Skin conditions that may improve in summer

Learn which skin conditions may improve during the summer months and why appropriate sun protection remains important in every case.

Although the skin symptoms of many conditions worsen with sun exposure and heat — including rosacea, lupus and premalignant lesions such as actinic keratoses — other dermatoses may improve during the summer.

Skin conditions that may improve in summer

Psoriasis

Psoriasis is a common chronic inflammatory skin disease. It is estimated to affect between 2% and 3% of the Spanish population. The condition is characterised by an accelerated turnover of skin cells, which causes cells to accumulate rapidly on the skin surface rather than being shed gradually.

This accumulation appears as red plaques covered with scales and may cause itching, irritation and cracking. Psoriasis is a chronic disease that typically follows a relapsing course. However, flare-ups can often be managed through appropriate treatment, lifestyle measures such as avoiding tobacco and excessive alcohol intake, stress management and the use of moisturising products suited to the condition.

Phototherapy — controlled exposure to ultraviolet A or ultraviolet B radiation — is also an established treatment option for psoriasis. For this reason, some patients experience an improvement in psoriatic lesions during summer, particularly with controlled sun exposure and in the more humid environment typical of coastal areas. Seawater may also be well tolerated by some patients. After swimming, however, the skin should be rinsed thoroughly with fresh water and the products recommended by the patient’s dermatologist specialising in psoriasis should be applied.

Can psoriasis improve even if you do not spend the summer at the beach? In some patients, yes. Research has linked stress and anxiety with worsening psoriasis, although the mechanisms involved are complex. For this reason, reducing stress is often recommended as part of the overall management of the disease.

As many people experience a change of routine and lower stress levels during the summer, some patients report an improvement even without spending time at the beach.

For these reasons, psoriasis is one of the skin conditions that may improve during the summer months.

For further information, you can read our article on how to care for psoriasis during summer.

Atopic dermatitis

Atopic dermatitis is one of the most common inflammatory skin diseases.

It is associated with dysfunction of the skin barrier, which normally helps retain moisture and protect the skin from external irritants. The condition is characterised by eczema, dryness and inflammation and may be affected by factors such as sudden temperature changes, heating and air conditioning, exposure to irritants and certain cosmetic products.

As a general rule, higher environmental humidity and some aspects of the summer climate can improve atopic skin in certain patients, although this is not always the case.

In fact, a small proportion of patients experience the opposite effect and may worsen during the summer. The improvement seen in some patients may be related partly to the humid climate of coastal areas, provided that the tap water at the holiday destination is not excessively hard.

Patients with atopic dermatitis who swim in pools rather than the sea should also bear in mind that chlorine can irritate and dry the skin, potentially worsening eczema. This is particularly important in children with atopic skin, as they often spend prolonged periods in the water.

It is advisable to limit the duration of swimming in chlorinated water, rinse the skin with fresh water after each swim and apply the products recommended by a dermatologist expert in atopic dermatitis at the end of the day.

Vitiligo

Vitiligo is an autoimmune condition characterised by loss of melanocytes, the cells responsible for producing melanin, the pigment that gives the skin its colour. As a result, depigmented white patches develop in affected areas. These areas may occur anywhere on the body, including the scalp, lips and inside the mouth. Vitiligo can begin at any age, although onset before the age of 20 is common.

There are treatments for vitiligo aimed at promoting repigmentation and controlling the immune and inflammatory processes involved in melanocyte loss. Some of these treatments may be combined with medically supervised phototherapy.

Certain patients therefore notice changes in the appearance of vitiligo during summer. However, depigmented skin contains little or no melanin and is particularly vulnerable to ultraviolet radiation, making appropriate photoprotection essential.

Lichen planus

Lichen planus is another inflammatory condition that may improve in some patients during summer. It is an immune-mediated disease affecting the skin and sometimes the scalp, nails, genital area and mucous membranes. Skin lesions typically appear as flat-topped reddish or violaceous papules. When mucous membranes are involved, lesions may appear white and can sometimes become painful or ulcerated.

Depending on their location, lesions can cause itching, pain, ulceration, nail abnormalities or hair loss. Treatment may include retinoids, immunomodulatory therapies, antihistamines and phototherapy, depending on the type and severity of the disease. As phototherapy can form part of the therapeutic approach, some patients may notice improvement during periods of greater natural light exposure. Nevertheless, this should not be interpreted as a recommendation for uncontrolled sun exposure.

Sun protection is still essential

The fact that certain dermatological conditions may improve during summer or with controlled ultraviolet exposure does not mean that patients should disregard recommended sun-protection measures.

On the contrary, it remains important to protect the skin from sunburn, photoageing and skin cancer by using appropriate broad-spectrum, high-SPF sunscreen and other photoprotection measures. Without adequate protection, patients are exposed not only to these general risks but also, in some conditions, to what specialists call the Koebner phenomenon.

This refers to the development or worsening of lesions in areas of skin that have been injured. In conditions such as psoriasis, vitiligo and lichen planus, sunburn may therefore trigger new lesions or worsen existing ones.

Acne does NOT improve in summer

Despite efforts by specialists in our Acne Unit to correct this misconception, the belief that sun exposure eliminates or improves acne remains widespread. It does not. Sun exposure may temporarily dry the skin and tanning can make redness less noticeable, creating the impression that acne has improved.

However, this effect is temporary and does not address the underlying mechanisms involved in acne. In addition, some patients experience a rebound flare after periods of intense sun exposure. For this reason, phototherapy is not used as a standard treatment for acne.

This misconception can also encourage some people to expose their skin to the sun without sunscreen because they believe that sun exposure will treat their acne or that sunscreen will make their skin oilier. Neither assumption is correct.

Uncontrolled sun exposure can also contribute to a form of inflammatory eruption known as Mallorca acne, or acne aestivalis. This typically affects the upper chest, shoulders and arms and may occur in people with current or previous acne after significant ultraviolet exposure.

In summary, acne should not be considered one of the skin conditions that improves in summer.

Phytophotodermatitis from preparing mojitos

What do mojitos have to do with skin disease? How can a drink made with mint, lime, sugar, rum and soda water cause dermatitis on the hands?

The problem is not the mojito itself but the lime used to prepare it, particularly when preparation takes place outdoors.

The reaction is known as phytophotodermatitis and is well recognised in dermatology. Phytophotodermatitis is a skin reaction that occurs when skin is exposed to ultraviolet radiation after contact with certain plants or plant-derived substances.

Plants commonly associated with this type of reaction include celery, fig plants, bergamot and lime.

Lime contains photosensitising compounds called furocoumarins, which can trigger erythema, itching, vesicles, blisters and subsequent hyperpigmentation following sun exposure.

The simplest preventive measure is to wash the hands thoroughly after handling lime and before exposing the skin to sunlight.

Post updated. First version published on 26 July 2022.

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