How to distinguish heat rash from allergies - recommendations from La Cree

Last update: 02/21/2021

Allergic reactions often cause various skin manifestations - rash, redness, irritation or swelling. Allergic dermatitis can often be difficult to distinguish from other skin conditions, such as infections or hives. Allergies are especially often confused with prickly heat, which occurs due to poor hygiene or temperature conditions.

What is the difference between prickly heat and allergies and how to determine which disease a child or an adult is suffering from? In order to answer this question, it is necessary to know the causes and symptoms of each disease and the characteristics of their course. In addition, the photos of heat rash and allergies presented on this page will help you.

General information

Miliaria is a form of dermatitis.
This is a non-infectious skin lesion, which is associated with increased function of the sweat glands when the body overheats and profuse sweating. Miliaria is considered a childhood disease, which is associated with imperfection and instability of skin thermoregulation: heat transfer prevails over heat production, and the sweat glands do not function sufficiently. This makes it difficult to maintain body temperature at a constant level. The anatomical features of children's skin (thin stratum corneum of the epidermis, structural features of sweat glands with narrow excretory ducts) make children very susceptible to the appearance of heat rash , which can develop in the first months.
Despite this, prickly heat also occurs in adults and occurs after exposure to heat, physical activity, or wearing clothes that are out of season. Miliaria is considered a physiological condition if it is not accompanied by complications. In adults, it has a slightly different localization (under the mammary glands, in the perineum and between the legs), can cause discomfort in everyday life, and given the possibility of a secondary infection, it requires timely treatment.

When and which doctor to contact

The patient copes with the first stage of prickly heat on his own. If severe swelling, crusts and pustules appear, the help of a dermatologist is required. After communicating with the patient, studying his medical record, and external examination, the doctor determines the cause of the condition and suggests measures to eliminate it. You may need to donate blood for a general analysis or to determine hormone levels.

The underlying disease is treated simultaneously with the elimination of signs of prickly heat. Medicines are prescribed by a doctor. Folk remedies are also used after its approval. If you are obese, you may need the help of a nutritionist. If the disease is associated with ovarian dysfunction during menopause, consultation with a gynecologist is advisable. Self-medication often causes serious complications, defects on the skin of the face and other parts of the body.

Pathogenesis

The sweating system is involved in the thermoregulation of the body, therefore, when the ambient temperature rises, the function of the sweat glands is significantly activated - intense sweat production helps cool the skin, and thus the body is protected from overheating. The same mechanism is activated when body temperature increases due to illness, physical activity, wrapping and thermal procedures. Intense sweating often leads to blockage of the sweat gland ducts and the development of prickly heat. Miliaria occurs especially often in newborns and children under one year old, since their sweat glands are not fully formed and have.

How to cure with folk remedies?

There are quite a few effective traditional medicine recipes that can help in the fight against excessive sweating. Among them are:

• Infusion of chamomile, string or calendula. Such herbs have excellent antiseptic, anti-inflammatory and drying qualities. 1 tbsp. l. of the selected herb, brew 1 tbsp. boiling water and leave covered for 30 minutes. Strain the finished infusion and use for lotions and wiping the affected areas.
• Soda solution. As soon as a sweat rash appears on the body, you can try to remove it with a soda solution. 1 tsp. Dissolve regular baking soda in 1 tbsp. warm water and use to wipe the skin 3-4 r. for a day.
• Alcohol tincture of calendula. It can be purchased at a pharmacy and used to prepare a solution. 1 tbsp. l. Dilute medications in 1 tbsp. warm heated water and use to wipe the affected skin up to 8 times a day.
• Bay leaf decoction. Brew 15 dry leaves with 1 liter of water and put on fire. Bring the product to a boil and simmer for 15 minutes, then cover with a lid and leave for another 40 minutes. for insisting. The finished medicine should be poured into a bathtub with warm water. Take such baths every other day or even every day for 15 minutes.

Treatment at home using traditional medicine techniques can be an excellent alternative to pharmaceutical drugs, if only prickly heat is at an early stage of development and is not accompanied by complications.

Classification

According to the clinical course, it happens:

• Miliaria crystalline (superficial).
• Miliaria rubra.
• White (papular)
• Yellow.

