Problem feet and hands on holiday

[benibug]

Every time I go abroad on holiday after a couple of days I notice my feet and hands reacting.  Each year i aim to keep them out of the sun, put them in the shade, wear high factor sun cream, not walk on the sand and without fail every year they react.  They feel boiling on the inside but not necessarily boiling to touch, they are not red, they swell up significantly, tingle if i go in water and are painful/itchy around the nails and tops of the toes.  I have always thought it was sun burn or prickly heat and have tried hydrocortisone cream on them and calamine lotion, taken anti-inflammatories and painkillers.  Nothing helps.  It gets to the point where i cannot walk far, go into any form of heat (even in the shade) without them burning up unbearably and cannot put shoes on which ruins my holiday and the holiday of those around me.   I have had to leave restaurants in the middle of my meal to run into the sea.  Keeping my feet in cold water is the ONLY thing that eases it.  Please advise me what i could try.  I am planning a big trip to Malaysia with a friend in August and am scared of how my feet will behave.

[Vanessa Lacuesta]

Hi

You have noted that this seems to affect only the hands and feet. Is this correct? Also, the swelling and tingling seems to affect these parts of the body only after sun exposure. Differentials for this may be a photosensitivity reaction or a nerve related problem. Photosensitivity reactions may range from solar urticaria to more severe forms. Avoid prolonged sun exposures as much as possible. If this is photosensitivity reaction, sunscreens and taking oral antihistamines may not be enough. Avoiding the triggers will always be the way to prevent this from recurring. A nerve related disorder secondary to vitamin deficiencies and even diabetes may also have to be ruled out.

Have you visited a dermatologist for this?