Prickly Heat

Prickly heat, heat rash or miliaria is a common condition that occurs mostly in hot and humid weather. It occurs when the sweat ducts under the skin are blocked. This causes the perspiration to remain trapped beneath the skin. Prickly heat can be mild or severe. It may lead to superficial bumps on the skin or deeper, red lumps. The rash may lead to a slight prickly sensation or intense itching. Heat rash is usually a mild condition and subsides on its own. However, in some cases prickly heat may be severe and medical attention is required. In most cases, prickly heat can be easily relieved at home by cooling the skin and preventing excessive sweating.

Symptoms of Prickly Heat

Prickly heat usually develops in the folds of the skin or in places where the skin rubs against clothing. Babies commonly develop prickly heat on the neck and chest. In some cases it can occur on the elbow creases, groin and armpits. There are three types of prickly heat:

  • Miliaria Crystalline: This is a mild form of prickly heat that develops when the sweat ducts in the uppermost layer of skin get clogged. Prickly heat symptoms arising from this condition include small, superficial bumps on the skin that rupture easily. This type of rash does not lead to much itching and pain. It subsides on its own but may recur if the heat and humidity continues. It is common in newborn babies, but can also develop in adults.
  • Miliaria Rubra: This type of rash also occurs in the outer layer of skin, but affects the deeper areas. The term prickly heat is used more commonly used to describe this condition. It can develop in adults following exposure to hot and humid climate. Individuals who are forced to take bed rest due to some other health condition are also susceptible to this rash. Babies may be affected by this rash during the first three weeks of life. The symptoms of miliaria rubra include itching, prickly sensation and red bumps. Sweating may or may not occur in the affected areas of the skin.
  • Miliaria Profunda: This type of heat rash is not very common and usually develops in adults who have recurring miliaria rubra. It affects the deeper layer of the skin and tends to develop soon after any activity that causes sweating. The symptoms of miliaria profunda include firm skin lesions that are flesh colored. Perspiration may be absent and this can lead to nausea, increased pulse rate and dizziness.

In most cases a heat rash subsides on its own and rarely requires medical treatment. However, it is advisable to see a doctor if prickly heat in children continues for several days or if the rash seems to worsen. In some severe cases, prickly heat may even lead to infection. The signs of infection include increased swelling, warmth and pain. There may also be pus formation in the affected area, along with fever and enlarged lymph nodes. In such cases, early medical attention is necessary.

Causes of Prickly Heat

Prickly heat occurs when the sweat ducts under the skin get blocked. This causes the perspiration to stay trapped under the skin, leading to rashes and inflammation. The exact reason why the sweat ducts get blocked is unknown, but the following factors may be involved:

  • Babies do not have fully developed sweat ducts, which may consequently be more prone to rupturing. When this happens, the perspiration gets trapped under the skin. This mainly happens when the weather is hot and humid. It can also occur if babies are wrapped up too warmly in clothes or blankets. Newborns babies that are placed in incubators may also develop heat rash.
  • Hot and humid weather is one of the main causes of prickly heat.
  • Intensive exercise or strenuous physical activity can lead to excessive perspiration and prickly heat rash.
  • Clothing made of synthetic fabrics can be extremely restrictive, limiting evaporation when perspiring and thereby trapping body heat. This increases susceptibility to heat rashes.
  • Intake of certain medications such as blood pressure, acne and ADHD medications has been linked with heat rash.
  • Overheating the body with too much clothing or use of an electric blanket may contribute to prickly heat.
  • Use of oily skin cosmetics can block the sweat ducts and thus result in rash.

Remedies for Prickly Heat

Prickly heat typically resolves naturally, as weather conditions improve, but it can at times be persistent, also depending on the weather patterns of the region you live in. In most cases home remedies will suffice to provide some quick relief, but in severe cases it would be best to consult with your doctor. While most home remedies remain untested and are unlikely to offer much help, some have been supported by research and others could at the very least offer some respite from the symptoms. The most common remedies for prickly heat include:

  • Add some oatmeal to your bathwater and soak in it for a while. Oatmeal helps to alleviate inflammation and itching.
  • Dust talcum powder on your skin after your bath or after a shower. This will absorb excess moisture from the body and prevent prickly heat. It is advisable to use non-perfumed talcum powders.
  • Apply aloe vera gel to affected areas to soothe redness and inflammation. The anti-inflammatory properties of aloe vera have been well established by various studies.
  • Apply a cold compress to the affected skin to bring down the temperature and cool the skin. This will also reduce swelling and redness.
  • Make a paste of gram flour and a little water and apply to the skin rash. Leave it on for about fifteen minutes and then wash off with cool water.
  • Combine one teaspoon each of sandalwood powder and coriander and apply to the affected area.
  • Fuller’s earth is a highly beneficial treatment for prickly heat. Add about four tablespoons of fuller’s earth to a couple of tablespoons of rose water and apply to the affected areas. Leave it on for two to three hours and then rinse with cold water.
  • Prepare a paste with margosa leaves and water. Apply to the affected skin and let it dry. This will relieve itching and inflammation.
  • Dip a clean wash cloth in a solution of cool water and baking soda and apply it to the affected skin.
  • Avoid scratching the affected areas as this may cause skin lesions that could get infected.
  • Wear light, comfortable clothing especially when the weather is hot and humid.
  • Drink plenty of water to keep your skin healthy and hydrated.
  • Keep your skin clean by washing regularly, but avoid using harsh soaps.
  • Avoid using heavy skin creams and moisturizers.
  • Take a slice of raw potato and gently dab it over the affected areas.
  • Boil some freshly grated ginger in water and allow it to cool. Then dip a sponge into the solution and dab over the affected skin.

Diet for Prickly Heat

The following dietary measures help in dealing with prickly heat:

  • Drink plenty of water and fresh fruit and vegetable juices. While an average recommended intake of 8 glasses is recommended, this varies greatly depending on various factors.
  • Consume cooling foods such as cucumber, lettuce, celery, beetroot, carrots, apples and lettuce.
  • Drink an herbal tea made with nettle leaves. This helps to cleanse the liver and serves as an excellent remedy for heat rash.
  • Drink buttermilk during hot summer months as it helps to increase the hydration levels in the body.
  • Add coriander powder to water and drink daily. This helps to combat various types of heat rash.
  • Make it a habit to drink coconut water on an empty stomach daily.

Suggestions for Prickly Heat

Protect yourself from prickly heat with the following tips:

  • Dress in light, cotton clothing during the summers. Avoid donning too many layers of clothing. Make sure that you dress your children in light, comfortable clothes as well.
  • Avoid wearing tight fitting clothes or garments made of artificial fabrics. These can prevent air circulation and can irritate the skin.
  • Try to stay in an air-conditioned environment when the climate is too hot. You can also use a ceiling or table fan for air circulation.
  • Ensure that your sleeping environment is cool and well ventilated.
  • Use cool water for bathing and avoid using harsh, drying soaps. Herbal soaps and skin cleansers are ideal for skin that is prone to heat rash.
  • Avoid using ointments or creams in hot weather. These can clog the pores and make your skin prone to prickly heat.

Prickly Heat - Frequently asked questions