Erythromelalgia – Specialist Diagnosis & Symptom Management in London

What is erythromelalgia?

Erythromelalgia is a rare vascular pain condition characterised by episodes of severe burning pain, redness, and warmth, usually affecting the feet or hands. Because of its hallmark symptom of “burning” discomfort, it is sometimes known as burning feet syndrome. Although uncommon, it can have a major impact on daily life and requires a tailored management approach.

Causes of erythromelalgia and how it develops

In many cases, erythromelalgia arises from abnormal blood vessel function. During flare-ups, small vessels in the skin dilate excessively, leading to redness, heat, and pain. Some cases are linked to genetic changes, while others occur secondary to medical conditions such as blood disorders, nerve dysfunction, or autoimmune disease.

Symptoms of erythromelalgia and flare-ups

The key symptoms include intense burning pain, redness, warmth, and swelling. Flare-ups are often triggered by external heat, exercise, tight shoes, or even emotional stress. Symptoms may improve with cooling measures but can quickly return when exposed to triggers.

Patient experience note: Many patients report symptoms becoming worse in hot weather, while others find even mild activity like walking can trigger a painful flare.

Who is most affected by erythromelalgia?

Erythromelalgia can occur at any age, though adults are more commonly affected. It may appear on its own, as part of an inherited genetic condition, or alongside medical issues such as neuropathy, autoimmune disorders, or myeloproliferative disease.

How erythromelalgia is diagnosed

Diagnosis is based on the patient’s history, symptom description, and clinical examination during or after a flare-up. Sometimes blood tests, nerve studies, or skin assessments are needed to rule out underlying causes.

Erythromelalgia treatment options and management

While there is no single cure, effective management can significantly reduce discomfort. Treatment is tailored to the individual and may include:

• Lifestyle changes: Avoiding heat, keeping feet cool, and wearing loose shoes.
• Topical therapies: Cooling gels, lidocaine, or capsaicin creams.
• Medications: Aspirin, gabapentin, pregabalin, or other nerve pain modulators.
• Advanced options: Dermatology-guided systemic therapies in resistant cases.

Specialist care is essential to balance symptom relief with avoiding excessive cooling, which can damage the skin.

Living with and managing erythromelalgia day-to-day

Daily life can be challenging with unpredictable flare-ups. Some patients find cold packs soothing, but over-cooling carries risks such as skin injury. Supportive footwear, pacing activities, and seeking emotional support are also important parts of care.

Special considerations for skin of colour

In darker skin tones, redness may appear as darkening or dusky patches rather than obvious flushing. Recognition of these subtle signs is important to avoid under-diagnosis and ensure timely treatment.

Why choose Skinhorizon for erythromelalgia treatment in London?

At Skinhorizon, we provide high-quality dermatology care for complex conditions such as erythromelalgia. Our consultants tailor treatment to your triggers, lifestyle, and health background, with a focus on improving quality of life and minimising flare-ups.

Your first visit — what to expect

During your consultation, our dermatology specialist will review your history, assess your skin, and discuss your symptoms. We will create a personalised treatment plan that may include topical, oral, or supportive therapies. Same-day appointments are often available for urgent concerns.

Reviewed by: Dr Mohammad Ghazavi, Consultant Dermatologist
Skinhorizon Clinic, 4 Clarendon Terrace, Maida Vale, London W9 1BZ
Last reviewed: 20 August 2025