Text Box: What is Miliaria? Miliaria, commonly known as heat rash or prickly heat, is a disorder of the sweat glands that occurs in conditions of increased heat and humidity. The pores become blocked and sweat is blocked under or within the skin layers. It is known as prickly heat because older children and adults have described it as a prickly "pins and needles" sensation. There are three types of miliaria: miliaria crystallina, miliaria rubra, and miliaria profunda. Miliaria crystallina is a milder form that produces superficial, fragile, clear, 1-2 mm blisters. They most commonly form in newborns younger than 2 weeks and adults which are feverish or have recently moved to a tropical climate. Miliaria rubra occurs deeper within the skin and causes itchy red papules or bumps. It usually affects newborns of 1-3 weeks and adults who live in hot, humid environments. Symptoms may occur within days of exposure, or they could appear months later after exposure. This condition produces extreme itching and stinging that is made worse by fever, heat, or exertion. Miliaria profunda occurs when obstruction of the sweat gland takes place at the dermal-epidermal boundary, and sweat leaks into the surrounding area and non-symptomatic flesh colored papules or bumps occur. This form usually affects persons who live in a tropical climate and have had repeated cases of miliaria. The symptoms resolve quickly, usually less than an hour after they appear. What causes miliaria or prickly heat? Prickly heat can be caused by perspiration, overdressing, fever, immature sweat ducts in newborns, change of climate to a warmer, humid one, any stimulus to sweating, and some drugs such as bethanechol and isotretinoin Text Box: (AccutaneŽ or AmnesteenŽ). Where does miliaria occur? Prickly heat most commonly forms on the forehead, cheeks, eyelids, and sometimes the nose. It often forms in the diaper area where the diaper fits snugly around the legs or waist. It can also occur in adults in places where clothing is tight and blocks evaporation of sweat. How is miliaria treated? Mild forms usually heal on their own, but there are ways to prevent the condition: Avoid excessive heat and humidity Wear loose cotton clothing Take cool baths and stay in air-conditioning In severe cases, apply lotion to the rash In severe cases, a 1% hydrocortisone cream or calamine lotion may relieve the itchy condition. In infants, an anti-yeast cream may be prescribed as well. It is best to avoid ointments as they can block sweat glands and worsen the condition. Are there any complications to miliaria? The condition should resolve within a few days. You should call your physician if symptoms last more than 3-4 days, or if an infection develops at the site of the rash. For more information on prickly heat, or heat rash, speak to your pharmacist or physician or visit the web site http://my.webmd.com/content/article/8/1680_54300.htm.

Heat Wave Causing a Heat Rash?

Contributed by: Tammy Stack, Pharm.D.

                             Community Pharmacy Resident

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