What is polymorphic light eruption. How does sun exposure trigger this skin condition. What are the symptoms of sun allergy. Who is most at risk for developing polymorphic light eruption. How can you treat and prevent sun allergy symptoms.

Understanding Polymorphic Light Eruption: A Common Sun Allergy

Polymorphic light eruption (PMLE) is a prevalent skin condition triggered by exposure to sunlight or artificial ultraviolet (UV) light. This sun allergy affects approximately 10% to 15% of the UK population, making it a significant concern for many individuals. PMLE is characterized by an itchy or burning rash that appears on sun-exposed areas of the skin, typically within hours or up to 2-3 days after sun exposure.

Key Characteristics of Polymorphic Light Eruption

• Affects sun-exposed areas: head, neck, chest, and arms
• Rash lasts up to 2 weeks
• Heals without scarring
• Can be triggered by as little as 20 minutes of sun exposure
• May develop through thin clothing or near windows

Is PMLE a serious condition? While polymorphic light eruption can be uncomfortable and distressing, it is generally not a serious health threat. However, it can significantly impact quality of life, especially during spring and summer months when sun exposure is more frequent.

Recognizing the Symptoms of Sun Allergy

The symptoms of polymorphic light eruption can vary from person to person, which is why it’s called “polymorphic.” The rash can take several forms, making it sometimes challenging to diagnose.

Common Manifestations of PMLE Rash

• Small, raised pink or red spots (2-5mm in size)
• Blisters that evolve into larger, dry patches resembling eczema
• Less commonly, target or “bulls-eye” shaped patches

Can PMLE be mistaken for other skin conditions? Yes, polymorphic light eruption is often confused with heat rash (prickly heat). However, PMLE is specifically triggered by sunlight or UV exposure, while prickly heat results from warm weather or overheating. Additionally, the skin affected by PMLE may “harden” or desensitize over time, which doesn’t occur with prickly heat.

Who’s at Risk: Demographics of Sun Allergy

Polymorphic light eruption doesn’t discriminate entirely, but certain groups are more susceptible to developing this condition.

Risk Factors for Developing PMLE

• Gender: More common in women than men
• Skin type: Primarily affects individuals with fair skin, but can occur in those with brown and black skin
• Age: Typically onset between 20 and 40 years old, but can affect children
• Family history: About 1 in 5 people with PMLE have an affected relative

Does having a family member with PMLE mean you’ll develop it too? While there is a slightly increased risk if you have a relative with PMLE, it’s not directly inherited. The condition’s prevalence in families is more likely due to its overall commonness in the general population.

The Science Behind Sun Allergy: Understanding the Cause

The exact mechanism behind polymorphic light eruption is not fully understood, but researchers have identified key factors contributing to its development.

Proposed Mechanism of PMLE

UV light is believed to alter a substance in the skin, triggering an immune system response. This reaction leads to inflammation, resulting in the characteristic rash. It’s important to note that PMLE is not contagious and cannot be transmitted from person to person.

Why does the immune system react to sunlight in some people but not others? The precise reason for this selective reactivity remains unclear. It’s likely a combination of genetic predisposition and environmental factors that influence an individual’s susceptibility to PMLE.

Managing Sun Allergy: Treatment Options and Prevention Strategies

While there is no cure for polymorphic light eruption, several approaches can help manage symptoms and prevent flare-ups.

Protective Measures

• Sun avoidance, especially between 11 am and 3 pm
• Wearing protective clothing
• Gradual sun exposure in spring to build tolerance
• Use of high SPF sunscreens (SPF 50 or above with UVA rating of 4 or 5 stars)

Medical Treatments

• Topical corticosteroids for acute flare-ups
• Desensitization therapy (phototherapy)
• Oral medications in severe cases

How effective is desensitization therapy for PMLE? Desensitization, or UV treatment, can be highly effective for some individuals. This therapy involves gradually exposing the skin to increasing amounts of UV light under medical supervision, typically over 4-6 weeks in spring. While it can significantly improve tolerance, the effects are temporary and need to be repeated annually.

Living with Sun Allergy: Lifestyle Adaptations and Coping Strategies

For many people with polymorphic light eruption, the condition becomes a seasonal challenge, particularly prominent in spring and summer. Adapting your lifestyle and developing coping strategies can help manage the condition effectively.

