Community sunbed use and photosensitivity reactions: a systematic review

Sunbeds emitting ultraviolet radiation (UVR) are an established carcinogen, but little attention has been given to the adverse photosensitivity reactions the UVR exposure can cause. We addressed this information gap through systematic review of the literature on photosensitivity reactions reported following community sunbed use. A systematic search of Medline (via PubMed), CINAHL and Embase identified studies published in English (inception to May 2025). The protocol was registered in Prospero (CRD420251048551). We included all study designs. Quality was assessed using JBI Critical Appraisal Checklists (Case-Reports, Case-Series) and Downes Appraisal (Cross-Sectional Studies), and narrative synthesis performed. Of 413 articles screened, 34 met inclusion criteria (26 case-reports, 6 case-series, 2 cross-sectional studies; 28 high quality for their study design). There were 67 photosensitivity reactions, including 33 cases of photodermatoses (29 pseudoporphyria; 4 solar urticaria, 3 as first presentations), and 3 cases of photoaggravated disorders (one first presentation and two exacerbations of known SLE). There were 31 photosensitivity reactions induced by exogenous substances including 11 to systemic drugs (10 skin, one retinal). Phototoxic reactions occurred to celery, parsnip and lime juice (14 via contact, one ingested), and 5 photocontact reactions to other topical agents including a well-being product. Severe systemic reactions occurred, and 6 cases hospitalised. Findings reveal wide-ranging and severe photosensitivity reactions and indicate attention should be given to providing effective information about the risks and triggers of photosensitivity reactions from sunbeds. This includes to sunbed-outlet staff, sunbed-users, patients with disorders that can be UVR-triggered or aggravated, and people taking potentially photosensitising medication.