With the dog days of summer still lingering on, I continue to get asked about heat rash. In my interview with the HuffingtonPost, I address those concerns:
1. What causes heat rash?
Heat rash, or miliaria, is a benign, transient condition that is caused by occlusion of sweat glands in the upper parts of the skin as a result of exposure to high heat and humidity, prolonged perspiration or following extended febrile illness. There are 3 subtypes, depending on the skin level where the occlusion occurs, with "prickly heat" or miliaria rubra being the most common type.
2. What are some of the symptoms?
The most common, miliaria rubra, type presents with numerous itchy, tiny pink and/or clear-fluid filled bumps, usually on the trunk, neck or back, but can affect any areas of the body, such as under tight clothing or under splints or braces because of the occlusive warm environment.
In severe, repeated cases, most commonly in the tropics, patients may develop symptoms of heat-exhaustion and even a heat stroke, due to inability to properly sweat and cool-off in the large areas where the rash is present due to occlusion of those sweat glands.
3. Top 10 tips on how to treat heat rash?
Overall, treatment involves cooling and drying, and avoidance of further over-heating and resultant sweating. All measures will prove ineffective if sweating is not reduced.
(1). Air-conditioning
(2). Loose fitting clothing and exposure of the involved skin
(3). Antipyretics (eg. Tylenol)
(4). Cool, regular showers (to decrease over-heating, remove remove salt and bacteria)
(5). Light cornstarch or baby talcum powder.
(6). Antihistamines (for itch)
(7). Cold packs
(8). Topical corticosteroids (for itch and bumpiness)
(9). Oatmeal baths
(10). Oral medications should only be prescribed by a qualified physician and include (a) retinoids (in severe, longstanding cases) and (b) antibiotics (only if infection occurs over-top of the heat rash)
Special attention to:
4. How can a person correctly identify heat rash?
Heat rash always happens after a period of overheating and excessive sweating. It is not uncommon during a febrile illness, when a person lies in bed for a prolonged period of time, with their back getting hot and sweaty. Heat rash is itchy, and presents on those areas where most occlusion happened during sweating (the neck, the back, trunk, thighs). It is often underneath tightly fitting clothing or splints. Heat rash looks like many tiny pink and/or clear-fluid filled bumps on a diffuse pink background.
5. How can heat rash be prevented?
Prevention and management begin with removal of the inciting factors.
Adults often develop miliaria during travel and military service in the tropics or with heavy work-out routines for exercise. Gradual exposure helps acclimatize to the hot and humid environment. Loose-fitting clothing and cool showers may prevent or at least minimize the symptoms if it happens. Showering also plays a role in removing certain strains of bacteria from the skin, overgrowth of which can predispose to heat rash. Cornstarch and other light powders may be used to absorb moisture and minimize the maceration that causes early changes necessary for the development of heat rash. Air conditioning is key. When working out, doing so in an air-conditioned space or outdoors when it is cool (usually in the morning or the evening) is very important.
6. If you have heat rash what should you avoid?
Miliaria is exacerbated by tight clothing and high humidity.
Neoprene, in particular, fails to wick away perspiration from the skin, providing an ideal environment for heat rash.
7. What makes heat rash better/worse?
Heat rash gets better with exposure of the affected skin to air, air conditioning, loose fitting clothing, regular cool showers, light cornstarch powder, oatmeal baths, antihistamines and topical corticosteroids when itchy. It is made worse with continued sweating, hot and humid environment and tight, occlusive clothing.
Heat rash, or miliaria, is a benign, transient condition that is caused by occlusion of sweat glands in the upper parts of the skin as a result of exposure to high heat and humidity, prolonged perspiration or following extended febrile illness. There are 3 subtypes, depending on the skin level where the occlusion occurs, with "prickly heat" or miliaria rubra being the most common type.
2. What are some of the symptoms?
The most common, miliaria rubra, type presents with numerous itchy, tiny pink and/or clear-fluid filled bumps, usually on the trunk, neck or back, but can affect any areas of the body, such as under tight clothing or under splints or braces because of the occlusive warm environment.
In severe, repeated cases, most commonly in the tropics, patients may develop symptoms of heat-exhaustion and even a heat stroke, due to inability to properly sweat and cool-off in the large areas where the rash is present due to occlusion of those sweat glands.
3. Top 10 tips on how to treat heat rash?
Overall, treatment involves cooling and drying, and avoidance of further over-heating and resultant sweating. All measures will prove ineffective if sweating is not reduced.
(1). Air-conditioning
(2). Loose fitting clothing and exposure of the involved skin
(3). Antipyretics (eg. Tylenol)
(4). Cool, regular showers (to decrease over-heating, remove remove salt and bacteria)
(5). Light cornstarch or baby talcum powder.
(6). Antihistamines (for itch)
(7). Cold packs
(8). Topical corticosteroids (for itch and bumpiness)
(9). Oatmeal baths
(10). Oral medications should only be prescribed by a qualified physician and include (a) retinoids (in severe, longstanding cases) and (b) antibiotics (only if infection occurs over-top of the heat rash)
Special attention to:
- High heat and humidity workers, such as military or miners, change to light sedentary duties in air-conditioned environment for 4 weeks will usually clear the rash.
- Infants, removal of excessive clothing, cooling baths, and air-conditioning is important.
4. How can a person correctly identify heat rash?
Heat rash always happens after a period of overheating and excessive sweating. It is not uncommon during a febrile illness, when a person lies in bed for a prolonged period of time, with their back getting hot and sweaty. Heat rash is itchy, and presents on those areas where most occlusion happened during sweating (the neck, the back, trunk, thighs). It is often underneath tightly fitting clothing or splints. Heat rash looks like many tiny pink and/or clear-fluid filled bumps on a diffuse pink background.
5. How can heat rash be prevented?
Prevention and management begin with removal of the inciting factors.
Adults often develop miliaria during travel and military service in the tropics or with heavy work-out routines for exercise. Gradual exposure helps acclimatize to the hot and humid environment. Loose-fitting clothing and cool showers may prevent or at least minimize the symptoms if it happens. Showering also plays a role in removing certain strains of bacteria from the skin, overgrowth of which can predispose to heat rash. Cornstarch and other light powders may be used to absorb moisture and minimize the maceration that causes early changes necessary for the development of heat rash. Air conditioning is key. When working out, doing so in an air-conditioned space or outdoors when it is cool (usually in the morning or the evening) is very important.
6. If you have heat rash what should you avoid?
Miliaria is exacerbated by tight clothing and high humidity.
Neoprene, in particular, fails to wick away perspiration from the skin, providing an ideal environment for heat rash.
7. What makes heat rash better/worse?
Heat rash gets better with exposure of the affected skin to air, air conditioning, loose fitting clothing, regular cool showers, light cornstarch powder, oatmeal baths, antihistamines and topical corticosteroids when itchy. It is made worse with continued sweating, hot and humid environment and tight, occlusive clothing.
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