Practical Tips for Daily Life

• Plan outdoor activities for early morning or late afternoon
• Invest in UV-protective clothing and accessories
• Apply sunscreen diligently and reapply every 2 hours
• Be cautious around reflective surfaces like water and snow
• Consider using self-tanning products for a sun-kissed look without UV exposure

How can you enjoy outdoor activities with PMLE? With proper precautions, individuals with polymorphic light eruption can still enjoy outdoor activities. Gradual exposure, appropriate sun protection, and timing activities wisely can help minimize the risk of flare-ups while allowing for enjoyment of the outdoors.

Advances in Sun Allergy Research: Future Prospects and Emerging Treatments

While current treatments for polymorphic light eruption focus on symptom management and prevention, ongoing research is exploring new avenues for more effective interventions.

Promising Areas of Research

• Identifying specific genetic markers associated with PMLE susceptibility
• Developing targeted immunomodulatory therapies
• Exploring the potential of antioxidants in preventing UV-induced skin damage
• Investigating novel sunscreen formulations with enhanced photoprotective properties

What potential breakthroughs are on the horizon for PMLE treatment? Researchers are particularly interested in understanding the precise immune mechanisms involved in PMLE. This knowledge could lead to the development of more targeted treatments that address the root cause of the condition rather than just managing symptoms. Additionally, advancements in photoprotective technology may provide more effective ways to prevent PMLE flare-ups in the future.

The Psychological Impact of Sun Allergy: Addressing Mental Health Concerns

Living with polymorphic light eruption can have significant psychological effects, particularly during times of the year when sun exposure is more frequent. The visible nature of the rash and the limitations it can impose on outdoor activities may lead to emotional distress and social anxiety.

Common Psychological Challenges

• Anxiety about sun exposure and potential flare-ups
• Depression related to lifestyle limitations
• Body image issues due to visible rashes
• Social isolation during peak sun seasons

How can individuals with PMLE maintain good mental health? Coping with the psychological impact of polymorphic light eruption often requires a multifaceted approach. This may include seeking support from mental health professionals, joining support groups for individuals with similar conditions, and practicing stress-reduction techniques. Additionally, educating friends and family about the condition can help create a supportive environment and reduce feelings of isolation.

Strategies for Emotional Well-being

• Practice mindfulness and relaxation techniques
• Engage in indoor hobbies and activities
• Connect with others who have similar experiences
• Focus on aspects of life unaffected by the condition
• Celebrate small victories in managing the condition

By addressing both the physical and emotional aspects of polymorphic light eruption, individuals can develop a comprehensive approach to managing the condition and maintaining a high quality of life.

Dispelling Myths: Common Misconceptions About Sun Allergy

Polymorphic light eruption is often surrounded by misconceptions that can lead to confusion and improper management of the condition. Addressing these myths is crucial for better understanding and treatment of PMLE.

Myth vs. Reality

• Myth: PMLE only affects fair-skinned individuals.
  Reality: While more common in fair skin, it can affect all skin types.
• Myth: Once you have PMLE, you can never enjoy the sun.
  Reality: With proper management, many people with PMLE can still enjoy outdoor activities.
• Myth: PMLE is the same as sunburn.
  Reality: PMLE is an immune reaction, distinct from the direct skin damage caused by sunburn.
• Myth: Using sunscreen completely prevents PMLE.
  Reality: Sunscreen helps but may not provide complete protection for all individuals.

Why is it important to dispel these myths about PMLE? Accurate information is crucial for proper diagnosis, treatment, and management of polymorphic light eruption. Misconceptions can lead to underdiagnosis, especially in individuals with darker skin tones, or to inappropriate treatment approaches. By understanding the true nature of PMLE, individuals can make informed decisions about their sun exposure and seek appropriate medical care when needed.

The Role of Education in PMLE Management

Educating patients, healthcare providers, and the general public about polymorphic light eruption is essential for improving outcomes and quality of life for those affected by the condition. This includes:

• Raising awareness about the diverse presentations of PMLE
• Providing clear guidelines for sun protection and gradual exposure
• Encouraging open communication between patients and healthcare providers
• Promoting research to enhance understanding and treatment of the condition

By fostering a better understanding of polymorphic light eruption, we can work towards more effective management strategies and support for individuals living with this challenging condition.

