A Prickly Summer Problem

Tempting as it is, scratching an itchy heat rash could lead to a secondary infection

Though it seems harder than ever to get kids to play outside these days, there are some instances in the summer when it’s best for everyone to take a break in a cool, dry place. One of the first signs from your body about the need to cool down is a heat rash.

What is heat rash?

“A heat rash is seen mostly in kids and people who work outside, exposed to the sun and heat for long periods of time,” says Carlos Victorica, MD, of St. Joseph’s/Candler Medical Group – Islands.  “If there is a fair amount of sweat that is blocked from reaching the skin’s surfacing and unable to evaporate, a rash forms.”

Heat rash is also sometimes known as prickly heat or miliaria.

“Small, reddish pimples will appear mostly in an intertriginous area, or a spot where two skin areas touch or rub together, such as the groin or the axilla of the arm,” Victorica says. “The skin will be red and quite pruritic, or itchy.”

How is heat rash treated?

Heat rash most often clears up on its own, but anti-itch creams, or topical steroids for significant irritation, can provide some relief from the itchiness. Patients need to be aware that too much scratching in the meantime could lead to excoriation, or a breaking of the skin. This allows bacteria to gain entry and possibly cause a secondary infection.

“People should monitor themselves for any signs of complications, such the reddish area enlarging or becoming more tender,” Victorica says. “In those cases, the rash should be seen by a physician to investigate further. If the area has become infected, antibiotics may be needed.”

Dr. Victorica also tells parents that a heat rash can be a symptom of broader heat and sun exposure.

“Some sun exposure is great, but we need to be mindful of how much our kids are getting,” he says.  “I try to let parents know that a heat rash could be indicator or a precursor to something more worrisome such as heat cramps or heat exhaustion.”

Prevention of all of these heat-induced conditions naturally involves spending enough time in a cool, dry environment, ideally with looser-fitting clothes that help allow sweat to evaporate.  While keeping yourself dry on the outside is important, Dr. Victorica notes that staying well-hydrated on the inside can help prevent heat rash as well. But sometimes it will be the result of kids simply having fun in the sun and that is to be expected.

“Heat rash will commonly not progress ,” Victorica says. “If you can cool yourself off and treat the rash without scratching too much, it tends to resolve on its own.”

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