Q. Our family is going on a two-week vacation to the beach. I read in your column that there is a problem with St. John’s wort and the sun. I am reluctant to stop taking this herb because it has dramatically improved my outlook. My kids don’t irritate me the way they used to and it doesn’t interfere with my sex life the way Prozac did. Will a high SPF sunscreen be enough to protect me from burning?

A. We cannot guarantee that even a powerful sunscreen will protect you from the phototoxic effects of St. John’s wort. Hypericin, one of the ingredients in this herb, reacts to light and can damage nerves and skin. Even more alarming, hypericin may damage the lens and retina of the eye when exposed to ultraviolet and visible light.
Because sunglasses encourage the pupils to dilate, they could actually do more harm than good. More light could get to the retina where it might cause damage. In our opinion, people taking St. John’s wort should play it safe and stay out of the sun.

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  1. es

    I started taking St. Johns wort for depression over the winter. It’s now May. Two weeks ago, I spent the day at the beach and ended up with severe heat rash. I am 33 and grew up on the beach and never had this before in my life. The pain was so unbearable at times that I could not sleep for several days. It felt like a combination of itching from a poison ivy rash with the added sensation of constant pins and needles. Feeling water, cold air, or objects touch my skin burned. I stopped taking the St. Johns wort immediately because I had to and now I’m struggling with my depression again. If you get this type of nerve damage, the best thing you can do is keep the skin clean and cool. Heat rash is basically your sweat not being released so even though you may not feel warm, it’s better to keep your skin out in the open, especially at night. Covering up under the blankets made it worse for me. Sleeping with the window open, with a slight breeze coming in, helped. I’m curious now if I will have permanent nerve damage from this. It seems to have gone away now and I do not feel any damage to my eyes.

  2. Karen

    Look out for scratches and cuts, too. I used SJW one summer and it was late fall before the hyper-pigmentation faded out of a normal summer’s gardening scratches.
    OTOH, suddenly stopping SJW also has a cost–rebound emotional reaction.

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