Polymorphic light eruption – NHS

Polymorphic light eruption is a fairly common skin rash triggered by exposure to sunlight or artificial ultraviolet (UV) light.

Symptoms of polymorphic light eruption

An itchy or burning rash appears within hours, or up to 2 to 3 days after exposure to sunlight.

It lasts for up to 2 weeks, healing without scarring.

The rash usually appears on the parts of the skin exposed to sunlight, typically the head, neck, chest and arms.

The face is not always affected.

The rash

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ISM/SCIENCE PHOTO LIBRARY https://www.sciencephoto.com/media/520428/view

The rash can take many different forms (polymorphic):

• you may get crops of 2mm to 5mm raised, pink or red spots, but redness may be harder to see on brown and black skin
• some people get blisters that turn into larger, dry patches – it looks a bit like eczema
• less commonly, the patches look like a target or “bulls-eye” (it looks a bit like erythema multiforme)

Polymorphic light eruption can be easily mistaken for heat rash (prickly heat).

Prickly heat is caused by warm weather or overheating, rather than sunlight or UV light.

The skin in prickly heat does not “harden” or desensitise, as it can do in polymorphic light eruption.

Polymorphic light eruption is thought to affect about 10% to 15% of the UK population.

Sunlight exposure

The rash may be a rare occurrence or may happen every time the skin is exposed to sunlight. It ranges from mild to severe.

Sometimes as little as 20 minutes of sun exposure is enough to cause the problem, and it can even develop through thin clothing or if you’re sitting near a window.

But for most people with polymorphic light eruption, the rash develops after several hours outside on a sunny day.

If further sun is avoided, the rash may settle and disappear without a trace within a couple of weeks.

It may or may not return when skin is re-exposed to sunlight.

If the skin is exposed to more sunlight before the rash has cleared up, it’ll probably get much worse and spread.

For many people with polymorphic skin eruption, the rash appears every spring and remains a problem throughout summer before settling down by autumn.

Who’s affected

Polymorphic light eruption is more common in women than men.

It particularly affects people who have white skin, although it can also affect those with brown and black skin.

It usually starts between the ages of 20 and 40, although it sometimes affects children.

Causes of polymorphic light eruption

Polymorphic light eruption is thought to be caused by UV light altering a substance in the skin, which the immune system reacts to, resulting in the skin becoming inflamed.

It’s not passed down through families, but about 1 in 5 people with the condition have an affected relative as it’s a fairly common condition.

It’s not infectious, so there’s no risk of catching polymorphic light eruption from another person.

Treatments for polymorphic light eruption

There’s no cure for polymorphic light eruption, but using sunscreens and careful avoidance of the sun will help you manage the rash.

Avoid the sun, particularly between 11am and 3pm when the sun’s rays are at their strongest, and wear protective clothing when outdoors (unless your doctor has advised you to try hardening your skin).

Introduce your skin to sunlight gradually in the spring.

Sunscreen

You may be prescribed sunscreens to help prevent the rash developing.

Use a sunscreen that is SPF 50 or above with a UVA rating of 4 or 5 stars. Apply sunscreen thickly and evenly around 15 to 30 minutes before going out into the sun

Reapply every 2 hours and straight after you’ve dried yourself off after swimming.

Steroid creams and ointments 

A GP can prescribe corticosteroid (steroid) cream or ointment that’s only applied when the rash appears.

You should apply it sparingly, as often as the GP advises. Do not apply it when there’s no rash.

Desensitisation or UV treatment

It’s sometimes possible to increase the resistance of your skin to the sun.

This involves visiting a hospital dermatology department 3 times a week for 4 to 6 weeks in the spring.

Your skin is gradually exposed to a little more UV light every visit to try to build up your skin’s resistance.

The effects of desensitisation are lost in the winter, so you’ll have to build up your resistance again in the spring.

Hardening or toughening

A GP or dermatologist may advise you to try increasing the resistance of your skin at home.

