Not only can the sun give me cancer, but it can also make me itchy.

February 27, 2012 6:31 AM

Do you have Polymorphic Light Eruption (PMLE), where your skin breaks into an itchy rash at least once a year when you're out in the sun? How do you deal with it?

I've always been fair-skinned and have a family history of skin cancer (sometimes fatal). I take precautions: SPF 40 in the winter, SPF 60 in the summer, long sleeves in the bright sun, big hats, no tanning, and so forth.

I thought I was pretty well-prepared for our honeymoon in Thailand, and was extra careful to slather on the sunscreen every 1-2 hours. I stayed out of the light when possible, but hell, it's Thailand and I'm not going to be a vampire. However, 12 days into our trip, my husband and I went on an afternoon bike tour in Chiang Mai, and hours later I had developed the itchiest, angriest rash on all parts of my skin that had been exposed to the sun.

Research and my dermatologist confirm that I indeed have PMLE, which sounds annoying but less worrisome than my skin cancer risks. It's been over a week and the rash is fading, but still itchy and unattractive. It's been quite a hassle, which is why I'm surprised to discover that an estimated 10% of the population has PMLE! If it's so irritating and occurs annually, how have I never heard of it? I'm also unhappy to learn that this could happen every time I'm out in bright sun from now on, or at least once a year when it starts getting sunny.

My question is this: is it possible that the intense Southeast Asian sunlight triggered an extreme reaction, and now that I'm back in a temperate NYC climate I'm at less of a risk? Or is it that the equatorial sun flipped a switch in my system and now I'll get it each and every summer? Has anyone had a PMLE reaction once and never again? And lastly, if you do have this stupid condition, how do you handle prevention and treatment. None of my methods (cortisone cream, lotion, cold baths, benadryl) did much good, and I had to wait it out while waking up every morning with the sheets streaked in blood because I scratched so vigorously in my sleep. Any advice is welcome.

posted by Viola to Health & Fitness (7 answers total)

I get PMLE on the backs of my hands, and it itches like crazy. The last time I think got it really bad was on a hiking trip in New Zealand--there were several times I would come to a stream and bathe my hands in the cold water for ten minutes to get some relief.

For me, lots of calamine lotion and cortisone cream dealt with the outbreaks as best as could be expected. I have some Mediterranean in me, and I generally tan nicely (and don't use much sun block), but I use a really high SPF on my paws. I have also used zinc creams and cloth barriers to the light (i.e., bandage or gloves). I'd be especially careful about biking--that seems like the very best way to get a painful sunburn on your hands, even if you don't have PMLE.

I don't think it ever really goes away, but if you take precautions and/or don't go out in the fierce sun, you may not have many outbreaks. I live in Boston now, and I don't think I've had an outbreak in four years (or more).
posted by Admiral Haddock at 6:55 AM on February 27, 2012

I have this too, and the first time I got it was from pretty significant sun exposure probably 10 or so years ago. I seem to be getting a little more sensitive and will have outbreaks from less significant exposure every year. Usually though, it isn't that big of a deal...the first time was pretty bad (like what you are describing) but since then I usually just end up with mild rashes on my feet and maybe hands, but no where else.

If you can tolerate it and not fall asleep, taking benadryl early on when you first notice a few spots usually slows things down, at least for me. The main thing that I try to avoid is numerous consecutive days of sun exposure after I already have the rash, that makes it way worse.

I remember after the first time I got the rash thinking that this was going to be a much more annoying lifelong issue than it has actually turned out to be...the first rash was absolutely the worst one. Hopefully your experience will be similar.
posted by mjcon at 7:23 AM on February 27, 2012

Gosh I thought this was just me and my stupid deal. Every spring as the mid-Atlantic days lengthen and I start going walkabout in the sun after hibernating, I break out in an itchy rash on my neck and chest. This started in my early 50's - after a lifetime of long sunny summers and sunburns on the Jersey Shore. I get through it each year with antihistimes and calamine as per others above. So odd...PMLE.
posted by henry scobie at 8:17 AM on February 27, 2012

I have something much like this, maybe the same, for which I use Gold Bond, which doesn't necessarily speed healing, but gets rid of the itch. The rash doesn't get any worse, year over year, but I go get it more easily.
posted by jeather at 8:50 AM on February 27, 2012 [1 favorite]

My mother has this and t's not a one-time thing. She deals with this by covering up with clothing as much as possible, wearing hats or parasols when out in the sun, and plenty of physical sunblock. What usually happens is that some time during the year she gets lax about the precautions, gets a rash, and goes back to her routine precautions. The rash goes away within a week for my mom, and they're not as severe as you described. Sometimes if the itching gets too much she'll go to the doctor and get some kind of cortisone cream.

(One side effect of all this sun protection is that she has beautiful skin for her age!)
posted by needled at 9:01 AM on February 27, 2012

Yeah, I have that.

Here's how I deal with it: long sleeves and hats. Fabric is the best sunscreen there is.

Otherwise you want to use sunscreen that blocks both UVA and UVB. Normal sunscreen doesn't block UVA. The magic ingredient is avobenzone or zinc oxide.
posted by plinth at 10:00 AM on February 27, 2012

I am so relieved to know that this is A Thing dermatologists know about; I thought it was just me. I've been using Benadryl cream but I am going to take everyone's advice about sunscreen vigilance from now on.

I've also been carrying parasols in the summer, but that requires a certain level of "fuck what people think" that not everyone might have. (Actually, I get about 100 compliments for every 1 "wtf" because I found really cute parasols.)
posted by Sidhedevil at 3:29 PM on February 27, 2012