What might help to protect you from developing polymorphic light eruption?
Prevention is definitely better than cure. If you have had polymorphic light eruption (PMLE) in the past, you are quite likely to get it again the following year when you start to go out in the sun.
- Sunscreen is helpful to prevent the rash.
- Make sure you use one with a good sun protection factor (SPF) and also protection against UVA and UVB (star system).
- Apply sunscreen frequently during the day, especially after swimming, towelling or sweating.
- Remember that sunscreen doesn't offer 100% protection.
- It is also important to stay out of the sun, especially in the middle of the day, between 11 am and 3 pm.
- Put on a wide-brimmed hat and wear clothes with long sleeves.
What might help to ease symptoms of polymorphic light eruption?
If you do develop polymorphic light eruption (PMLE), there are several things you can try to ease the symptoms:
- A mild steroid cream like hydrocortisone can help the redness to settle down.
- Antihistamine tablets can help to reduce the itching as well.
- If the rash is very severe then a doctor may prescribe a short course of corticosteroid tablets (often just called steroids) such as prednisolone which will help the inflammation to settle.
If you get the rash, you should stay out of the sun as much as possible and the rash should settle within a week. If you go out in the sun while the rash is still there, it is likely to get worse. It may come back if you go out in the sun again but tends to get less severe as the summer progresses and your skin becomes adapted to being out in the sun.
What other treatments are there for polymorphic light eruption?
For severe or troublesome polymorphic light eruption (PMLE)
If the above treatments are not sufficient, other options are:
- Light therapy (phototherapy). This is treatment with UV light, in gradually increasing doses. It helps the skin to become more resistant to PMLE when you go into natural sunshine. Effectively it desensitises you to the sun by preparing your skin for sun exposure. This treatment is sometimes called photo-hardening which means increasing the skin's resistance to light - not actually making the skin hard. The treatment is usually given in a hospital outpatient department. It is normally given in the spring but its effects wear off, so it has to be repeated every year.
- Hydroxychloroquine. This is a tablet normally used against malaria. It helps to reduce PMLE symptoms but can have side-effects in some people.
Various other treatments have been tried, and might have a role in helping PMLE, although they are not standard treatment at present. These are:
- Special sunscreens with high UVA protection.
- Cream containing sunscreen plus antioxidants (alpha-glucosylrutin and vitamin E).
- Tablets containing carotenoids such as beta-carotene.
- Vitamin supplements (vitamin E or nicotinamide).
- Cream containing a form of vitamin D
A note about vitamin D
If your PMLE makes you avoid sunlight to a large extent, you may be at risk of vitamin D deficiency. This is because most of the body's vitamin D is made by the action of sunlight on skin, and it needs outdoor sunlight, without sunscreen, to make vitamin D. You may need to take vitamin D supplements if you have very little sunlight exposure over a long period. You can discuss this with your doctor. See separate leaflet called Vitamin D Deficiency including Osteomalacia and Rickets for more details.
Further reading and references
Polymorphic Light Eruption; DermNet NZ
Fesq H, Ring J, Abeck D; Management of polymorphous light eruption : clinical course, pathogenesis, diagnosis and intervention. Am J Clin Dermatol. 20034(6):399-406.
Percy Lehmann P and Schwarz T; Photodermatoses: Diagnosis and Treatment, Dtsch Arztebl Int. 2011 March 108(9): 135–141
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