This is known as “hardening” and involves going outside for short periods in the spring to build up your resistance.

You might find the time is as short as a few minutes at first, but you may be able to gradually build up to longer times.

You’ll have to be careful not to overdo it but, as you begin to understand more about how much light triggers your rash, you’ll be able to judge how long to stay out.

Like desensitisation, the effects of hardening are lost in the winter, so you’ll have to build up your resistance again in the spring.

Vitamin D

People with polymorphic light eruption are at greater risk of vitamin D deficiency, as a certain amount of sun exposure is needed to make your own vitamin D.

A GP can advise whether you need treatment with vitamin D supplements.

Outlook

Many people with polymorphic light eruption find their skin improves over the years.

Your skin may harden (become more resistant to sunlight) during the summer, which means more sun can be tolerated without your skin reacting.

The rash may even eventually clear up on its own, although this is unusual.

Hardening of the skin does not always happen, and some people with very sensitive skin may even get the rash in the winter.

For these people, it may be a long-term condition to manage with lifestyle changes and creams.

Page last reviewed: 28 July 2021
Next review due: 28 July 2024

Heat rash, sun rash — what’s the difference?

Your skin sure does take the brunt of summer’s hot, humid and sunny weather.

Too much sun can cause a rash. Too much heat can cause a rash. But what’s the difference, how do you treat them and how do you avoid getting them?

Melinda Cooling, vice president of Advanced Practice Providers at OSF HealthCare and chief clinician executive for OSF Saint Gabriel Health, breaks it down for us.

Heat rash

Heat rash, also known as prickly heat, often occurs during hot, humid weather. This rash usually appears in areas where the skin folds or areas where clothes causes friction like armpits, elbow creases, or the groin area.

“This type of rash often is not related to sun exposure but rather when blocked pores trap sweat under the skin,” Melinda said. “A patient may have small blisters or a deep lump that can feel prickly or itchy.”

Other than the hot humid weather, heat rash can develop due to:

• A lot of physical activity
• Illness with fever
• Tight or warm clothing

• Bandages
• Medicine patches that stick to the skin

Treatment

“Most of the time, heat rash will resolve on its own by cooling the skin with cool compresses and avoiding exposure to the heat,” Melinda said.

Other treatment options may include:

• Using a gentle exfoliator in the bath or shower
• Corticosteroid cream or lotion to help reduce itching and inflammation

• Antibiotic cream or lotion if bacteria is part of the cause
• Drying powders

“If you would have increased pain, swelling, or redness around the affected area or a fever, it could be a sign of an infection and you should seek urgent care,” Melinda said.

Prevention

Sometimes in the summer, to prevent heat rash may require changing clothes more frequently and keeping the skin cool and dry.

Other ways to prevent heat rash:

• Wear lightweight, loose clothing
• Wear fabric that lets air get to the skin, such as cotton

• Remove bandages or patches

Sun rash

Sun rash starts in areas where the skin is exposed to sunlight.

“It usually presents as a red, itchy rash that groups together and it can feel like it is burning,” Melinda said. “Normally it shows within hours of the sun exposure. If the burn is severe, some patients may feel nauseated or feverish.”

Treatment

Most sun rashes will resolve on its own within 10-14 days, she said.

“Over-the-counter aloe vera or anti-itch ointments can be helpful. Cool compresses or a cool bath can provide itch relief,” Melinda said. “If you have blisters, keep them clean and dry to help to prevent infection.”

If you have increased pain, fever, swelling or redness, you may have an infection and should seek urgent care, she said.

Prevention

“The key to sun rash is prevention by using sunscreen with an SPF of at least 30 and to reapply the sunscreen every two hours or more often if you’re swimming or perspiring,” Melinda said. “Protect your skin with clothing and wear a wide-brimmed hat. Avoid the sun between 10 a.m. and 2 p.m. when the sun is most intense.”

Seek urgent care

 Whether you’re dealing with a heat rash or a sun rash and aren’t sure what to do, you can seek out urgent care at an OSF OnCall Urgent Care or OSF PromptCare clinic or go online and connect with a board-certified advanced practice provider at OSF OnCall.

Last Updated: May 22, 2023

View all posts by Lisa Coon

Tags: rash, skin care

Categories: General

Allergy to the sun – photodermatitis (photodermatosis) and its prevention – St. Petersburg State Budgetary Healthcare Institution Dermatovenerological Dispensary No. 11

The sun’s rays not only warm us with their warmth in the spring and summer and delight us in winter, but also help strengthen the immune system. But, unfortunately, in some people, exposure to the open sun can cause an allergic reaction.

Allergy to the sun, photodermatitis (photodermatosis) are diseases caused by increased sensitivity of the skin to sunlight. This is not at all a rare occurrence. Statistics show that about 20% of people around the world experience this disease.

Sun allergy is actually photodermatitis or photodermatosis. The toxic or allergic effect of the sun is manifested by the interaction of solar (ultraviolet) rays with any substance that is on the skin (exogenous photodermatitis) or in the skin (endogenous photodermatitis).

Sun allergy in the form of exogenous photodermatitis

The most striking example of exogenous photodermatitis is the so-called meadow dermatitis. In the summer, during the flowering period, many meadow plants secrete special substances – furocoumarins, which are deposited on the skin when a person is in these places. With simultaneous exposure to ultraviolet radiation, some people who are sensitive to it may experience skin redness and vesicles (erythema, vesicles, bullae). The rash is accompanied by intense itching. In the future, long-term pigmentation remains on the affected areas of the skin.

Sun allergy or photodermatitis can also occur if a person who is sensitive to the sun puts on a cream or ointment, or uses perfume and deodorant before going out into the sun. Substances that make up various cosmetics or perfumes can react with ultraviolet rays and cause an allergic reaction. Such properties are, for example, eosin, which can be found in lipstick, and para-aminobenzoic acid (surfactant), which is part of some sunscreens. In addition, polyunsaturated fatty acids, retinoids, bergamot oil, St.

Fair-skinned people and young children, whose skin defense mechanisms are much weaker, are more likely to be allergic to the sun.

Photodermatitis is often caused by many drugs. This effect is possessed, in particular, by sulfonamides, barbiturates, chlorpromazine, some antibiotics (doxycycline, tetracycline), antihistamines, some cardiovascular agents (amiodarone, trazikor), cytostatics, some non-steroidal anti-inflammatory drugs (ibuprofen, aspirin), oral contraceptives.

In addition, an increased reaction of the skin to the sun’s rays appears when the skin is “weakened” by some additional effect – peeling, tattooing using cadmium salts.

Allergy to the sun in the form of endogenous photodermatitis

This group of photodermatitis includes rather rare diseases, in the development of which disturbances in the functioning of the body’s immune system, as well as various metabolic disorders (metabolism disorders) play an important role. Endogenous photodermatitis includes, in particular, porphyria, xeroderma pigmentosa, sun eczema, sun pruritus, Hydroa vacciniformia, polymorphic photodermatosis.

Typically, these reactions can proceed through two mechanisms: 1) phototoxic reaction and 2) photoallergic reaction. Phototoxic reactions are much more common than photoallergic ones.

How does sun allergy or photodermatitis usually manifest itself?

Main symptoms of photodermatosis:

• redness and inflammation of the skin,
• skin peeling,
• often accompanied by intense itching and burning,
• rashes may be in the form of folliculitis (pustules) or papules.

Often this condition does not develop immediately. Unlike a burn, it can occur several hours after you leave the beach, and in some cases even after returning from the resort. A phototoxic reaction can occur several hours after sun exposure, while a photoallergic reaction can occur even days after sun exposure.

Increased risk of sun allergy:

• in people with naturally fair skin;
• in pregnant women;
• in young children;
• a number of drugs can make the skin burn faster – including tetracycline antibiotics, sulfanilamide drugs, painkillers, etc.;
• who has relatives with sun allergies. You are more likely to be allergic to the sun if you have a sibling or parent with a sun allergy;
• also having atopic dermatitis or another type of dermatitis increases the risk of developing a sun allergy;
• Some skin allergy symptoms are triggered when your skin is exposed to a certain substance and then sunlight. Some common substances responsible for this type of reaction include fragrances, disinfectants, bleach, and even some of the chemicals used in sunscreens;
• those who abuse solariums;
• In addition, an allergic reaction from exposure to the sun can also develop in those who have performed cosmetic procedures with the use of cadmium salts (tattooing, chemical peeling) the day before.