In the crystalline form, superficial blockage of the ducts occurs. Bubbles up to 1 mm with clear liquid appear on the skin, which easily open with the formation of peeling. The rash is localized in adults on the torso, and in children - on the body, face and neck.

Red is the most common type, appearing in hot weather in adults and with increased sweating in children. It is characterized by the appearance of red itchy spots with papules and papulo-vesicles. With this form, the level of blockage of the ducts is deeper. Localized in skin folds and infection is possible. When white, milky white blisters appear, which is associated with infection with coccal flora. With yellow, true blisters with yellow pus appear located inside the epithelium.

Rashes occur at any time of the year, but most often during hot periods, which is associated with increased sweating. With any type of rash, most often appear on closed areas of the skin, which sweat a lot under clothing and are additionally irritated by friction - the elbows on the arms, armpits, inguinal and intergluteal folds. In children and adults, irritation occurs in the mouth when in contact with synthetic “non-breathable” fabrics (bandages, clothing or low-quality diapers). With severe sweating, rashes appear on the face (mainly on the forehead), neck and head, which is accompanied by itching . If hygiene is not observed, complications can occur - vesiculopustulosis and sweat gland abscess .

Treatment

Miliaria can occur at any time of the year, but most often it manifests itself during the hot period, when we sweat a lot. It can also appear on vacation in warm countries. It is necessary to treat prickly heat, and as soon as possible. You can get rid of a mild form in one to two weeks. In severe cases, the sweat glands become depleted over time, leading to dry skin. Against the background of deep heat, infection and microbial eczema may occur. But it is much more difficult to deal with it - treatment can take years. This is another reason why you should get tested without delay. In newborns, during the treatment of prickly heat, you should discard the cream, replacing it with powder, which will absorb excess moisture and allow the skin to breathe. You can add chamomile decoction to bathing water, which soothes the skin and helps restore it. And don’t forget about the need for daily air baths. Sometimes it is recommended to treat the skin with zinc oxide powder or salicylic-zinc ointment, but such treatment must be prescribed by a doctor. Treatment of prickly heat in adults begins with eliminating the factors that caused it. Of course, nothing can be done about the hot weather, but if you are one of the people with excessive sweating, you can still make your life easier. Choose loose, non-restrictive clothing made from natural materials, and if necessary, use cosmetic talc in areas where clothing or underwear may rub the skin. On hot days, you should not use cosmetics that can clog pores or greasy creams. It is better to limit yourself to water-based lotion. Skin affected by prickly heat must be wiped with an antiseptic - for this, alcohol solutions of salicylic or boric acid, or a weak aqueous solution of potassium permanganate are used. To reduce itching and swelling, antihistamines are prescribed - tavegil or suprastin.

Causes

Some of the reasons for this condition include:

• Increased sweating due to dysfunction of the apocrine glands.
• Infectious diseases with fever and increased sweating.
• Endocrine diseases: diabetes , hypothyroidism and hyperthyroidism .
• Neurological diseases.
• Excess weight.
• Lack of hygiene.
• Hard physical work in a hot climate.
• Wearing clothes out of season (especially synthetic clothing).
• Skin injuries and abrasions.
• The use of oily foundation and nourishing creams in the summer, which creates artificial blockage of pores.

If we consider the causes of prickly heat in children, we can say that its appearance is caused by:

• Overheating of a child by wrapping.
• High temperature in the room.
• Rare diaper changes.
• Rare water and air procedures.
• Use of synthetic clothing.
• Use of low-quality skin care products.
• Frequent use of soap.

Why does it often occur in newborns?

If your baby has heat rash, don’t worry, because you can get rid of it quite quickly if you follow simple rules for caring for your child’s skin. Just try to start treatment as early as possible so that the process does not reach a serious stage.

Usually prickly heat in babies occurs in the summer heat. But, if you are used to wrapping your child in a blanket that is too warm in winter and spring, then it may appear in the cold season. When a baby's sensitive skin is severely irritated, a small red rash appears on it - the main sign of heat rash.

