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30 years
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I have a prickly heat rash at the bottom of my back that comes back every summer. What to do? Will a moisturizing cream be useful?
Oct 21, 2014
2nd opinion

Dr. Zakia Dimassi Pediatrics
Prickly heat rash, also known as miliaria rubra, is a type of itchy rash that consists of small, raised red spots that produce a stinging or prickling sensation on the skin.

Prickly heat can develop anywhere on the body, but it is most common to occur on the face, neck, back, chest and thighs. It usually appears a few days after exposure to hot temperatures.

The rash consists of tiny spots that are surrounded by an area of red skin. The spots sometimes look like tiny blisters and can cause mild swelling, itching, and a stinging or intense prickling sensation.

Prickly heat rash usually appears when a person sweats more than usual, such as during the summer. But it is not uncommon for it to occur during the winter months.

The rash is the result of the blockage of sweat glands. With excess sweating, the rate of sweat production exceeds the rate of sweat evaporation off the skin surface; this can lead to sweat trapped beneath the skin. The trapped sweat causes skin irritation and the characteristic heat rash.

The symptoms of prickly heat are usually worse in areas that are covered by clothing. This is because clothing may increase sweating and cause friction.

Being in a hot environment where sweat is more than usual predisposes to having heat rash. Other risk factors include:
-illness: being bed ridden for long periods of time can make you sweat more, especially if you have warm bedding
wearing too much clothing, particularly in the winter
-sitting too close to a fire or heater
-being overweight or obese – which is more likely to lead to excessive sweating

Prickly heat is a benign self limited condition that does not require any specific treatment. To alleviate the symptoms, you can do the following:
1- Avoid excessive heat and humidity whenever possible – if you need to go outside, spend time in the shade or take a small fan with you so as to avoid excessive sweating. Drink plenty of fluids to avoid dehydration.
2- Wear loose cotton clothing – avoid wearing synthetic fibers like polyester and nylon, which are known to trap heat.
3- Keep your skin cool – a cool bath or shower will cool you down.
4- Staying in an air-conditioned room.
5- Use calamine lotion – it helps soothe irritated skin.
6- Keep your skin moisturized
7- Topical hydrocortisone cream in case you get very itchy and irritated areas of skin. This is to be used only if the symptoms are severe, only for a few days, and never on the face.
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