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Heat rash is a skin condition which is characterized by a reddish, pimply rash which is especially common in the folds of the skin or around tight waistbands and clothing. It is caused by excessive heat, which clogs the sweat glands of the body. Although a heat rash is not inherently dangerous, it does suggest that the patient may be getting dangerously hot. In addition to treating the heat rash, it is important to take steps to ensure that the condition does not happen again.
You may hear a doctor refer to a heat rash as miliaria. Other people call the condition a sweat rash, in a reference to the blocked sweat glands, or they term it “prickly heat,” in a reference to the faintly itchy, prickling sensation which accompanies a heat rash. Astringents like witch hazel can help to relieve the itching, while cooling ice compressed may relieve the heat which is causing the rash to appear. Miliaria can be prevented by staying clean and cool, with the assistance of regular showers, air conditioning, and fans.
Infants and young children are especially susceptible to heat rash, both because they have under-developed sweat glands and because they cannot dress themselves or vocalize about feeling too hot. Since most parents want to keep their infants warm, they may err on the side of caution and get their children too hot. Runners may also get heat rash, as do people in hot, humid climates.
Ultimately, a heat rash will go away once the body has had a chance to grow fresh cells around the sweat glands. If a heat rash does break out, regular cool showers with mild soap are an excellent idea, since they will keep the affected skin clean and reduce the risk of infection. Oil-free lotions can help to control the itching associated with a heat rash, and doctors may prescribe antibiotics or antiseptics to prevent bacterial colonization of the delicate skin.
A basic heat rash is called miliaria rubra. Should the skin become infected, it is termed miliaria pustulosa, and it requires more aggressive medical treatment. It may also be more painful for the patient. A recurring case is known as miliaria profunda, and it should be addressed by a doctor, since it indicates that the patient's body is getting too hot on a regular basis. This can be extremely dangerous or even fatal if it turns into heat stroke or heat exhaustion.
Adults usually develop heat rash in folds of skin and wherever clothing causes friction. In infants, the rash is mainly found on the neck, shoulders and chest, but it can also occur in the armpits, elbow creases and groin.
There are three types of miliaria, which are classified according to where the sweat ducts are blocked. Signs and symptoms for each type vary.
The mildest form of heat rash affects the sweat ducts in the topmost layer of skin. Miliaria crystallina is marked by:
Clear, fluid-filled blisters and bumps (papules) that break easily
The blisters that occur with miliaria crystallina aren't itchy or painful. This type of heat rash usually clears on its own but can come back if hot, humid weather persists. And though it's common in newborns, adults can develop it, too.
Occurring deeper in the outer layer of skin (epidermis), miliaria rubra is sometimes called prickly heat. Adults usually develop miliaria rubra after they're exposed to hot, humid weather or if they're confined to bed rest. Infants usually develop this type of heat rash between the first and third weeks of life. Signs and symptoms typically include:
Red bumps
Itchy or prickly feeling in the affected area
Little or no sweating in the affected areas (anhidrosis)
Occasionally, miliaria rubra vesicles become pustular and then are called miliaria pustulosa.
A less common form of heat rash, miliaria profunda occurs mainly in adults who have had repeat bouts of miliaria rubra. It affects the dermis, a deeper layer of skin, and appears soon after exercise or any activity that causes sweating. Signs and symptoms may include:
Firm, flesh-colored lesions that resemble goose bumps
A lack of perspiration, which may lead to symptoms of heat exhaustion, such as dizziness, nausea and a rapid pulse
Heat rash usually heals on its own and doesn't require medical care. See your doctor if you or your child has symptoms that last longer than a few days, the rash seems to be getting worse, or there are signs of infection, such as:
Increased pain, swelling, redness or warmth around the affected area
Pus draining from the lesions
Swollen lymph nodes in the armpit, neck or groin
A fever or chills
Heat rash usually goes away if the skin is kept dry and cool within a few days. The most common treatment for miliaria is to let it dry on its own. It is advisable to relax your skin in an air-conditioned room or under a fan to cool off.
Avoid application of insect repellents, lotions, powder to your skin in case you continue to sweat and cannot cool down. To treat infected rash, antibiotics may be needed. Avoid using ointments or creams as they make the skin warm and moist and may worsen the heat rash condition.
In order to prevent heat rash, avoid humid environments, strenuous physical activity. Do not apply oil-based products to your skin as they may block the sweat glands. Application of over-the-counter 1% hydrocortisone cream or calamine is recommended to relieve the itching, proving to be an effectual heat rash treatment.
Treating miliaria is simple and usually does not require medical assistance. If you experience a prolonged heat rash, seek immediate medical attention.