Acne aestivalis is a special form of light dermatosis. It is also known as summer acne or Mallorca acne.
What is acne aestivalis?
Acne aestivalis represents a special form of polymorphic dermatosis (sun allergy). Acne aestivalis represents a special form of polymorphic dermatosis (sun allergy). It is also known as Mallorca acne or summer acne. This refers to a disease of the skin sebaceous follicles. In this genetically predisposed acneiform condition, pustules and nodules form on skin areas exposed to sunlight. The name acne aestivalis is due to the Danish dermatologist Nils Hjorth, who first described the clinical picture in 1972. Particularly affected by Mallorca acne, which has nothing to do with either acne or the island of Mallorca, are vacationers who expose themselves to UV radiation again after a long period of absence from the sun. This initially occurred mainly on Mallorca when it gained importance as a vacation destination for German tourists, giving rise to the term “Mallorca acne”. In principle, however, acne aestivalis can occur in any sunny place in the world. The skin problem is particularly common in younger women.
Causes
Acne aestivalis is a particular form of sun allergy that is called polymorphic dermatosis by medical professionals. It is seen in people who have a predisposition to blemished or oily skin or acne. Acne aestivalis is caused by an excess of skin moisture, which leads to clogging of the pores. Dermatologists suspect that cosmetics containing emulsifiers and fats play a special role. For example, these substances are also found in products used for protection from the sun. If the affected persons stay in the sun for a longer period of time, for example by sunbathing, using sunscreen products or cosmetics rich in fats, this leads to the development of acne aestivalis. So-called free radicals are formed by the UV rays. These substances form compounds with other substances. If they meet cosmetic ingredients such as fatty acids on the skin, substances are formed that damage the tissue. If the affected person is predisposed accordingly, inflammation occurs at the hair follicles, which becomes noticeable through complaints that are typical of acne aestivalis. Sometimes the harmful substances are also formed from the body’s own sebaceous oils due to a reaction with solar radiation. People who already have acne or a tendency to acne are considered to be particularly at risk. Thus, they often show a worsened skin condition and develop Mallorca acne.
Symptoms, complaints and signs
Acne aestivalis is characterized by typical complaints that occur after intense exposure to the sun. These are the appearance of small papules and pustules the size of a pinhead, nodules with a reddened yard, and severe itching. Particularly affected areas of the skin are the outside of the upper arms and the décolleté. The face and chest are also frequently affected. In contrast, acne aestivalis rarely occurs in the abdominal region and on the lower legs. In contrast to classic acne, Mallorca acne does not show any blackheads.
Diagnosis and course
Acne aestivalis can usually be diagnosed by an experienced dermatologist based on the characteristic symptoms alone. When summarizing the medical history, the physician asks the patient about his or her stays in the sun as well as the use of cosmetic products containing fatty components. To confirm the diagnosis, there is an option to irradiate a certain skin area with UV-A light. This procedure is called photoprovocation in medicine and triggers the typical skin reactions of Mallorca acne. In addition, blackheads are absent in acne aestivalis, which is another indication of the skin condition. The course of acne aestivalis is usually harmless. If the patient consistently avoids the sun, the troublesome symptoms disappear by themselves after a few days. In addition, the affected person can improve the skin problem himself by getting used to the sun and increasing skin tanning.
Complications
Acne aestivalis, also known as Majorca acne, spring acne, or summer acne, usually heals after a few days in healthy adults. Scarring or other complications are extremely rare. However, the disease most often affects adolescents and young adults with oily, oily skin and with a tendency to acne vulgaris. The reason for this is the fact that acne aestivalis does not only result from a combination of UV radiation and oily sunscreens. In addition, a reaction between UV radiation and the body’s own sebum in the uppermost layers of the skin is also possible. If severely itchy summer acne is added to acne vulgaris, a number of complications may result. Acne aestivalis itself causes the formation of usually very itchy pustules and nodules on skin areas that are exposed to the sun. The intense itching causes patients to scratch the affected skin areas. Constant contact with microbially contaminated fingers can cause an already existing acne vulgaris to worsen. This is especially true if purulent acne pustules are scratched open and the contaminated contents come into contact with other skin areas. If superinfections form in this way, they usually have to be treated with antibiotics. Scratching open the pustules can also cause them not to heal without leaving a trace, but to form scars.
When should you go to the doctor?
