Symptoms and Treatment of Solar Urticaria - Dermatology

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Solar urticaria, also known as sun-induced urticaria, is a rare type of physical urticaria that occurs in response to exposure to sunlight. The symptoms you describe—red hives or welts appearing on your chest, back, neck, and face after sun exposure or heat—are indeed characteristic of solar urticaria. This condition is triggered by ultraviolet (UV) light, and it can manifest within minutes of exposure, leading to discomfort and distress.


Symptoms
The primary symptoms of solar urticaria include:
- Red, itchy hives: These can appear anywhere on the body that has been exposed to sunlight.

- Swelling: The affected areas may swell, leading to a raised appearance.

- Burning or stinging sensation: Many individuals report discomfort in addition to itching.

- Timing: Symptoms typically develop quickly, often within minutes of sun exposure, and can last for several hours.


Diagnosis
To diagnose solar urticaria, a dermatologist will typically conduct a thorough medical history and physical examination. They may perform a phototest, where the skin is exposed to UV light in a controlled setting to observe if hives develop. This helps confirm the diagnosis and rule out other conditions that may cause similar symptoms.


Treatment
Treatment options for solar urticaria primarily focus on prevention and symptom relief:
1. Avoidance of Sun Exposure: The most effective way to manage solar urticaria is to avoid direct sunlight, especially during peak hours. Wearing protective clothing and using broad-spectrum sunscreen can help minimize exposure.


2. Antihistamines: Over-the-counter or prescription antihistamines can help reduce itching and hives. Non-sedating antihistamines like cetirizine or loratadine are often recommended.

3. Phototherapy: In some cases, controlled exposure to UV light under medical supervision can help desensitize the skin over time.

4. Topical Treatments: Corticosteroid creams may be prescribed to reduce inflammation and itching in localized areas.

5. Emergency Medication: For severe reactions, your doctor may prescribe an epinephrine auto-injector (EpiPen) in case of anaphylaxis, although this is rare with solar urticaria.


Prognosis
The prognosis for solar urticaria varies among individuals. Some may experience a decrease in symptoms over time, while others may have persistent reactions. Regular follow-up with a dermatologist is essential for managing the condition effectively.


When to See a Doctor
If you suspect you have solar urticaria, it is advisable to consult a dermatologist. They can provide a definitive diagnosis and tailor a treatment plan to your specific needs. If you experience severe symptoms, such as difficulty breathing or swelling of the face and throat, seek emergency medical attention immediately.

In summary, solar urticaria is a manageable condition with proper precautions and treatment. A dermatologist is well-equipped to help you navigate this condition, ensuring you can enjoy outdoor activities while minimizing discomfort.