Treatment For Prickly Heat Rash and other Heat and Humidity
Related Skin Conditions
Prickly heat rash, also referred to as Miliaria, is a common skin
disease, typically brought on by overheating due to high heat and
humidity. It can appear anywhere
on the body. This and other heat and humidity related problem
such as Tropical Acne, Hypohidrosis syndrome and Cholinergic Urticaria
are particularly common in tropical
climates. While most of these conditions usually heal on their
own, it may cause a short
circuit in the body’s heat-regulation ability, leading to illness. It
is quite common in infants, small children and physically active people
at work or that exercise ."
What is Prickly Heat Rash
As outside temperatures increase, and body heat increases
above normal levels, the body seeks to cool down. When the
sweat glands cannot keep up, as as humidity in the air decreases the
ability of sweat to evaporate, the body heats even more. With sweat,
water levels and salt levels in the body decline, leading to
dehydration. Said another way, when outside temperature is
higher than body temperature, the skin temperature will rise unless
cooled by water or circulating air.
The result of inefficient cooling are heat related skin
problems such as prickly heat. Other conditions that are also
heat related include cholinergic urticaria, tropical acne and
The causes of
prickly heat include the following:
- Plugged sweat ducts, with bacteria from the staphylococcus
present on everyone’s skin
- Plugged hair follicles, with bacteria from the
present on everyone’s skin
While it may seem like a minor problem, to have plugged sweat
and/or hair follicles, when they are plugged, they form tiny, clear,
almost translucent watery bumps, that sting like the dickens when they
burst. This is due to the salt in your sweat. Not only is sweat a skin
irritant, it has the potential to cause skin rashes.
Prickly Heat Rash
(Miliaria crystallina) Picture. Note the superficial skin
vesicles, with no noticeable skin inflammation. Treatment is
not required and the condition only lasts for a short period of time.
Source: Borden Institute, US Army
Prickly heat normally looks like a series of pointy, small bumps,
located at the base of small hair follicles. You may see pink or red
patches of skin initially. If your rash progresses, you may develop
angry, raised red bumps, hives and skin welts and have an insanely
irritating itch. Some people don’t experience the itch.
You may find prickly heat rash on various body parts, such as the:
- Elbow folds
- Under the breasts
Symptoms of Prickly Heat Rash
The first signal that you may have prickly heat is the red
rash and small blisters in various locations on your body.
often, the blisters will appear all at the same time. There are four
categories of prickly heat rash, usually graded by what layer of skin
they affect. Those categories are:
You may have signs and symptoms that include the following:
crystalline: no rash, just tiny blisters, minor, if any
symptoms. Heals on its own in a short period of time.
- Miliaria rubra:
most common form, where blockage causes sweat to
leak into deeper layers of the skin, producing red rash which are
capped with blisters (vesicles). Itching, prickly sensation,
no sweating in those areas. Heat
exhaustion is a possibility. Treatment is required to keep
the condition from becoming severe and then spreading to other parts of
profunda: this is a severe form of prickly heat rash that
develops as the result of Miliaria rubra. It spreads like
with a severe burning sensations. Blockage is deep in sweat gland,
leaks into the deep layers of skin. Rash is skin colored; not red.
Higher risk of heat exhaustion.
pustulosa: pustules formed as a result of bacterial
infection. Inflammation. Very high risk of heat exhaustion.
IT is always the result of some other type of skin
inflammation that effects the sweat ducts.
Miliaria pustulosa is a type of prickly heat that results in discrete
skin papules that are not associated with hair follicles. It occurs
after other forms of dermatitis (skin inflammation) that impacts the
Source: Borden Institute, US Army
- small red rash areas, or papules, which may itch and
cause a prickling feeling
- small red rash areas, which may not itch
- larger areas of lesions that are flesh colored and may
Diagnosis of Prickly Heat Rash
Typically, prickly heat rash will go away on its own. The
best approach is to stay out of the heat and stay hydradated.
If you are in the heat, try and work in the shade and near a
circulating fan or in circulating air.
However, if your
rash doesn’t go away, it’s time to call your doctor. If you have the
mild form of prickly heat rash, it will be evident on visual
examination. The same holds true for the other forms of prickly heat
rash; again, diagnosed on appearance and by your answers to questions
about heat exposure.
If you have one of the more advanced forms of prickly heat rash, the
doctor may want to take a skin culture, skin biopsy or exam skin
scrapings to examine under a microscope. If the results are
inconclusive, they may also get tests done for eczema, fungal
infections, allergy reactions and bacterial infections.
If you have any of these
following symptoms, go to the doctor
Prickly Heat Rash Treatment
As mentioned, prickly heat rash will heal on its own. To
bring relief and to speed healing consider the following options:
- Drink lots of water to assist your body in cooling down and
- Lower the temperature in your home
- Wash the area several times a day, with mild soap for
rinse and pat dry.
- Try cool showers or baths
- In areas where you have skin folds, tuck a clean piece of
- Use a package of frozen corn or ice gel packs directly on
area(s), but do not leave them on any longer than 10 minutes on and
then ten minutes off and repeat, or you run the risk of an ice burn
- If you have more than a mild case of prickly heat rash, try
hydrocortisone ointment found in your local pharmacy
- If you have more than a mild case of prickly heat rash, you
may get a
prescription cream from the doctor, such as triamcinolone
- If you have a bacterial infection, your doctor may give you
- You may also wish to try antihistamines (Claritin or
tackle the itching
- Aloe vera
- Honey paste
- Lavender essential oil
- Cool oatmeal baths
- Cool Epsom salts baths
- Try a homeopathic remedy that supports skin health such as Clear
Other Heat Related Skin Rashes
syndrome (tropical anhidrotic asthenia) occurs when the
body stops sweating, or only sweats excessively in one area of the body
such as the face. Treatment involves rest and in a cool area
over several weeks. Recovery can take as long as 4 months.
Symptoms at the onset of Hypohidrosis syndrome is similar to
prickly heat rash, and then becomes scaly.
- Tropical Acne
also occurs in hot climates where there is also high levels of
humidity. It appears in individuals that had mild acne when teens, only
to see tropical acne erupt later in life. It usually starts 3 to 6
months after moving to a tropical climate and is more prevalent in
adults age 25 to 30. Symptoms include skin lesions that are
large, inflamed and pus filled. Areas of the body include the
upper thighs, buttocks, the entire torso (back and front), neck and
arms. The patient will feel sick. Treatment
involves moving to a cooler climate with lower levels of humidity.
Medications are available for treatment.
Urticaria is very common, particularly in younger adults.
It is also triggered by high heat, particularly when exercising or in
times of stress. Individuals suffering from cholinergic
urticaria will feel warm, followed by the appearance of skin wheals
(1mm to 3mm in diameter). Other cholinergic urticaria symptoms include
headache, nausea and pain in the abdomen). The wheals appear on the
torso, but can appear in other areas of the body when the condition is
chronic (severe). Treatment involves removal from the heat,
and no exercise. Antihistamines may be helpful.
Skin Diseases Associated with Excessive heat, Humidity and Sunlight
Leonard Sperling, M.D.