In many cases, acne aestivalis does not require direct medical treatment. The symptoms usually disappear again when the affected person shortens or completely stops exposure to light, and there are no further complications. Usually the use of sunscreen also helps to directly prevent and avoid the symptoms of acne aestivalis. An examination and treatment by the doctor should be performed if the symptoms do not disappear on their own or persist for a very long period of time. In this case, most patients also suffer from severe itching or pustules and papules. If these symptoms occur, a doctor should be consulted. The treatment itself is relatively simple with the help of creams and ointments and quickly leads to a positive course of the disease. However, the affected person should take care of his skin and not expose it to long and strong sunlight. This can prevent burns and further skin diseases. The treatment of acne aestivalis takes place at a dermatologist.
Treatment and therapy
Medical treatment is not always necessarily required for acne aestivalis. In mild cases, avoiding the sun for several days is considered the best option against the skin symptoms. It is also important not to apply greasy sunscreens, creams and after-sun lotions to the skin, preferring to use products that are free of grease. If the patient suffers from itching, compresses for cooling are recommended. If severe discomfort is present, there is a possibility that the doctor will prescribe a cortisone cream or an antihistamine. However, antihistamines are considered useful only if there is an allergic reaction of the organism to substances that appear when sunlight is present. In particularly pronounced cases, the implementation of a special light therapy promises relief. Artificial light irradiation can also be used to achieve stronger pigmentation. For the treatment of clogged hair follicles and sebaceous glands, the drugs isotretinoin and tretinone can be used. These have an opening effect and relieve skin inflammation.
Outlook and prognosis
Acne aestivalis causes discomfort mainly when the affected person is exposed to direct sunlight. In this case, there is severe redness of the skin and the appearance of papules. These can lead to feelings of shame and inferiority complexes, so that the patient withdraws. The quality of life is usually reduced by the subjective sensation of acne aestivalis. Not infrequently, the skin complaints are also associated with severe and unpleasant itching, which can also lead to sleep problems. In severe cases, scars and sores can also form. Due to contamination or poor hygiene, infections and inflammations can also form on the skin, which later have to be treated with the help of antibiotics.In order to avoid the symptoms of acne aestivalis, the affected person must avoid direct sunlight and is restricted in his or her life. Acute attacks are treated with the help of creams and antihistamines. Furthermore, light therapy can also lead to an improvement of the disease. There is usually no change in life expectancy due to acne aestivalis.
Prevention
The best way to prevent acne aestivalis is to consistently avoid prolonged sun exposure. If the sun is not to be avoided, it is recommended to get used to it slowly and to start with short sunbaths lasting no longer than five to ten minutes and taking place in the early morning or late afternoon.
Aftercare
In acne aestivalis, no aftercare is usually necessary or possible. In this case, the affected person is dependent on purely symptomatic treatment to alleviate the symptoms of this condition. In most cases, self-healing does not occur. Patients are usually dependent on taking medication or using creams to alleviate the symptoms of acne aestivalis. When taking the medication, care should be taken to ensure that it is taken regularly. Possible interactions with other medications should also be taken into account to avoid complications. When applying the creams, the skin should be washed beforehand. Likewise, the use of greasy creams should be avoided as far as possible in order to protect the skin. If acne aestivalis is caused by an allergic reaction, the triggering substance must be avoided. In some cases, light therapy can also be used to relieve the symptoms. Since acne aestivalis is often associated with psychological complaints or depressive moods, contact with other sufferers can also be helpful. Likewise, conversations with friends or with one’s own family help to alleviate psychological discomfort.
What you can do yourself
Those who suffer from acne aestivalis usually have to deal with unpleasant consequences in the form of a skin rash on the neck, upper arms and décolleté area after intensive sunbathing. If the rash is inflamed or becomes purulent, a doctor should be consulted. Milder forms can be treated with a few simple measures. To prevent acne aestivalis, hydro-gel based or aqueous sunscreens should always be used – sunscreen products containing fat and emulsifiers should be avoided. By taking beta-carotene, the skin’s natural sun protection can be strengthened and thus acne aestivalis can be prevented. Beta-carotene capsules should be taken a few weeks before the vacation. If acne aestivalis does occur despite good precautionary measures, it should be treated with calcium tablets, for example in the form of effervescent tablets, and anti-allergic agents. The most reliable protection against acne aestivalis is, of course, avoiding UVA radiation by not exposing oneself to the sun in the first place or by protecting the skin from sunlight with clothing. Another effective precautionary measure against acne aestivalis is to take echinacea drops a few days before traveling. Many sufferers take this preparation in combination with calcium preparations as protection against acne aestivalis.
