Toasted Skin Syndrome – Causes, Symptoms, & Prevention Tips

What Is Toasted Skin Syndrome?

Toasted skin syndrome or Erythema ab igne (EAI) is a medical condition characterized by skin irritation, erythema (patchy redness), and hyperpigmented rashes on the skin due to frequent and chronic exposure to heat, mainly infrared radiation (1).

Toasted skin syndrome occurs after chronic exposure to a low-heat source (around 109.4 to 116.6 °F) over a long period. This heat is below the heat levels that may cause a burn (2).

This syndrome was earlier associated with the elderly who spent a lot of their time sitting or standing too close to an electric space heater in cold countries. However, this condition is now also observed in people of all age groups. Apart from severely discolored net-like patches (due to hyperpigmentation), people with toasted skin syndrome may also experience itching, peeling, and burning sensations in the affected area.

Erythema ab igne may cause net-like patterns on the skin. However, it depends on the type of radiation and the skin contour. These rashes usually begin as a mild and localized lesions and often go unnoticed. On prolonged and repetitive exposure to the heat source, the lesion gains a more reticulate pattern and darkens due to increased pigmentation.

Did You Know?

The toasted skin syndrome is also called fire stains, granny’s tartan, hot water bottle rash, and laptop thigh.

According to the study published in StatPearls, the number of cases of Toasted Skin Syndrome was higher in women than in men with a ratio of 10: 1. It was further estimated that this condition was primarily found in people between 18-39 years old, with coal fires, laptop heat, and stove exposure stated as common causes of this condition.

Causes Of Toasted Skin Syndrome

Initially, toasted skin syndrome was caused by long-term exposure to:

• Open fire sources like stoves
• Bonfires or proximity to the fireplace

However, nowadays, any heat-emitting device may cause toasted skin syndrome. They include:

• Heat pads or hot water bags
• Electric heating blankets in hospital ICUs and hotels
• Electric and space heaters
• Infrared lamps (used for pain management)
• Laptops
• Seat heaters in cars
• Steam radiators
• Sauna belts

Applying heat to relieve any symptom of an underlying medical condition may also cause toasted skin syndrome. It is usually observed in conditions like (3):

• Pancreatic pathology
• Carcinoma of kidney
• Hypothyroidism (rarely)

The signs and symptoms of toasted skin syndrome are very characteristic and can be easily identified.

Diagnosing Toasted Skin Syndrome: Signs And Symptoms

The symptoms of toasted skin syndrome primarily arise from cellular changes in the skin layers, similar to tanning or sun damage. The signs and symptoms include:

• Net-like pink patches (that may turn red)
• Dark or hyperpigmented patches
• Scaling
• Telangiectasia (spider veins)
• Burning sensation
• Itchiness

The dermatologist may do a quick physical examination to diagnose your condition. However, the symptoms of toasted skin syndrome can look similar to livedo reticularisⁱ  XA skin condition marked by reddish-blue discolorations in a net-like pattern that can occur due to swollen or constricted blood vessels. and poikilodermaⁱ  XA skin disorder marked by atrophy, telangiectasias (spider veins), hypopigmentation, and hyperpigmentation. . Hence, the doctor may collect tissue samples for additional tests.

Some people are at greater risk of developing toasted skin syndrome due to several factors. Let’s take a look.

Who Are At Risk Of Developing Toasted Skin Syndrome?

Toasted skin syndrome is common in individuals who are exposed to high amounts of heat due to their occupation. They include:

• Bakers
• Chefs
• Factory workers (those who work in metal and coal factories)

Other people who are at risk of developing toasted skin syndrome include:

• People spending long hours in front of a fire
• Middle-aged and older adults who are more likely to spend their time in front of stoves or fireplace, or room heaters
• People undergoing medical treatment for conditions that require exposure to heat and radiation such as malignancies, musculoskeletal conditions, chronic pancreatitis, IBD (Inflammatory Bowel Disease)
• Youngsters and corporate workers who spend a large part of their time on the laptops resting on their thighs
• Silversmiths and jewelers
• Repeated use of furniture with in-built heaters
• Dentists or surgeons who work with powerful lights

Trivia

During the discovery of the toasted skin syndrome, a wood-burning stove was identified as the primary contributor to this skin rash.

Treating And Managing Toasted Skin Syndrome

1. Remove The Heat Source

Avoid proximity to heating devices. Do not work with your laptop resting on your thighs. Maintain a safe distance and avoid constant exposure to fireplaces, infrared lamps, and other heating devices. Also, be careful when using a hot water bag – do not put it on bare skin. Use warm water instead of hot water and wrap a cloth around it to minimize skin damage.

Charlotte Holdcroft, a lifestyle content creator, had toasted skin syndrome after using a hot water bottle. In her vlog, she explains how she managed it by removing the heat source from direct skin contact: “I just stopped using them all together. If I really needed one, then I would put it over the top of my jumper instead of putting it up my jumper, which is what I always did. I put it against my bare skin (i).”

Note: Newer sunscreens that offer infrared protection can help reduce the effect of heat. You can use physical sunscreens with zinc oxide and titanium dioxide.

2. Use Medication

The doctor will prescribe topical medications depending on the severity of your condition. They may prescribe:

• 5-fluorouracil for chronic cases of toasted skin syndrome
• Topical tretinoin to minimize hyperpigmentation
• Topical ointments with hydroquinone or other bleaching agents to manage pigmentary changes

The doctor may also prescribe therapies like:

• Laser therapy with ruby, alexandrite, or Q-switched Nd: YAG lasers to reduce pigmentation.
• Photodynamic therapy to rejuvenate the skin and reduce hyperpigmentation. However, its efficacy in treating this condition is still under study.

3. Use Aloe Vera

Aloe vera facilitates wound healing and may help protect the skin against the symptoms of radiation-induced dermatitis such as rashes and itching (4), (5). Therefore, it may help soothe the skin and alleviate some of the discomfort associated with toasted skin syndrome. To use it, follow these steps:

• Wash your hands to ensure they are clean before touching your affected skin.
• Now, clean the affected area with mild soap and water and pat it dry with a clean, soft towel.
• Apply the fresh aloe vera gel directly to the affected area.
• Gently massage it in and ensure you cover the entire area with a thin layer of the gel.
• Let it dry completely. You do not have to rinse it off.
• Follow this remedy 2-3 times a day or as required.

In some patients with erythema ab igne, the rash may turn into fluid-filled blisters. This is rare but usually indicative of lichen planus (an inflammatory condition of the mucous membranes) in the area. Toasted skin syndrome is a harmless condition. However, if not treated properly, it may lead to serious complications.

Complications Related To Toasted Skin Syndrome

If ignored for long, toasted skin syndrome may lead to malignant transformation of the skin cells (6).

In many cases, patients with a history of erythema ab igne develop skin cancers after a latent period of a few decades.

Although it is rare, erythema ab igne may lead to squamous cell carcinoma (3). This is the second most common form of skin cancer that occurs due to damage caused by UV exposure and tanning beds. This slow-developing cancer may take a few decades to develop.

Erythema ab igne may sometimes mark internal malignancies, such as (7):

• Pancreatic adenocarcinoma
• Rectal carcinoma
• Gastric adenocarcinoma
• Hepatic metastases from primary lung cancer
• Merkel cell carcinomaⁱ  XA rare but aggressive form of skin cancer that generally develops in the sun-exposed parts of the body.
• Lymphomaⁱ  XCancer of the lymphatic system, the body's disease-combating network which consists of the thymus gland, spleen, and bone marrow.

If you experience chronic pain and toasted skin syndrome, consult a doctor immediately for proper diagnosis.

Infographic: Toasted Skin Syndrome: At-Home Remedies To Soothe The Discomfort

Treat your skin with extra caution if it displays signs of hot water bottle burns or toasted skin syndrome. It may appear severe now, but it will improve over time. Just stop exposing that area of your skin to heat.

To treat your skin that has been harmed by heat and is experiencing toasted skin syndrome, you don’t need any pricey skin care creams or ointments. Instead, you can use simple remedies to improve the state of your skin right away. Check out the infographic below to learn more.

Illustration: StyleCraze Design Team

Frequently Asked Questions

Is toasted skin syndrome rare?

Yes, toasted skin syndrome is considered a rare skin condition. It is more prevalent in women than men and in people suffering from chronic pain (6).

How long does toasted skin take to heal?

Once you remove the heat source, toasted skin syndrome may go away on its own within a few weeks or months (6). Consult your doctor for better understanding and treatment.

Is toasted skin syndrome the same as a sunburn?

No, toasted skin syndrome is a medical condition that is caused due to prolonged exposure of heat or infrared radiations from a laptop or heating pad, while sunburn is caused by overexposure to ultraviolet radiations from the sun.

How long does it take for toasted skin syndrome to develop after exposure?

It varies for different individuals and depends on the duration and intensity of the heat exposure. In some cases, skin lesions may develop immediately after exposure, while for others, it may take up to a few weeks to develop (6).

Should I seek medical attention if I suspect I have toasted skin syndrome?

Yes, it is important to seek medical attention if you have reason to believe so.

Image: Stable Diffusion/StyleCraze Design Team

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Dr. Swati MuthaMBBS, DDV

   

Dr. Swati Mutha is a clinical and aesthetic dermatologist with over 10 years of experience. She has done her fellowship in Pediatric Dermatology from Singapore. She is a part of the Indian Dermatologist Association(IADVL) and has presented several papers and given lectures at national dermatology conferences. She practices at Assure Clinic, Breach Candy, and is also a consultant at ACI...more

Ramona SinhaEditor

 

Ramona is an editor at StyleCraze with 11 years of experience in writing and editing. She has authored over 200 articles on skin and hair care. She graduated from the University of Calcutta, West Bengal, and did her post-graduation from the University of Kalyani, West Bengal. She also did a certificate course in dermatology offered by the Novosibirsk State University...more

Eshna DasAssociate Editor

Eshna is an associate editor and a certified skin care coach. She has over three years of experience, a triple main bachelor’s degree in psychology, English, and journalism from Mount Carmel College, Bengaluru, and a master’s degree in psychology from Sampurna Montfort College, Bengaluru. Her passion for writing and editing and her background in psychology help her create content that...more

Shiboli ChakrabortiCommerce Editor

Shiboli has a master’s degree in English literature from The English and Foreign Languages University, Hyderabad, and is a certified skincare coach with four years of experience. As a commerce editor, she guides her team members on the best practices to create crisp and authentic content. She loves reviewing skin care and hair care products and constantly endeavors to provide...more