Why is the skin of newborns prone to prickly heat? It's all about unformed sweat glands, which will begin to work in normal thermoregulation mode only by the age of 5-6 years. In addition, children's skin is still very thin and sensitive, it has very powerful blood circulation, and it consists of 85% water (unlike adult skin, which retains only 65% ​​moisture).

The processes of constriction and dilation of blood vessels, which occur quickly in an adult body, are still slowed down in a child’s body - so thermoregulation also occurs very slowly. This is why the newborn’s body overheats and becomes hypothermic instantly.

Symptoms of prickly heat

When considering the symptoms of prickly heat in adults, it should be noted that the rashes come in the form of papules (nodules) or blisters with contents. What does prickly heat look like in adults? Several types of rashes are possible. Miliaria crystalline appears as pearly blisters 1-2 mm in size, which can merge into larger formations.

Within a few hours, as a result of minor exposure, the vesicles open, dry out and form flaky areas. This type occurs in newborns on the face and neck. If we talk about adults, common locations are the chest, back, legs and arms on the flexor surface.

Miliaria rubra looks like red nodules of the same size. The nodules on the periphery are surrounded by an inflammatory halo, so the skin looks sharply hyperemic. This form involves large areas of skin. The rash may fill with clear fluid, forming vesicles that do not merge with each other. Purulent contents may appear.

Patients are concerned about itching, which intensifies with sweating and an increase in ambient temperature. This type appears in adults in hot weather or during physical labor. Areas subject to friction are affected: inguinal folds, under the breasts, axillary area, elbow and popliteal folds.

Papular (deep) is a severe form that lasts a long time and affects the ducts of the glands at the level of the dermis. It is considered as a consequence of red in the absence of treatment. The gland ducts become clogged with epithelium, and non-itchy papules resembling “goose bumps” appear on the skin.

The rashes are located on the torso, arms and legs. This type affects people who are poorly adapted to heat. It is found in tropical countries, which is why it is also called “tropical”. Papules increase when exposed to sweat, and when an infection occurs, microbial eczema .

Symptoms of pustular miliaria are characterized by the appearance of purulent contents in the blisters - small pustules (pustules) of varying degrees of severity appear on the skin.

This disease is called vesiculopustulosis . If the process is widespread, the temperature and malaise may increase (especially in children). After opening the pustules, purulent crusts appear, which, when rejected, do not leave scars or spots. In general, the process can take 10 days.

Prickly heat under the chest

Irritation and rashes appear when sweating and rubbing the skin with a bra. Considering that the skin here is delicate and sensitive, the process spreads quickly. Against the background of general redness, small papules appear above the skin.

The skin burns and itches, and the itching intensifies with sweating, which is accompanied by constant discomfort. The integrity of the skin is not compromised.

Miliaria in the groin in men

This problem is quite common in men and occurs more often than in women. This is due not so much to a sedentary lifestyle, but to wearing trousers in the hot season, which do not always meet the requirements for wearing cotton clothing. Wearing synthetic underwear also contributes to inguinal-perineal hyperhidrosis. For this reason, this disease may occur in men on the head of the penis or on the pubis. If its manifestations are ignored, the skin lesion spreads rapidly and invades new areas. This is how heat rash appears on the penis, around the anus. Scrotal hyperhidrosis is the most difficult to tolerate .

Miliaria rubra in the groin, scrotum and penis is manifested by inflammation of the upper layer of skin and the formation of a small rash. The affected area appears red, and discomfort occurs when moving or touching clothing. Occasionally itching may occur. In constantly moist and “unventilated” places, favorable conditions are created for infection by bacteria, so prickly heat is complicated by purulent inflammation, and scratch marks turn into weeping wounds.

When is urgent pediatrician care needed?

• if, subject to hygiene rules and treatment, the rash does not go away after 3 days;
• if the rash interferes with the child’s normal sleep, causes itching, pain and anxiety;
• if there is serious inflammation and swelling at the site of the rash;
• if ulcers with an unpleasant odor or cracks have formed in the affected areas;
• if the baby has a fever;
• if prickly heat in an infant continues for more than three days, and instead of improvement (drying out of the rash), the opposite process occurs (yellow or white liquid appears inside the blisters, the scale of the rash increases, and the child behaves very restlessly), consult a pediatrician immediately;
• If bloody contents are released from the rash, and the baby begins to vomit, call an ambulance immediately.

Such symptoms may signal an infectious process, and it will be difficult to cope with it without the help of a doctor. Contact your pediatrician: he will either prescribe treatment on his own or refer the child for a consultation with a dermatologist.

Miliaria in children

The skin of children differs in structure from the skin of adults, and the subcutaneous fatty tissue is loose. Despite the fact that sweat glands are formed in the 4-5th month of development, they begin to function in adolescence. In this regard, thermoregulation is impaired, which is especially evident in infancy. Excessive sweating when a child overheats causes dilation of the excretory ducts of the glands and the formation of cysts, which is manifested by prickly heat . Thus, immaturity of the skin and improper care are the main causes of this condition. In newborns, prickly heat can be considered a borderline skin condition.

What does prickly heat look like in children? Miliaria appears as red dotted spots, nodules or transparent bubbles the size of millet grains, which are localized on the torso, neck, folds, lower abdomen and buttocks.

Photos of prickly heat in children

Symptoms of prickly heat in children, in addition to rashes, may include slight itching, but most often it does not cause discomfort to the child and the general condition of the baby is not affected.

What does prickly heat look like in newborns?

When overheated, obese infants often develop rashes that vary in nature. Crystalline prickly heat in infants looks like small transparent millet rashes localized on the face, neck and butt. Wearing a support collar can cause rashes on the neck. They are located scatteredly. In another form (miliaria rubra), abundant red nodules with a red rim around appear on the skin.

Characteristic localizations of rashes in children of different ages

Rashes on the butt and groin appear when using diapers that do not allow air to pass through, in the summer, with infrequent diaper changes and the absence of air baths. Heat rash on the face of a baby often causes discomfort - it can itch. Damage to the rash by active hand movements results in the formation of a flaky crust on the surface of the rash.

Miliaria in newborns with insufficient care quickly turns into white heat. These are bubbles filled with milky white contents that can be located on the face of newborns, skin folds, on the head and torso. Blisters of miliaria alba are located on reddened skin and are a manifestation of staphylococcal infection ( vesiculopustulosis ).

Treatment of prickly heat in children

Treatment begins with proper care. You can get rid of prickly heat in a newborn if you constantly follow the following rules:

• Ventilate the room several times a day.
• Maintain the air temperature in the nursery at 20-22 C and normal humidity (45-60%), since the baby does not tolerate dry air well (the loss of fluid from the body increases and overheating occurs).
• The side walls of the crib should allow air to pass through easily.
• The right choice of clothing - it should protect against heat loss, but not cause overheating, be natural, not restrict movement and be appropriate for the season.
• Daily morning toilet - treatment of folds with a tampon soaked in baby oil.
• Daily bathing with the addition of a decoction of herbs (chamomile, string, calendula). Use detergents no more than 2 times a week. The skin should be thoroughly dried, especially the folds, using blotting movements.
• Protection against irritating factors involves the use of powder or cream. Powdering prevents the skin from chafing, but it should be done in moderation, since using too much powder clogs the pores and inhibits sweating. Do not use baby oil in excess, as it makes it difficult for the skin to breathe.
• Use high-quality diapers that absorb waste well, keep it inside, and keep the baby’s skin dry.

How to treat prickly heat in children at home?

If to treat crystalline prickly heat it is enough to adjust your daily care, then for red prickly heat you need to use additional remedies. The main treatment for this condition is the use of baby powder. These can be powders based on talc and zinc, or they can be natural. You can use Babycoccole drying lotion (this is liquid talc), which eliminates heat rash, diaper rash , softens the skin and moisturizes due to chamomile bisabolol and vitamin F , linseed oil .

Some mothers try to choose organic powders that do not contain talc, since some studies have proven its adverse effects on the body. White clay (kaolin), flour from arrowroot root, and chamomile, lavender or calendula flowers ground into flour are indifferent in this regard. For prevention and at the first symptoms, you can use Flofeta Baby gel , which contains liquid extracts of chamomile , calendula , witch hazel , glycerin , polysorbate , and does not contain zinc oxide or talc .

