This Is MS Multiple Sclerosis Community: Knowledge & Support

Along with the seasonal change in the northern hemisphere to longer, sunnier days, I thought it might be wise to remind people taking doxycycline that they should avoid prolonged unprotected exposure to the sun. Although on vacation at the moment, David went in to the hospital today to check his mail and found a few people experiencing rashes and suchlike, so please remember your sunscreen and/or sunhats and long sleeves.

Sarah

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An Itinerary in Light and Shadow Completed Dr Charles Stratton / Dr David Wheldon abx regime for aggressive secondary progressive MS in June 2007, after four years. Still improving with no relapses since starting. Can't run but can paint all day.

To add to this, I found the following.

I found this warning to travellers using doxycycline as a prophylactic for malaria:

http://www.patient.co.uk/showdoc/30002288/

Common side effects
If the contents of the capsule/tablet come into contact with the oesophagus (the tube from the mouth to the stomach) they may irritate it leading to unpleasant "heartburn" symptoms. To prevent this it is important to wash down the capsule/tablet with plenty of water. It is also wise not to lie down immediately after taking the drug (to avoid reflux).

As doxycycline is an antibiotic it may cause diarrhoea (paradoxically it will treat some causes of travellers diarrhoea) and may increase the incidence of vaginal thrush especially in those prone to this problem.

Rarely, doxycycline may sensitise the skin to the sun (approximately 3% of people taking this dose of doxycycline will be affected) leading to an unpleasant rash or increased risk of sunburn. It is wise to use high factor sun screens covering both UVA and UVB.

Travellers taking the combined oral contraceptive pill should take extra contraceptive precautions for the first month of taking doxycycline.



However, this is quite interesting because I had never thought about nails before:

(I never wear either nail varnish or false nails, but I have never found this a problem myself.)

http://bmj.bmjjournals.com/cgi/content/full/329/7460/265

http://www.lareb.nl/documents/BMJ2004_1325.pdf

The Netherlands Pharmacovigilance Centre Lareb received five reports concerning photo-onycholysis associated with the use of doxycycline. All five patients used 200 mg of doxycycline a day for the prophylactic treatment of Lyme disease after tick bite. In all cases the affected nails had been exposed to the sun during the summer. All patients showed (partial) recovery after several months. To our knowledge, no other factors (either specific physical disorders or concomitant drug use) were responsible for the onycholysis in these patients.


Sarah

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An Itinerary in Light and Shadow Completed Dr Charles Stratton / Dr David Wheldon abx regime for aggressive secondary progressive MS in June 2007, after four years. Still improving with no relapses since starting. Can't run but can paint all day.

Sarah

Thanks for posting this. My question to David was more about alternatives to doxy - are there any that do not sensitise skin to the sun?

I have hardly been out in the sun and my hands are unsightly! I now carry sun cream in my handbag, but what about getting vitamin D from the best source? Are we stuck?

How soon do the effects wear off? I was wondering about holidays once I have completed the year of continuous doxy?

I thought I'd post this publicly in case others who are affected would like to know the answers.

Best wishes

J.

Oh, I didn't know you were one of the people who had written! David is back at work tomorrow.

Once you are on intermittent therapy you should be able to work round it. The funny thing is I never found this problem. I don't know how much was due to just constantly putting sunscreen on my face and hands that year or just not being someone who although she has very fair skin is not inclined to burn so much: the difference between a burn prone Celtic skin and a Scandinavian one. Now I can just choose not to take my intermittent bouts if the weather is very good or I am going on holiday. When it was very sunny last week, I wasn't wearing anything to protect myself.

I think this sun sensitivity is a problem with all tetracyclines, unfortunately, but if you work your pulses around holidays and carry on taking NAC all the while, this guards against any reinfection, as does the sun, ironically.

Take care,

Sarah

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An Itinerary in Light and Shadow Completed Dr Charles Stratton / Dr David Wheldon abx regime for aggressive secondary progressive MS in June 2007, after four years. Still improving with no relapses since starting. Can't run but can paint all day.

Many thanks Sarah.

By the way, I have meditteranean skin so I am not used to being burned.

I wear sunscreen on my face in the UK - hands get washed too often so I'll have to make a special effort. I always wear sunscreen on holiday but I guess it needs reapplying on hands!

Best wishes

J.