Photosensitizers cause sun allergy

Some vegetables and plants can cause sun sensitivity when they come into contact with the skin. Mango peel, lime juice, parsnips, celery can cause temporary discolouration (darkening) of the area of ​​skin exposed to the sun. The main phototoxic fruits and vegetables are celery, carrots, rice, parsley, parsnips, and all kinds of citrus fruits. Therefore, before going to the beach, you should not eat oranges, tangerines or grapefruits. Swelling, redness and itching may occur on the surface of the skin, where there are drops of juice from these fruits. And the more active the sun, the more acute will be the reaction of the body.

Prevention of sun allergy (photodermatitis and photodermatosis)

Unfortunately, there are not many methods for preventing such allergies.

If you have very sensitive skin, make it a habit to sunbathe under an awning or umbrella. Avoid exposure to the sun during its peak hours (from 11:00 to 16:00). Protect yourself with a headdress and loose clothing made from natural fabrics: linen, cotton. Children have a very weak protective skin reaction, so babies under three years of age are generally not recommended to be in direct sunlight.

Use high-protection sunscreens from well-known brands at regular intervals of at least every two hours. Please note that the cream contains protection against UVB rays (SPF) and UVA rays (PPD) – they affect the occurrence of photodermatosis.

It should be noted that the wavelength plays an important role. Try not to go to resorts where the sun is especially strong.

Recommendations for the prevention of photoallergy on the beach:

1. Before going to the beach, you should not use cologne, perfume and ordinary moisturizers. They contain alcohol, which in the sun can cause a burn.
2. Sunscreen in your case should be used as often as possible. Just pay attention to its composition. A fat-based product can provoke an allergy. It is better to choose a hypoallergenic spray with a protective SPF factor.
3. It is best not to use waterproof sunscreen as it clogs pores and can cause pustules on the skin. For a trip to the beach, you should opt for a water-soluble product.

If there is no way to see a doctor, how to relieve acute manifestations of an allergy to the sun?

None. Only a doctor will be able to understand: manifestations on the skin are phototoxic reactions, or this is a manifestation of another disease. Often, “folk” methods only exacerbate the course of toxic and allergic reactions.

Pimples on the skin of the face from the sun – what to do

Does your skin react strangely to ultraviolet light? Have you noticed that you get acne from the sun? Let’s figure out why this can happen and how to reconcile you with the sun’s rays!

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Causes

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Do not self-medicate! In our articles, we collect the latest scientific data and the opinions of authoritative health experts. But remember: only a doctor can diagnose and prescribe treatment.

This unpleasant phenomenon can be found as many as five quite logical explanations.

First and most incredible: you suffer from a natural intolerance to ultraviolet rays. Scientifically, this disease is called photodermatitis. It is said that it was it that gave people with a rich imagination the ground for creating legends about vampires. In fact, “allergy to the sun” is a rather rare skin pathology, it manifests itself in only 2% of people around the world and requires specialized outpatient treatment.

The second, much more possible: you spend too much time on the beach, the skin becomes too dry, and the sebaceous glands begin to behave unpredictably. Intense exposure to ultraviolet radiation leads to the fact that the pores become clogged with fat and dead cells. All this becomes inflamed over time and turns into red, inflamed pimples, often with purulent contents. What to do? Dose the time spent in the sun, sunbathe only during “safe” hours: before 10 am and after 4 pm. And in your case, it’s better not to abuse the solarium!

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The third reason is related to the wrong choice of sunscreen cosmetics. It is important that milk or spray with UV filters not only protect against burns, but also suit your skin. If they are chosen incorrectly, then acne after the sun will appear, like an allergy to cosmetics. Most often, such reactions are observed as a result of using products with essential oils of sandalwood, musk, amber, tea tree, rosemary. But sometimes even completely harmless, at first glance, components can cause an undesirable effect. Choosing the right composition is usually necessary through trial and error.

Fourth, excessive sweating. It may well be that the true cause of inflammation is actually not the sun, but a reaction to it.