Monday, March 4, 2024

How to treat a heat rash

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Q:        I’ve been battling a heat rash from the hot weather we’ve been having recently. What’s the best way to get rid of it?

Donna, a 75-year-old grandmother, developed redness and itching during a summertime heat wave in her groin area.

“I’ve tried putting Gold Bond® powder on it for the past 3-4 days, but it’s not helping. What else do you recommend, instead?”

Heat rash, or prickly heat, can happen to anyone with active sweat glands. It’s estimated that at least 40% of infants will get a heat rash at one point. Heat rash also afflicts people who sweat in the summer heat doing strenuous physical work, performing sports, exercising, even gardening.

Prickly heat or heat rash is caused by clogged sweat glands. When sweat builds up under your skin, it can become trapped, causing your pores to swell and rupture. This creates small red, raised lesions that burn or itch. These reddened bumps may be clustered in small clumps or spread out over larger areas.

Heat rash can occur anywhere that sweat accumulates: your armpits, chest, upper back, belly, and groin. The blockage creates inflammation, pustules, or a yeast infection if it is severe enough.

Heat rash or prickly heat can also happen to people treating dry or itchy skin with heavy creams or ointments. Although soothing in winter, thick creams and ointments can plug up your hard-working sweat glands during hot, humid summer weather.

Keeping your skin dry is one key to relieving the itching and burning of prickly heat. One of the best ways to do that is by maximizing airflow to the skin to discourage sweating. Wearing loose, lightweight clothing during hot weather and using fans to improve airflow is essential. Fevers can cause profuse sweating and should be treated with appropriate doses of acetaminophen to decrease excess moisture next to the skin.

Another key to treating heat rash is avoiding oils, heavy creams, or ointments on areas that perspire heavily. This can include under your arms, your chest, around your groin, behind your knees, and under any skin folds.

Avoid using medicated or plain powders on red, irritated, or broken skin when treating prickly heat. Powders can clog inflamed pores and sweat glands, so it’s best to stay away from them entirely until your skin has calmed down.

Heat rash can cause intense itching and an almost uncontrollable urge to scratch. Although scratching feels good, your relief is short-lived, as it will trigger an increase in inflammation and even more itching. Applying cloths dampened with cool water can help, along with non-prescription steroid creams containing 1% hydrocortisone. Hydrocortisone 1% cream is safe for small areas of broken skin or larger areas of intact skin in adults. You should avoid applying medicated creams directly over areas of damaged skin, especially the skin of children or infants.

Finally, avoid using hydrocortisone ointment when addressing heat rash because they are occlusive, which can block or clog your sweat glands.

If these strategies don’t help the itching and irritation of heat rash, contact your doctor, as other conditions may look like heat rash at first but need to be treated differently.

Here are 7 Tips for Treating Prickly Heat or Heat Rash:

1.         Increase airflow to the affected area.

Wear lightweight, loose clothing or no clothing at all. House fans can help circulate air over your skin.

2.         Lukewarm sponge baths increase evaporation, helping to cool and dry the skin.

Avoid hot water for showers or baths, which can increase inflammation. Adding oatmeal or a product that contains oatmeal like Aveeno® to bath water helps soothe irritated skin.

3.         Avoid using skin powders like Gold Bond®, especially on broken skin.

The powder can create clogged sweat glands. Avoid applying powders until the acute symptoms of redness and itching subside.

4.         Avoid Benadryl® cream or spray. Use 1% hydrocortisone cream instead.

Although Benadryl® (diphenhydramine) capsules and liquid can help relieve itching, diphenhydramine cream or topical spray should be avoided. Benadryl® can be absorbed into the bloodstream from areas of broken skin. Combing diphenhydramine pills or syrup with a skin cream also containing it can result in drowsiness and confusion.

5.         Avoid applying heavy creams and ointments.

Ointments and heavy creams can block sweat glands. Keep your armpits, groin, chest, and skin folds as dry as possible. Tucking a light cloth like a pillowcase between skin folds helps absorb excess perspiration.

7.         Cool it before you use it.

Refrigerating your medicated cream or aloe vera gel before applying it can provide additional soothing power.

Dr. Louise Achey, Doctor of Pharmacy, is a 43-year veteran of pharmacology and author of Why Dogs Can’t Eat Chocolate: How Medicines Work and How YOU Can Take Them Safely. Get clear answers to your medication questions at her website and blog, TheMedicationInsider.com.

Ó2023 Louise Achey

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