What general advice is available for travelers with Erythromelalgia (a disorder characterized by burning pain, heat, and redness in the hands and feet)?

From the Guidelines

When traveling with erythromelalgia, it is crucial to prioritize comfort and symptom management to minimize the risk of flares and ensure a safe trip. According to the most recent and highest quality study 1, erythromelalgia is a rare disorder characterized by episodic, burning pain associated with erythema and warmth of the extremities, and effective treatment resulting in symptomatic relief is essential to avoid severe complications and improve outcomes.

To achieve this, several measures can be taken:

• Pack prescribed medications, such as gabapentin, pregabalin, or amitriptyline, ensuring enough for the entire trip plus extra in case of delays 1.
• Bring cooling aids like portable fans, cooling towels, and ice packs that can be refrozen at the destination, as cooling the affected areas is a key factor in relieving pain 1.
• Wear loose, breathable clothing made of natural fibers and comfortable shoes that don't constrict the feet, to minimize triggers and keep the affected areas cool 1.
• Plan the itinerary to avoid excessive heat and include rest periods, especially during midday when temperatures peak, to prevent flares 1.
• Stay well-hydrated and avoid alcohol and spicy foods, which can trigger flares, and consider requesting special accommodations like aisle seats on planes for easier movement, rooms with air conditioning, and ground floor lodging to minimize walking 1.
• Inform travel companions about the condition and potential limitations, and carry a medical letter explaining the condition and medications, particularly when traveling internationally 1.

These measures are essential because erythromelalgia involves painful burning sensations and redness in extremities triggered by warmth and exertion, so keeping cool and minimizing triggers is crucial for symptom control during travel 1. Additionally, considering the treatment approach for management of erythromelalgia, which includes evaluating for underlying causes or associations, treating or managing underlying causes or associations, providing patient counseling, maintaining a lifestyle that is as normal as possible, and cooling affected areas safely 1, can help alleviate symptoms during travel.

From the Research

General Advice for Travelling with Erythromelalgia

When travelling with erythromelalgia, it is essential to consider the following factors:

• Avoid triggers that can exacerbate the condition, such as extreme temperatures 2, 3
• Keep the affected areas cool, as warming can aggravate the condition 2, 3
• Learn to relieve discomfort during episodes, such as elevating the affected limbs or using cool compresses 4
• Consider a multidisciplinary approach to management, including patient education and learning to avoid episodes 5, 4

Medication and Treatment

It is crucial to continue medication and treatment as prescribed by a healthcare professional:

• Topical medications, such as capsaicin cream, may be effective in managing symptoms 6
• Systemic medications may be necessary to control pain and other symptoms 5, 2
• Procedural interventions, such as sympathetic ganglion block or spinal cord stimulation, may be considered in severe cases 5

Precautions and Preparation

Before travelling, consider the following precautions:

• Consult with a healthcare professional to discuss travel plans and any necessary precautions 4
• Pack essential medications and supplies, such as cool compresses or topical creams 4
• Research destinations and plan for potential triggers or exacerbating factors 2, 3