Heat rash, or prickly heat or miliaria, or sweat rash is a non-contagious, self-limiting skin condition seen most often in babies and young children. It generally occurs during hot and humid weather conditions, when the sweat gland openings get blocked (1).
However, it can also occur during winters if your baby is wearing too many layers of clothing, which can block ventilation to the skin (2). This results in the development of heat rash around the sweat duct openings, causing irritation and distress and making the baby fussy (3). As a parent, you might be looking for treatment or home remedies to comfort your baby.
In this post, MomJunction tells you about heat rash, its causes, treatment, and prevention.
Causes Of Heat Rash In Babies
According to Dr. Jody A. Levine, parents’ advisor and director of dermatology at Plastic Surgery & Dermatology of NYC, “Heat rash develops when sweat becomes blocked, which is common with infants, and is trapped under the skin.” Perspiration allows the dead skin cells and bacteria to clog the sweat glands, trapping the sweat under the skin, resulting in characteristic bumps. A stinging or prickling sensation can be felt when these bumps burst to release the sweat.
Usually, babies develop heat rashes during hot or humid environment, when the body tends to show excessive perspiration. But, some other factors might contribute to heat rash (4):
- Fabrics that do not allow sweat to evaporate from the skin
- Overdressing a child or dressing in heavy fabrics in the weather which do not allow ventilation.
- Sleeping under too many blankets
- Use of oils, thick creams or ointments, which can block the sweat ducts
- Immature sweat ducts, such as in a newborn
- Prescription medications that increase sweat gland function
How To Identify Heat Rashes In Babies?
Heat rashes appear as clusters of small white, red, or pink bumps or dots, and are similar to blisters or pimples. They are typically not painful but can be uncomfortable, itchy, and cause crankiness or restlessness in babies, besides creating a tingling or pricking sensation.
As heat rash has different types, it is always wise to know about them in detail (5).
1. Miliaria rubra:
This is the most common type of heat rash frequently observed in neonates up to three weeks of age. However, it is also observed in adults living in hot and humid conditions. This type of rash is caused by the blockage of the sweat glands near the surface of the skin. It appears as red bumps accompanied with itching.
2. Miliaria crystallina, or sudamina:
This type of miliaria affects neonates with highest occurrence at two weeks of age or less. However, it could also be seen in adults living in warmer climates. It is the most benign form of heat rash that also happens due to the blockage in the sweat glands. This type of heat rash causes tiny blisters which could be clear or white in appearance.
3. Miliaria profunda:
This type is the rarest and very uncommon. It is observed only in people who have recurrent episodes of miliaria rubra. It happens when baby’s sweat seeps inside the skin causing intense burning sensation.
In infants, a heat rash usually develops on the neck, armpits, elbow creases, and groin — areas where the skin folds are seen. In older children, it can also occur on the chest and back. The rash does not typically involve the eyes, nose, mouth, palms, or soles (4). It may even be found on the scalp or head if the baby wears a hat or cap.
There are some home treatments that you may try to get symptomatic relief from the condition. However, it will be ideal to have a pediatric consultation before trying any home remedies to avoid complications.
Home Treatment For Heat Rash In Babies
As you look for home remedies, remember that the key to eliminating heat rash lies in keeping the baby cool and the skin ventilated. These home remedies could help in making your baby comfortable but do not warrant complete relief from the rash.
- Cool bath: Cooling the skin helps in soothing skin affected by heat rash. After bath pat or air dry the skin gently. Remember to dry all the baby’s skin folds after every bath.
- Prevent sweating: Ensure to use a fan or an air-conditioner or natural breeze. to prevent sweating. Proper ventilation is crucial to aid the healing of heat rashes. Keep the baby in a ventilated room and avoid areas with too much congestion.
- Ice pack: To calm itching, you can apply cool damp cloth or ice pack on to your baby’s skin for no more than 20 minutes. Pat the skin rather than scratching as the same can cause more itchiness leading to increased discomfort (5).
- Wear light fabric: Dressing the baby in a lightweight, breathable fabric can help in providing some relief by limiting frictional itching of the rashes. For example, cotton, a fabric that is lightweight and breathable. You can also try for fabrics that are moisture-wicking or anti-sweating like bamboo fabric.
- Oatmeal: Conferred by its chemical heterogeneity, colloidal oatmeal is promoted for its moisturizing, cleansing, antioxidative, and anti-inflammatory properties. The topical application of colloidal oatmeal powder while bathing could aid in soothing your baby’s skin (6).
- Calamine lotion: Calamine lotions contain zinc oxide as their prime ingredient. The use of zinc could provide relief from itching because of its soothing properties (7). Consult a pediatrician before buying a calamine lotion to understand its proper use.