Due to the increased absorption function of the skin on the face and head, it is important to carefully select drugs for external treatment. Treatment of prickly heat in newborns consists of using a solution of Furacilin and a weak solution of potassium permanganate to wash the affected areas. For treatment, preparations based on zinc oxide are used, which has an anti-inflammatory, astringent (drying) and antiseptic effect:

• Sanosan cream contains panthenol , zinc oxide , olive oil .
• "Weleda Calendula and Chamomile Extracts" . The cream contains zinc oxide, lanolin, glycerin, almond oil, sesame oil, calendula and chamomile extracts, beeswax, clay. The cream dries well, eliminates redness and irritation.
• Zinc paste , which is more acceptable for children because it is softer and more delicate in consistency than ointment.
• Emulsion Tsindol .
• Cream Belobaza Zinc . In addition to zinc oxide, this cream contains bisabolol, white petrolatum and cetearyl alcohol.

How else can you treat your baby? In pediatric practice, Bepanten is used in the form of ointment and cream. What is better to choose in such a situation - cream or ointment? The cream is recommended for prevention purposes against dry skin and a tendency to dermatitis. The ointment is used when problems arise, since it increases the protective function of the skin, but when used, the skin breathes. The main active ingredient of Bepanten is dexpanthenol , which has a regenerating effect and relieves redness and irritation. The composition of the ointment, compared to the cream, includes paraffin (liquid and soft), as well as almond oil. Lanolin has a protective effect, but does not interfere with gas exchange. If a child has itchy skin, this drug eliminates it. When using Bepanten, the symptoms disappear within 2-3 days, and following other care recommendations will allow you to finally cure heat rash in your baby. If there is a threat of infection, it is better to use Bepanten Plus (contains the antiseptic chlorhexidine, used in children from one year of age) or Drapolen (antiseptic). If the process is complicated by purulent infections, the doctor may prescribe ointments containing an antibiotic.

Parents should know that when caring for their baby, they should not squeeze out blisters, lubricate rashes with alcohol-containing solutions to avoid skin burns, or use topical antibiotics and corticosteroids without a doctor’s recommendation. When rashes appear for the first time, parents wonder: is it an allergy or heat rash in the baby? In these conditions, the nature of the rash and localization are different.

With heat rash, the rash first appears on the body, neck, and then on the face. Since there are no signs of inflammation, the rash does not affect the general condition. At the initial stages, the rashes do not contain fluid, and stretching the skin leads to their disappearance. With proper care and elimination of the provoking factor (overheating), the rashes disappear after 2-3 days.

The allergy manifests itself as a rash that first appears on the cheeks and then on the entire body. The skin with allergic rashes is swollen and inflamed. The rash may be small, like prickly heat, but the boundaries of the rash quickly expand. The child is bothered by severe itching, which increases, there may be lacrimation and sneezing, and in some cases the temperature rises. Even after eliminating the allergen, the rash does not go away quickly.

How to treat prickly heat at home

Whatever method of treatment is chosen, an adult must do two things: firstly, remove the irritating factor that caused the rash, and secondly, strictly observe hygiene requirements. And if, for example, in the summer it is quite difficult to get rid of the heat, then changing tight clothes to looser ones, regularly washing in the shower and wiping the skin with antibacterial wet wipes will not be difficult for anyone.

Depending on the severity of the disease, treatment for prickly heat at home is prescribed using drugs for external and oral use. An overview of all effective remedies for prickly heat is presented below.

Powders

Doctors recommend using these drugs if prickly heat has “occupied” skin folds, areas that are quite difficult to dry - the genitals, buttocks.

Powder options:

• Talc,
• Starch,
• Baneocin.

Ointments for the treatment of heat rash

External remedies such as creams and ointments are very important in the treatment of prickly heat.

For their effectiveness to be high, the skin should be prepared before using creams and ointments - washed with laundry soap and dried. Then you need to put on a medical fingertip and treat the inflamed skin. Salicylic acid effectively dries surfaces that become wet and itchy. Ointments recommended by experts always have a non-greasy base, so as not to clog pores and not aggravate the problem, and also have drying properties.

