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Yes, There Really Are Vampires...May 23 '04 (Updated Aug 16 '07) Write an essay on this topic.
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The Bottom Line People can be allergic to just about anything -- sunlight, water, metal, plastic...
My childhood memories of playing outside might be different than most people's. Oh sure, I did all the things a normal kid would do, just a bit differently. I loved to swim -- only whenever I swam I had to wear a long-sleeved shirt over my swimsuit. I never went outside without a large, floppy hat that provided lots of shade. I wore long sleeved shirts even in the heat of summer. I had to put on sunblock even if I was only going outside to check the mail. Why, you might ask? Because as I child I was allergic to sunlight. Polymorphic Light Eruption The technical term for a sun allergy is Polymorphic Light Eruption, or PMLE for short. People who have PMLE are photosensitive and get a rash wherever skin is exposed to sunlight. It most commonly affects adult women in their 20's and early 30's, however it can also affect children and adult males. It is also more common in fair-skinned people (I am a very pale-skinned blue-eyed blonde). It is a surprisingly common affliction that is frequently misdiagnosed. For most people who have PMLE, it only affects them during the first sun exposure after a long time of no exposure (so people who live in seasonal areas who bundle up for the winter will get a reaction when first exposed to the sun again in the spring or summer). In others, like when I was a child, the welts appear any time the skin is exposed to the sun. The milder forms are often mis-diagnosed because people think they just have a case of poison ivy, or that their skin has reacted to something in their suntan lotion. It is estimated that as much as 10% of the US population may have PMLE, however many of those people are unaware of exactly why they are breaking out. The skin's reaction to sunlight exposure most commonly consists of pink or red raised spots that are quite itchy. Although people can get the red welts anywhere, usually the arms but also the chest and legs, the skin on the face typically does not break out. The rash appears anywhere from a few hours to a few days after the sun-exposure. The spots slowly fade after you stay out of the sun for a few days (further sun exposure makes the rash worse). In more severe cases the skin can form blisters or large patches of dry, red skin. Other additional symptoms can include chills, headache, nausea, or a generally "sick" feeling. Although no one is sure exactly what causes the bad reaction, it is believed to be caused by an immune reaction to a compound in the skin that gets altered by exposure to ultraviolet (UV) radiation. Basically, the immune system starts to see the sun-altered skin as "foreign" and attacks it. Both the short-wave UVB and the long-wave UVA cause the reaction. Most over-the-counter sunblocks only block the UVB, so you can be affected even if you wear a sunscreen. UVA can also pass through glass, so you can be affected even if you stay indoors! Although PMLE can be quite debilitating and can affect your quality of life, it is usually not life-threatening (unlike those with peanut, bee-sting, or other allergies that can send you into anaphylactic shock). How to avoid the bumps: Sunblocks are an important preventative (but are not 100% affective). You need to wear sunblocks with an SPF (Sun Protection Factor) of at least 30. You should also make sure that it blocks both UVA and UVB rays. The products that stop both types of rays are usually termed "broad spectrum" sunblocks or sunscreens, and they include ingredients such as avobenzone, titanium dioxide, or zinc oxide. UVB rays are what usually cause sunburn and are considered the cause of most skin cancers. UVA rays penetrate the skin more deeply than UVB, and are considered to be the culprit behind "aging" and wrinkles. Recent studies have also linked UVA rays with skin cancers. BOTH types of rays can induce the allergic reaction in people with PMLE. Try to apply the sunblock 30 minutes before you go outside, and don't forget to re-apply it every few hours. Photosensitive people are also advised to wear hats with wide brims and to cover all exposed skin with clothing. It is also wise to just stay inside when the sun is at its peak, typically anywhere from 10am to 3pm. Many (but not all) people affected experience a "hardening" effect, meaning that you can slowly condition your skin to accept more and more direct sunlight. You expose the skin and let it react, wait for the blotches to go away, then expose it again. Over time more and more sun can be tolerated before the rash appears. For very severe cases: * Oral steroids can be used for a short time, such as if you are going on a vacation to a sunny location. * Some prescription medications can be used to lessen symptoms (such as Hydroxychloroquine, which is actually a malaria medication that has been found to help some skin disorders). Beta-Carotene tablets have also proved effective in lessening the photosensitive reaction. * You can undergo "phototherapy" treatment, which exposes the skin to the long-wave UVA radiation. The therapy forces your skin to "harden" by exposing it to increasing doses of ultraviolet light in the doctor's office. Typically you would get many treatments over a 3-to-6 week period, which should provide protection for the remainder of the summer. The treatment will "wear off" over the winter and need to be