- Antihistamine and hydrocortisone: Some topical antihistamine medications can relieve itching (8). Likewise, topical hydrocortisone creams that available over the counter could also relieve itching (9). They are to be used only in severe conditions.These medications are available over the counter, but may have some probable side-effects, and must be used after pediatric consultation only.
While you use home remedies for your baby, be cautious of any side-effects or possible allergies. Seek medical help in case the rashes do not seem to reduce.
When To Seek Medical Attention?
Fortunately, heat rash does not require medical attention in most cases. But, in very few cases, the rashes might persist or even spread. Seek medical attention if:
- The rash seems to get worse
- Rashes do not subside within two to three days
- Blisters look swollen or ooze pus
- Symptoms of the infection are found (usually happens due to scratching)
- The baby, under three months, has a 38°C or higher fever
- The baby, between three and six months, has a 39ºC or more temperature
- Red streaks extend beyond the affected area.
Are Heat Rashes Serious?
Heat rashes are not serious but indicate that your baby is too warm. In rare and serious cases, prickly heat rashes may interfere with the heat-regulating system of the body, causing heat exhaustion. It rarely leads to an extreme medical emergency called ‘Heatstroke,’ when the body fails to cool by itself. And excess warmth by covering the baby with too many blankets may increase the risk of Sudden Infant Death Syndrome (SIDS), according to a few studies (10).
Ways To Prevent Heat Rashes In Babies
The effective way to prevent heat rashes in babies is to keep the skin dry and cool.
- Avoid hot weather or more time in sling or carrier. Head to shades if you are outdoors. Avoid direct sunlight.
- Loosen your baby’s clothes and try to keep the baby in a cool area.
- Keep the indoors cool. Have proper ventilation for fresh air to flow in.
- Use fans or air conditioners whenever possible to keep air circulating.
- Ditch heavy clothing. Prefer loose, light cotton clothes. Natural fabrics like cotton would wick moisture away from the skin at the same time, give enough space to breathe. The best thing to do is to dress your baby as you would dress yourself for that weather.
- Avoid plastic diaper liners or pants. Leave the baby diaper-free for some time during the day.
- Lightly dust cornstarch, but avoid talcum powder, especially scented talcum powder, as they might increase irritation.
- Keep babies below six months of age well hydrated, by frequently offering breast milk or formula.
Next, we answer a few commonly asked questions about heat rashes in babies.
Frequently Asked Questions:
1. Are there any tests for heat rash in babies?
The diagnosis of heat rashes happens through clinical examination. Unless some other symptoms, such as fever, are accompanying rashes, no specific tests are needed for heat rash.
2. Can I use baby powder for heat rash?
Baby powder is usually a milder astringent effective on baby rashes. You dust baby powder to keep the skin dry and sweat-free. But avoid perfumed talcum powder or those containing asbestos, dyes, or harsh skin irritants.
3. How to differentiate between eczema and heat rash in babies?
The primary cause of heat rash is clogged sweat glands. Eczema in babies is a result of allergens present in the surrounding environment. Heat rash heals a lot faster than eczema (11) (12). Eczema rashes have different presentations on different babies. Typical signs of eczema rash in babies could be as below.
- Even though they are like red bumps similar to that of heat rash, they might be dry, scaly, and itchy rashes around the neck, face, mouth, eyes, arms, legs, upper body, etc.
- Eczema is found even on the chin and cheeks of babies who tend to drool.
- Eczema is localized
Heat rash in babies is fairly common. It is a self-limiting condition and seldom raises grave concerns. But to avoid the discomfort that babies experience because of it, prevention is the best way. It is wise to consult a pediatrician for treatment and before using any of the home remedies we have discussed earlier. A baby’s skin is delicate and sensitive and could be vulnerable to skin issues. Maintain hygiene and follow a healthy skin care regimen to prevent any skin conditions.
How did you deal with heat rashes in your baby? Share your experience with us in the comments section below.
2. Skin care for your baby; National Center For Biotechnology Information (2007)
3. Babies and heat rashes; National Institute of Health; U.S National Library of Medicine
4. Does Your Child Have a Heat Rash? Cool It Down — Here’s How; Cleveland Clinic
5. Heat rash (prickly heat); National Health Service, UK
6. Maryline Criquet et al.; Safety and efficacy of personal care products containing colloidal oatmeal; National Center For Biotechnology Information (2012)
7. Mrinal Gupta et al.; Zinc Therapy in Dermatology: A Review; National Center For Biotechnology Information (2014)
8. Itching; National Health Service, Scotland
9. Hydrocortisone for Itching; University of Michigan Health
10. Sudden Infant Death Syndrome (SIDS) and Other Sleep-Related Causes of Infant Death; NIH
11. Eczema: Overview; National Center For Biotechnology Information (2013)
12. Karla C. Guerra and Karthik Krishnamurthy, Miliaria; National Center For Biotechnology Information (2018)
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