Skin problems caused by hot water bottles and Co.

Toasted Skin Syndrome
What to do if the hot water bottle causes skin problems?

Hot-water bottles, electric blankets and grain pillows are more in demand than ever this autumn and winter. But their intense heat can change the appearance of the skin. What is Toasted Skin Syndrome?

Is there anything cozier than snuggling up with a hot water bottle in cold temperatures? Especially now, when many people don’t want to turn up the heating too much, hot-water bottles, grain pillows or electric blankets are very popular.

However, their cozy warmth can have a downside – in the form of heat-related skin damage. Two dermatologists explain what’s behind it.

Regular, deep heat is the problem

Sure, heat can be very beneficial: a cherry pit pillow against stomach ache, a hot water bottle against period pain and a heat patch against aching back. Or just fall asleep warmed up with a hot water bottle.

At temperatures of 40 to 50 degrees, short skin contact cannot cause burns, says Friederike Wagner from Dermatologikum Hamburg. But “regular, deep heat” can still cause skin problems. The skin then discolours, creating a red-brownish mesh.

Experts call this brown pigmentation “erythema ab igne”, which means “redness from fire” in ancient Greek. The phenomenon is also known under the name Buschke heat melanosis, based on the German dermatologist Abraham Buschke. A little more descriptive is the name Toasted Skin Syndrome – “toasted skin”.

The blood vessels are damaged

Whatever it is called: the phenomenon can only be determined by the visual changes in the skin, explains Friederike Wagner, who is a specialist in dermatology and allergology. So far, however, there have only been a few studies on this.

However, it is believed that the intense heat causes damage to the blood vessels. through the heat they initially expand, as the Munich dermatologist Esther Wißmüller explains. This causes the skin to redden.

If the blood vessels are then damaged, red blood cells leak out. Their degradation products – called haemosiderin in medicine – are deposited in the skin. According to Wißmüller, this leads to discoloration of the skin, a so-called hyperpigmentation.

Toasted skin syndrome can become chronic

“If heat is applied regularly over a long period of time, the skin change becomes chronic. That means the erythema ab igne is permanent and won’t go away,” says Friederike Wagner.

After all, the discoloration is not painful and usually does not cause any other symptoms. If the skin itches or burns, you can treat it with an ointment or cream.

However: “There are no special treatment options,” says Friederike Wagner. And yet it is better to go to the dermatologist if you discover a red-brownish mesh on your skin. There are also diseases with a similar appearance that are not benign.

It depends on the dose

Avoiding toasted skin syndrome is quite simple: by not exposing yourself to the intense heat as often. But how much is too much?

This question is not easy to answer. According to dermatologist Wagner, a few evenings with a hot-water bottle tend not to lead to chronic heat melanosis. However, there is still not enough knowledge about the role played by genetic predisposition. Or after how many hours of heat a discoloration develops.

Especially people who often fall asleep with a hot water bottle or who often have a heat patch on their back should check their skin regularly.

In principle, heat melanosis can trigger any type of deep and long-lasting heat, says Wagner. A hot-water bottle, electric blanket, heated seats in the car – and of course an overheated laptop on your lap. Even if we usually find their warmth pleasant, the skin should not be exposed to it too often.

Not a phenomenon of the current time

However, the toasted skin syndrome is not just a phenomenon of the home office or the increased heating costs. Heat melanosis used to be widespread, especially among blacksmiths, engine drivers or people who worked on stoves or open fires, says Wagner.

In her practice, dermatologist Esther Wißmüller comes across toasted skin syndrome “from time to time”. She suspects that the phenomenon is “certainly more common”.

As tempting as it may be to snuggle up on the sofa with an electric blanket or in bed with a hot-water bottle – it’s better not to do that every evening, recommends dermatologist Wagner. You should be very careful with temperatures above 40 degrees, especially with small children, who cannot tell you when they are getting too warm.


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