From the Guidelines
Prickly heat treatment should focus on keeping the affected skin cool and dry, with topical corticosteroids or systemic antihistamines used in severe cases. The primary goal is to reduce inflammation and prevent further irritation. According to the UK guidelines for the investigation and management of eosinophilia in returning travellers and migrants 1, treatment for prickly heat usually involves allowing the condition to resolve spontaneously within days to weeks. However, in severe cases, topical corticosteroids or systemic antihistamines may be used to alleviate symptoms.
Some key measures to take include:
- Staying in air-conditioned environments or using fans to keep cool
- Wearing loose, lightweight clothing made of breathable fabrics like cotton
- Taking cool showers or baths and gently patting the skin dry afterward
- Applying calamine lotion or hydrocortisone cream (0.5-1%) to soothe itching and inflammation
- Avoiding heavy creams, ointments, or oils that can block pores further
- Using over-the-counter antihistamines like diphenhydramine (Benadryl) or cetirizine (Zyrtec) to reduce itching
- Drinking plenty of water to stay hydrated
It's essential to note that prickly heat occurs when sweat ducts become blocked and sweat gets trapped under the skin, causing inflammation and the characteristic tiny, itchy red bumps. Most cases resolve within a few days with these treatments. If the rash worsens, spreads, or shows signs of infection like increasing pain, swelling, or pus, it's crucial to consult a healthcare provider. The treatment approach should prioritize reducing morbidity, mortality, and improving quality of life, as outlined in the guidelines 1.
From the Research
Prickly Heat Treatment
Prickly heat, also known as miliaria, is a benign cutaneous manifestation due to the obstruction of the sweat ducts following excessive exposure to heat, humidity, or hyperthermia 2. The treatment for prickly heat includes:
- Rapid cooling to reduce body temperature
- Fluid replacement to prevent dehydration
- Physiologic support to manage symptoms 3
- Avoiding further heat exposure and staying in a cool environment
- Using gentle skin care products to avoid irritating the skin
Types of Prickly Heat
There are different types of prickly heat, including:
- Miliaria crystallina: a benign cutaneous manifestation due to sweat retention secondary to obstruction of the sweat ducts in the stratum corneum 2
- Miliaria rubra: due to obstruction within the malpighian stratum
- Miliaria profunda: due to obstruction in or below the dermoepidermal junction
Prevention and Management
Prevention and management of prickly heat include:
- Staying hydrated by drinking plenty of fluids
- Avoiding strenuous activities in hot environments
- Wearing lightweight, loose-fitting clothing
- Using sunscreen and protective gear to prevent sunburn
- Monitoring body temperature and watching for early warning signs of heat illness, such as flushed face, hyperventilation, headache, and dizziness 4
Treatment of Heat Illness
Heat illness can range from benign rash to fatal heat stroke, and treatment consists of: