Toasted Skin Syndrome: what is it and How to Manage It?

  • What Is Toasted Skin Syndrome?
  • Causes Of Toasted Skin Syndrome
  • Diagnosing Toasted Skin Syndrome: Signs And Symptoms
  • Who At Risk Of Developing Toasted Skin Syndrome?
  • Treating And Managing Toasted Skin Syndrome
  • Complications Related To Toasted Skin Syndrome

What Is Toasted Skin Syndrome?


Toasted skin syndrome or Erythema ab igne (EAI) is a medical condition characterized by 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 lesion 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.

Toasted skin syndrome is caused by exposure to any device or object that emits heat and infrared radiation.

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 due 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 reticularis and poikiloderma. 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 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

Early diagnosis and treatment are crucial to heal toasted skin syndrome. Here is how you can manage this condition.

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 damage.

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.

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 (4).

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 (5):

  • Pancreatic adenocarcinoma
  • Rectal carcinoma
  • Gastric adenocarcinoma
  • Hepatic metastases from primary lung cancer
  • Merkel cell carcinoma
  • Lymphoma

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

To Conclude

The eyes cannot see what the mind does not know. As most of us use laptops comfortably perched on our thighs, we expose our skin to the heat radiated from the device. The same is true when we search for warmth in the electric/wood heaters and stoves during cold winter months. Constant heat exposure can damage the skin and the underlying tissues. Moreover, toasted skin syndrome may also indicate other underlying health conditions. If you have observed any changes in your skin texture and appearance due to constant heat exposure, consult with your doctor right away.

Frequently Asked Questions

Will toasted skin syndrome go away?

Toasted skin syndrome can resolve on its own, especially when detected in the early stages and when the heat source is removed.

How do you treat toasted skin syndrome at home?

Removing the heat source may help prevent toasted skin syndrome at home. However, it is better to consult a doctor and follow proper treatment.

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