PRICKLY HEAT

(Miliaria Rubra)

 Basic information

description

Prickly heat is a skin disorder caused by blocked sweat-gland ducts. Miliaria rubra is the medical name. It affects all ages, and is common in infants and children.

FREQUENT SIGNS & SYMPTOMS

• Clusters of vesicles (small, fluid-filled skin blisters that may come and go within a matter of hours) or red rash without vesicles in areas of heavy sweating.
• In adults, it occurs more often in the skin fold areas or where clothes cause friction. In infants, it can occur on the chest, back, neck, head, and, sometimes, the groin or armpits.
• May have itching, burning, tingling, prickling, or stinging.

causes

Blockage of sweat-gland ducts (such as with dead skin cells or bacteria). The trapped sweat causes an inflammatory response. There are different type of miliaria depending on the skin level that is blocked. When it occurs in the upper skin level (epidermis), it results in prickly heat (miliaria rubra). Other types of miliaria are less common.

risk increases with

• Heavy sweating.
• Hot, humid weather.
• Clothing that keeps in heat and moisture.
• Infants and young children (sweat glands are not mature).
• Infants that are bundled up.
• High fever.
• Use of certain drugs.
• Prolonged bedrest with infections, other medical disorders, or treatments that cause excess sweating.

PREVENTIVE MEASURES

• Avoid risk factors where possible.
• Use anhydrous lanolin to help prevent blockage of sweat ducts. Apply to affected skin areas prior to activity in hot weather.
• Bathe regularly, especially in hot, humid situations. This helps get rid of salt and bacteria on the skin.
• Use water-based products for moisturizing skin.
• Use sunscreens, but avoid oily/cocoa butter types.

expected outcomes

Prickly heat is not a serious condition. Most rashes heal on their own within days to weeks. Symptoms can often be relieved with treatment.

possible complications

• A bacterial skin infection may develop.
• Some people never adapt to hot climates and may end up moving to milder weather location.

 diagnosis & treatment

general measures

• Avoid further sweating. Provide a cool, dry environment. Spend time in an air-conditioned room or office.
• Avoid clothing that irritates the skin or clothing that is too tight.
• Use topical skin products or drugs.
• Use cool-water soaks to relieve itching. Pat skin dry and dust with cornstarch after soaks.
• Wear cotton socks and leather-soled footwear rather than shoes made of synthetic materials.
• Expose the affected skin to air as much as possible.
• Don't use binding materials, such as adhesive tape.
• Change diapers on infants as soon as they are wet.
• Avoid sunburn once you have had prickly heat. The body's inflammatory reaction to sunburn may trigger a new outbreak of prickly heat.
• See your health care provider if skin symptoms cause concern.

medications

• Use lotions that contain menthol or pramoxine, or calamine lotion to relieve symptoms.
• Nonprescription cortisone cream may be recommended by your health care provider. Follow product instructions carefully.
• Oral antibiotics may be prescribed if there is a secondary bacterial infection.
• Drugs may be prescribed for a fever or illness.

activity

Decrease activity during hot, humid weather or until skin heals.

diet

No special diet.

 notify our office if

• You or a family member has a rash that causes concern.
• Prickly heat doesn't improve in 10 days, despite home care.
• Rash worsens or other symptoms occur.

Special Notes: