How To Treat Heat Rash
Apply an ice pack or an ice cube to the heat rash
Excessive sweating causes overhydration of skin and blocks sweat pores, causing heat rash
Heat rash medically termed as miliaria, occur when the flow of sweat to the skin surface, is impeded by obstruction of the sweat duct.
Common predisposing conditions:
- A relative immaturity of sweat gland ducts in early infancy.
- Infants being nursed in excessively warm and humid conditions.
- Occlusive pants, that cause sweat to get trapped in the skin folds and provide particularly favorable conditions for the development of miliaria in the napkin area.
There are three basic forms of heat rash, which include the following:
- Miliaria Crystallina or sudamina: This form reflects obstruction of the sweat duct within the uppermost layer of Stratum corneum of the epidermis of the skin. It commonly occurs in neonates, due to the immaturity of the sweat gland ducts, that favors pore occlusion and sweat retention. It also occurs in febrile illnesses, when profuse sweating accompanies fever, and causes excessive hydration of the uppermost layer of skin.
- Miliaria Rubra or prickly heat: It is caused by sweat duct obstruction deeper within the epidermis of the skin, induced perhaps, by increased activity of bacteria within sweat pores. It commonly occurs in hot and humid climatic conditions, but may also occur in desert regions. It affects up to 30% of people exposed. It may begin within a few days of arrival in a tropical climate but is maximal after 2-5 months. It can occur under tight and impermeable clothing, and under occlusive dressings. High humidity, excessive salt on the skin, and occlusive clothing, serve to maintain and exacerbate skin overhydration, that occurs from excessive sweating.The initial event may be an increase in the bacterial counts on the skin surface. Certain bacteria of Staphylococcus species produce a sticky substance or slime, that blocks the lumen of sweat duct. A retrograde pressure in the duct leads to its rupture, and sweat leaks into the upper layers of skin, leading to itching and redness.
- Miliaria Profunda: These are the common summer boils. Herein, there is a rupture of sweat duct at the level of the dermo-epidermal junction of skin. The rash occurs due to more severe damage to the sweat duct, and usually follows repeated attacks of prickly heat.
Appearance of Heat Rash
- Miliaria Crystallina: It develops as crops of clear, thin-walled superficial tiny blisters, without any associated redness, resembling "dew drops", on a normal looking skin. These bubble- like blisters are exceedingly delicate, usually rupture within 24 hours, and are followed by peeling of skin. They arise most frequently in the early neonatal period, during the initial two weeks of life, and are particularly likely to occur on the head, neck, and upper trunk. In adults, they occur along with persistent fever and are common on the trunk region.
- Miliaria Rubra or prickly heat: It consists of red-colored, minute boils or bumps, that occur on a background of uniform redness. Sometimes quite large, hive-like patches may develop. This type of rash commonly occurs in the neonates. It occurs as more or less symmetrical crops of lesions, most often in the body folds, especially around the neck, in the groin, and underarm area. The face, scalp and upper trunk are also frequently affected. When the eruption is profuse, the child may be restless or distressed. In susceptible children, the upper part of the face, including the forehead, is a common site of involvement. Each crop of rash will subside within a few days, but recurrences commonly occur, unless the provocative environmental conditions are modified. In adults, the rashes develop especially in areas of friction with clothing. Characteristically, they lead to intense discomfort, in the form of unbearable stinging or pricking sensation. The disease resolves with skin peeling.
- Miliaria Profunda: This includes large pus filled boils, that nearly always follow repeated attacks of prickly heat, and resemble gooseflesh. They are uncommon, except in the tropical region. The affected skin is covered with pale, firm boils, especially on the body, but sometimes, also on arms and legs. There is no accompanying itching or discomfort. Compensatory excessive sweating may occur on the face or underarm area, with widespread involvement.
Natural Course and Complications of Heat Rash
Evolution and progress of the rash depend mainly on environmental factors. If continued sweating occurs, recurrent episodes, lasting for a few days are usual, but the discomfort may be continuous. However, after a few months, our body begins to adapt to the hot climate, and some degree of acclimatization occurs, and then this condition becomes less prevalent.
Complications of Heat Rash:
- Secondary bacterial infection: Skin infections, superimposed on prickly heat, are common. At times, multiple abscesses or large collections of pus may develop, superimposed on a background of skin rash. In most instances, these infections are reversible, and curable, if further sweating is avoided, but permanent damage to the sweat ducts may occur, especially when large boils develop.
- Disturbances in heat regulation: These occur in people unaccustomed to the tropical heat. Infants and premature children are particularly prone to heat intolerance, in the presence of a widespread eruption.
Ways to Prevent Prickly Heat
- Reduce sweat. The only really effective protection from, or treatment of heat rashes, is avoidance of further sweating. Even if this is achieved for a few hours in a day, as in an air conditioned office or shopping mall, considerable relief is experienced. For a very susceptible person, a move away from tropical climates may be essential.
- Avoid being overdressed in summer. Avoidance of excessive clothing and friction with clothes is essential. Allow your skin to breathe. If possible, wear lightweight, loose-fitting cotton garments, through which air can easily reach the body folds, and prevent the sweat from getting trapped, and causing irritation.
- Avoid excessive exposure to heat, humidity, and strenuous exercise.
- Avoid excessive use of soap, and contact of the skin with irritants.
- Apply an antibiotic ointment to the affected area. This prevents further spread of rash, secondary infections, and pus formation.
- Drink plenty of fluids to cool the body, and stay hydrated.
Cold Shower Is The Simplest Method To Prevent And Reduce Heat Rash
How to Manage Prickly Heat
- Stay in a cool environment.
- Let your skin air dry, instead of using towels, else pat dry to ensure not to break the blisters, and simultaneously remove excess sweat.
- Ice compresses: Applying the ice directly, or in the form of ice bags, provides instant relief from painful blisters. If you are on a trip and do not have ice packs, then take an ice cube, wrap it in a clean, cotton cloth, and apply it onto the affected area. Do this for 10 minutes, every 2 hours, until the discomfort reduces. Ice improves blood circulation to the affected area, clears the blockage of sweat ducts naturally, reduces the urge to itch or scratch, and has a soothing effect on the skin.
- A cold shower or cold water bath: It is the simplest, and probably the easiest method to prevent and reduce the itching and discomfort that accompanies heat rashes. Try to be under the shower for as long as you can. Bath with cold water twice a day. This clears the sweat, and prevents skin infections, especially in a hot climate.
- Rub the affected area with the inside of watermelon rind.
- Sprinkle cornstarch, or unscented powder, or talc, on the affected area, to eliminate excess moisture.
- Aloe vera: Apply freshly extracted sap from an aloe leaf to the affected area.
- Apply calamine liniment to reduce the discomfort. You can later on replace it with a bland non-comedogenic, non-scented emollient or a moisturizer.
- Vitamin-C: Take a vitamin-C supplement on a regular basis. This improves skin immunity and reduces secondary infections.
- Antibiotic tablets may be required in the presence of infections.
Have a few sips of Peppermint tea every hour
- Avoid eating spicy food, excess sugar, or drinking hot beverages or alcohol.
- Prepare a cooling herbal tea with 1 tablespoon of peppermint leaves in 2 cups of water. Steep it for 20 minutes, then strain, and cool. Have a few sips of it every hour, until the rash clears.