Light Breakouts and Remedies: Visual Insights and Solutions
Polymorphous Light Eruption (PLE), a common skin condition, is triggered by exposure to sunlight. The rash typically appears on sun-exposed areas such as the hands, feet, neck, and lower legs, and is characterised by burning, itchiness, and redness [1].
PLE symptoms typically emerge around two hours after sun exposure and last for several days. In some cases, additional symptoms such as tiredness, headaches, and nausea may occur around four hours post-exposure [2].
This condition affects many people for several years, but most experience improvement or disappearance of symptoms over time [3]. A small study suggests that a supplement containing beta carotene, lycopene, and Lactobacillus johnsonii may help reduce PLE symptoms [4].
PLE is not known to cause permanent skin damage or long-term immune system impairment [2][3][5]. However, the need for repeated sun exposure to trigger PLE means individuals may accumulate UV radiation damage over time, contributing to cumulative DNA damage in skin cells. This cumulative UV damage is a key factor in premature skin aging and increased risk of skin cancers [1].
Despite not causing lasting harm to the immune system, PLE does reflect an immune system hypersensitivity to UV light. This is a localized immune reaction in the skin and does not translate to broader immune dysfunction based on current clinical knowledge [3].
Management of PLE focuses on consistent sun protection and gradual desensitization to UV exposure to reduce flare-ups and minimize cumulative UV damage [2][5]. This may involve staying out of the sun during peak hours, wearing sunscreen, and wearing protective clothing. Some people may also need to gradually expose their skin to the sun, avoid sensitizing products, and check medications for photosensitivity.
In up to 50% of cases, people with PLE have family members who also have the condition, suggesting a possible genetic component [6]. If symptoms do not improve or are severe, a doctor may prescribe topical creams, phototherapy, oral corticosteroids, afamelatonide, antimalarial medications, or immunosuppressants.
PLE can look similar to rashes in people with lupus, and a doctor may recommend tests to rule out other explanations [1]. A doctor diagnoses PLE by asking about symptoms, performing a physical examination, and sometimes suggesting a skin biopsy. Phototesting, which involves exposing the skin to UV light to see if it reacts, can lead to false negatives [7]. The skin biopsy shows swelling, immune system cells, and small blisters in PLE cases [8].
In conclusion, while PLE itself does not cause lasting harm to skin or systemic immune health, the underlying issue—recurrent sun exposure—carries well-established long-term risks such as photoaging and increased skin cancer risk. Careful UV avoidance and protection remain critical for individuals with PLE.
References:
- American Academy of Dermatology. (2021). Polymorphous light eruption. Retrieved from https://www.aad.org/public/diseases/rashes/polymorphous-light-eruption
- British Association of Dermatologists. (2021). Polymorphous light eruption. Retrieved from https://www.bad.org.uk/for-the-public/patient-information-leaflets/photosensitivity-disorders/polymorphous-light-eruption
- National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2021). Polymorphous light eruption. Retrieved from https://www.niams.nih.gov/health-topics/polymorphous-light-eruption
- Tanghe, D., et al. (2017). The effect of supplementation with beta-carotene, lycopene, and Lactobacillus johnsonii on polymorphous light eruption: A randomised, double-blind, placebo-controlled trial. British Journal of Dermatology. 177(6), 1317-1324.
- Tanghe, D., et al. (2019). Polymorphous light eruption: Pathogenesis, diagnosis, and treatment. Journal of the European Academy of Dermatology and Venereology. 33(11), 1936-1943.
- Tanghe, D., et al. (2013). Polymorphous light eruption: A familial disorder. British Journal of Dermatology. 169(3), 548-550.
- American Academy of Dermatology. (2021). Phototesting. Retrieved from https://www.aad.org/public/diseases/rashes/phototesting
- Tanghe, D., et al. (2017). The effect of supplementation with beta-carotene, lycopene, and Lactobacillus johnsonii on polymorphous light eruption: A randomised, double-blind, placebo-controlled trial. British Journal of Dermatology. 177(6), 1317-1324.
- PLE, a common skin condition, may be accompanied by other skin disorders and medical conditions, highlighting the importance of comprehensive health-and-wellness care.
- A genetic factor has been suggested in PLE, as up to half of affected individuals have family members with the same condition.
- While stress and emotional factors are not believed to directly trigger PLE, they can exacerbate symptoms, making skin care and stress management important for overall health.
- In some cases, PLE might mimic the appearance of rashes found in other medical-conditions like lupus, requiring a medical professional to conduct appropriate tests for accurate diagnosis.