TOP 9 best ointments for prickly heat that are easy to use at home:

• Zinc ointment,
• Calamine (instructions for use can be found here),
• Pharmacy talker,
• Desitin,
• Pantoderm,
• Bepanten,
• Levomekol (with antibiotic),
• Fenistil (antihistamine decongestant),
• Akriderm (hormonal ointment).

Antiseptics

You cannot do without these remedies if a secondary bacterial infection is added to prickly heat. Effective against it:

• potassium permanganate solution,
• boric acid,
• Fukortsin.

Antihistamines (tablets)

What to do if prickly heat is accompanied by severe itching and swelling? Use antihistamines in tablet form:

• Tavegil,
• Zyrtec,
• Fenkarol.

Antibiotics

Antibiotics are not used in all cases - only for severe forms. The most common drugs:

• Doxycycline - prescribed by a doctor;
• Azithromycin - available without a prescription;
• Amoxicillin for prickly heat;
• Ciprofloxacin.

The course of treatment is at least five days. It must be continued even after the rash and redness disappear. At the same time, you need to take antihistamines.

Physiotherapy

Acupuncture and reflexology are effective. These methods affect the points of accumulation of nerve endings that are associated with the center for regulating the process of sweating in the brain.

Phytotherapy

Plants that normalize the process of sweating also have an antiseptic effect - St. John's wort, calendula, celandine, chamomile, string.

Any of these plants can be used to make a lotion to rub on the skin or an infusion to add to your bath. For 1 liter of boiling water you need to take 1 tablespoon of the herb and leave it for half an hour, then strain. You can add lotion to a warm bath or lubricate problem areas of the body with it.

Tanning infusions are also used - oak bark, bay leaf. Their preparation follows the same principle and is also used to lubricate the skin.

Prevention

Prevention of this condition in a child is to ensure:

• correct temperature conditions;
• air baths;
• daily bathing;
• regular drying of the skin;
• timely diaper change;
• using a “barrier” diaper cream.

If we consider the prevention of this disease in adults, then skin care and personal hygiene also come to the fore, especially in the hot season. If possible, you need to maintain the optimal temperature in the room (air conditioning). If this is not possible, then wear cotton clothes and shower daily. In case of severe sweating, showers should be taken 2 times a day, after which the skin should be thoroughly dried. It is also important to change clothes to dry ones during the day and give preference to clothes made from natural fabrics that allow air to pass through.

Polina Vasilyeva

dermatologist

In cases where prickly heat has developed from redness to a rash, and then bacterial infection occurs, treatment with special creams and ointments may be prescribed. If the symptoms show that the disease has reached a serious stage, consult a doctor and he will tell you how to treat it. Take regular photos of problem areas to track progress.

List of sources

• Dermatovenerology. National leadership. Ed. Yu. K. Skripkina, Yu. S. Butova, O. L. Ivanova. – M.: GEOTAR-Media, 2011. – 1024 p.
• Zanko N. I. Efficiency of new technologies for skin care for young children: abstract of thesis. dis. ...cand. honey. Sciences, M., 2000.
• F. A. Zverkova. Skin diseases of young children. Saint Petersburg. - Sothis. -1994 — 235 p.
• Yatsyk G.V., Akoev Yu.S. Clinical effectiveness of various newborn skin care products based on D-panthenol. Cons. Med. Pediatrics, 2004; 6 (2): 41-3.

How to prevent heat rash in newborns

• Your baby will not develop heat rash even in the hot summer if you always dress your child according to the weather and monitor the temperature in the children's room;
• choose clothes for your baby not based on “beautiful”, but on the quality of “breathable” materials;
• dress your child in loose clothing;
• change your baby’s diapers regularly and often leave him naked to “ventilate”;
• bathe your baby daily;
• do not swaddle your baby too tightly;
• use powders and baby creams exclusively on a water basis;

wash children's clothes with special hypoallergenic products.

Localization of the problem

Most often, prickly heat affects the following areas of the body:

• the area called natural folds, that is, the armpits, groin, knees and elbows;
• area under the breasts in women;
• if a person has thick hair, then prickly heat may develop in the area behind the ears;
• with excessive fullness of the legs, prickly heat appears on the inside of the thighs;
• an area of ​​the body that is constantly under clothing or some additional accessories, such as bandages.