What is the treatment for heat rash?

Treatment of Heat Rash

The treatment of heat rash primarily involves cooling the affected area, keeping the skin dry, and using topical corticosteroids to relieve itching and inflammation. 1

First-Line Management

• Remove the patient from hot, humid environments and place them in a cool, dry environment to prevent further sweating and irritation 1
• Keep the affected area clean and dry; avoid tight clothing that traps heat and moisture 1
• Use lightweight, loose-fitting cotton clothing to allow air circulation and reduce friction on the skin 2
• Apply cool compresses to soothe the affected area and reduce inflammation 1
• Avoid using soaps and detergents that remove natural skin lipids; instead, use a dispersible cream as a soap substitute to cleanse the skin 2
• Apply topical hydrocortisone (1%) to affected areas up to 3-4 times daily for adults and children over 2 years of age to relieve itching and inflammation 3
• For children under 2 years of age, consult a doctor before applying hydrocortisone 3

Additional Therapeutic Measures

• Emollients can be applied after bathing to provide a surface lipid film that retards evaporative water loss from the epidermis 2
• Avoid extreme temperatures and activities that cause excessive sweating until the rash resolves 2
• Keep nails short to minimize damage from scratching 2
• Antihistamines may be useful as a short-term adjuvant to topical treatment during episodes with severe itching, primarily for their sedative properties 2
• Non-sedating antihistamines have little to no value in treating heat rash 2

Management of Complications

• If secondary bacterial infection is suspected (indicated by increased redness, swelling, pain, or purulent discharge), appropriate antibiotics may be necessary 2
• Flucloxacillin is usually most appropriate for Staphylococcus aureus infections, which are the most common bacterial superinfections 2
• For patients with penicillin allergy, erythromycin can be used as an alternative 2

Special Considerations

• Heat rash typically resolves within a few days with proper care and removal from the triggering environment 1
• Persistent or worsening symptoms despite appropriate treatment may indicate a different diagnosis or complications requiring medical evaluation 2
• Prevention is key - avoid excessive heat and humidity, wear loose cotton clothing, and use air conditioning or fans in hot weather 1

When to Seek Medical Attention

• If the rash persists for more than a few days despite home treatment 1
• If there are signs of infection (increased pain, swelling, warmth, redness, or pus) 2
• If the patient develops fever or other systemic symptoms 4
• If the rash is widespread or severely uncomfortable 2