done again the next year. If you get an occasional rash and are unsure of whether or not it is caused by the sun, your doctor can give you a "phototest". Usually, small areas of normally-unexposed skin (such as the small of your back or your buttocks) are exposed to different does of UVA and UVB light. The exposed areas are examined 24 hours later to determine whether or not there was a change in any of the tested skin-patches. Normally this type of test isn't needed for a PMLE diagnosis. More about my allergy: Needless to say, being allergic to sunlight does affect one's childhood a bit. I suppose I was lucky -- the pediatrician realized what was wrong with me very quickly (I tended to break out only an hour or two after being exposed to the sun, and I didn't need to be exposed for very long, so it was easy to determine what was causing my rashes) and I was given a prescription sunblock. In later years, as the public became more aware of how damaging the sun is to the skin, the available over-the-counter sunblocks were just as effective and I no longer needed the prescription stuff. My rash was usually on my arms and legs. I would get large red welts that itched quite badly. Fortunately, they would go away after a couple of days (as long as I stayed out of the sun). Although I used sunblock religiously, it did not always protect my skin (either I didn't put on enough, it was absorbed faster than I was able to re-apply it, it washed off as I swam in the pool, or sometimes it just wasn't enough of a barrier). I could always count on a few decent breakouts a year regardless of how hard we tried to prevent it. I did tend to avoid going outside. Going outside meant slathering my skin with a bunch of sticky, often smelly junk that left me feeling wet and grimy. Going outside often meant getting hot because I was wearing more clothes than your average kid. Going swimming at a public pool meant being looked at strangely because I was wearing a long-sleeved shirt over my swimsuit (eventually a relative installed a pool in their back yard, so I started going there instead). I did go outside and I did play and have fun, however I probably did it less often than I might have liked because there was so much extra work involved in getting ready to go out. Many allergies affect a person throughout their entire life, but some childhood allergies lessen with puberty. I am very happy to state that my sun allergy was one of those that lessened. These days I do still break out, but only on that first sun-exposure after the winter months, and the welts aren't as bad as what I had as a child (although that might be because the sunblocks are better). I suppose that I still have PMLE, but now I experience the "hardening" effect that I never seemed to have when I was a child. I still wear sunblock with the highest SPF I can find any time I'm outside, and I cannot tan. Although it is definitely a "weird" allergy to have, in some ways it has probably helped me today. Scientists now realize that sun exposure, no matter how young or old you are, is bad for your skin. The sunburn that you got when you were eight is going to cause of some the wrinkles you'll have when you are 58. Because I have been guarded against sun exposure since I was a young child, I am now wrinkle-free in my mid-30's. I may be white as a ghost, but at least I don't have crow's feet or laugh-lines. My husband and I were recently "carded" when we tried to get into a rated "R" movie... that cracked me up. Other strange allergies: I'm frequently surprised by the strange things that people can be allergic to. The strangest one I've seen lately is a girl in England who is allergic to water -- she cannot drink it or bathe in it, and her skin reacts to her own tears, blood, saliva, and sweat. I feel very lucky by comparison. My family appears to be prone to strange skin-related allergies. My mother recently developed an allergy to plastic. Her skin reacted when she got a cut and put a band-aid on it -- welling up wherever the band-aid touched her. Her most notable allergic reaction is the one she got when she sat on a plastic toilet seat -- very unpleasant. Even my 2 year old son is afflicted with an odd allergy -- he is allergic to nickel. We first noticed it whenever he wore baby clothes that had snaps -- we started seeing ring-shaped welts that matched up with where the snaps touched his skin. People with severe nickel allergies can get rashes when they handle money, wear jewelry, or wear clothes with metal zips or snaps (such as on jeans). To get around this on his baby clothes, we would coat the backs of the snaps with a coat of clear, formaldehyde-free nail polish (formaldehyde is another substance that one can become allergic to, and it is a common nail-polish ingredient, so it is important to get a formaldehyde-free brand). Final Thoughts: Allergic reactions can strike anyone at any time and at any age. On top of all that, apparently you can be allergic to just about anything! If you or someone your love develops a rash, don't be tempted to exclude common, everyday items from your list of likely causes. Related Sites: General information on PMLE and other photosensitive disorders: http://www.intelihealth.com/IH/ihtIH/WSIHW000/9339/25934.html A more doctor/medical-staff oriented piece on PMLE: http://www.emedicine.com/derm/topic342.htm ------ This Epinion is an entry in krissingene's Truth is Stranger Than Fiction write-off. Please visit here to see her entry, as well as links to the other participants.  |
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