiagnosis and Photodynamic Therapy (2023)
Cutis, Botanical Briefs: Phytophotodermatitis (2021, older source, still worth reading)
McSweeney et al., solar urticaria, Experimental Dermatology (2022)
Kiefer et al., solar urticaria patient survey, Frontiers in Immunology (2025)
Kadurina et al., polymorphic light eruption, Dermatologic Therapy (2021)
Burfield et al., how common light rashes are, JEADV (2023)
MedlinePlus, Lupus (2026)
Klein and Kunz, photosensitivity in lupus, Frontiers in Medicine (2022)
Miller et al. (Johns Hopkins), autoimmune arthritis after Lyme, Seminars in Arthritis and Rheumatism (2025)
Global Lyme Alliance, Ask a Lyme Doctor: Q&A with Dr. Tania Dempsey (2022)
Dr. Tania Dempsey, introduction to mast cells and MCAS, podcast transcript (2023)
EWG, Guide to Sunscreens (2026)
NIH NCCIH, Aloe Vera (2025)
Ito et al., astaxanthin and UV skin, Nutrients (2018, older source, still worth reading)
Natarelli et al., oral supplements and sun protection, Journal of Medicinal Food (2025)
Faisal et al., nicotinamide or Polypodium leucotomos and UVA, Photochemical and Photobiological Sciences (2026)
Hyeraci et al., systemic photoprotection, Biomolecules (2023)
Disclaimer: Rise Above Lyme makes no claims about any possible benefit of using any product mentioned within this site. Always consult with your doctor before adding anything. The information shared is based on personal experience, years of accumulated researched resources from Lyme Literate doctors and polls conducted within Lyme groups from actual patient experience using these solution ideas.
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