Erythromelalgia: Definition, Symptoms, Treatment and Causes

It is a rare disease that causes episodes of burning pain and redness in the feet and sometimes in the hands, arms, legs, ears, and face.

The symptoms of erythromelalgia can begin at any age. Some people may have had it from early childhood, while others are only affected as adults.


The three main symptoms of erythromelalgia are heat, pain, and skin redness.

The feet are affected more frequently, but the hands, arms, legs, ears, and face can also be affected.

The pain can vary from mild, with only a tiny tingling like pins and needles, to an intense and burning pain, severe enough to make walking, standing, socializing, exercising, and sleeping difficult. It can have a significant impact on work or school life.

People with erythromelalgia usually experience episodes or “flares” of pain lasting from a few minutes to days. The buds typically begin as a sensation of itching, which gets worse with pain, and a tender, mottled red skin that feels warm or hot to the touch.

Other symptoms may include:


  • Swelling of the affected body part
  • Sweating in the affected area more than usual.
  • Purple discoloration when there is no outbreak.
  • An increase in body temperature usually triggers symptoms.

This can happen:

  • After exercising.
  • When wearing warm socks, gloves, or tight shoes.
  • After entering a warm room.
  • When you feel stressed
  • When you drink alcohol or eat spicy food.
  • When you are dehydrated.

Treatment of Erythromelalgia

Medicines for the skin

Some medications that are applied directly to the skin (topical medicines) have been found to help relieve the symptoms of erythromelalgia.

These can be in creams, gels, sprays, or patches. You may be prescribed a cream or capsaicin patch to make the heat receptors on your skin less sensitive. Lidocaine (a local anesthetic) may also be defined as a cream, gel, patch, or spray.

Your doctor can give you more information about these medications and if they are right. You can also talk with your pharmacist about lidocaine creams.

Oral medications

A series of different medications taken orally may help relieve the symptoms of erythromelalgia. You may need to try several other drugs, under the supervision of your doctor, before finding one or the combination that works best for you.

Your treatment options will also depend on the type of erythromelalgia you have. Many treatments require referral to a specialized center so that the benefits and possible side effects can be monitored closely.

The types of medications your doctor can prescribe include:

  • Dietary supplements: like magnesium, which can help open blood vessels.
  • Aspirin: only used for adults, not for children.
  • Epilepsy medicines such as gabapentin or carbamazepine.
  • Blood pressure medications: medications to open blood vessels and increase blood flow or beta-blockers to help reduce blood flow, depending on the cause of erythromelalgia.
  • Low doses of antidepressants: duloxetine, venlafaxine, amitriptyline, or nortriptyline
  • analgesics with prescription only.
  • Medications are administered through a drip in some cases. When the oral medication has not managed to control the symptoms, drugs can be administered directly into the bloodstream by a dot (intravenous infusion).
  • Lidocaine: a local anesthetic that can help nerve-related pain, can be administered this way. But how much time works varies by people.

Causes of erythromelalgia

In most cases of erythromelalgia, the cause is unknown. However, it is sometimes due to another underlying medical condition or a defective gene inherited from a parent.

Other medical conditions

Erythromelalgia sometimes results from an underlying condition, such as:

A blood disorder, such as polycythemia, damage to the nerves, for example, caused by peripheral neuropathy

multiple sclerosis (MS) is an autoimmune problem, such as lupus or rheumatoid arthritis, where the immune system attacks the body’s tissues.

Certain medications can also cause it. Your doctor can give you more information about this.

Genetic cause: in some people with erythromelalgia, the disease is caused by a defective gene. Erythromelalgia can occur in families when a father’s defective gene is transmitted to his (inherited) child.

The defective gene causes changes in how pain signals are sent to the brain, increasing or strengthening them.