About two months ago, I was doing a medical/eye camp in a small town in Sindh with three other voluntary doctors. We saw about 150 patients. Most of the patients had outdoor occupations, like construction workers, donkey cart owners, bakers, nan and roti makers, rickshaw drivers and carpenters. Most of the women were farmers working in the fields in the heat and humidity. Besides eye problems, there were innumerable skin issues. Over seventy per cent of the patients suffered from prickly heat.
Prickly heat usually develops when a person sweats more than usual, especially during hot or humid weather. Also known as Miliaria, is an itchy rash of small, raised red spots that causes a stinging or prickling sensation on the skin. However, it is possible to get prickly heat in winters. Although it is less common during dry heat.
Causes of Prickly Heat
Prickly heat occurs when body’s sweat glands become blocked because of excessive sweating, leading to skin irritation and red rashes.
If you sweat excessively, it is easier for dead skin cells and bacteria to collect in your sweat glands. If your sweat glands become blocked, sweat will be trapped underneath your skin in tiny swollen pockets. It will also seep into the nearby tissue and irritate your skin. When the pockets burst and release sweat, it causes a stinging and prickling sensation.
- Illness and immobility – long periods of time spent in bed can make you sweat more, particularly if you have warm bedding.
- Wearing too much clothing, particularly in winter.
- Sitting too close to a fire or heater like bakery workers, iron mongers. road construction workers who melt tar and brick manufacturers. Many factory workers, farmers and cotton pickers are also at risk.
About Prickly Heat
The rash can develop anywhere on the body, but it most commonly occurs on your face, neck, back, chest and thighs. The rash is made up of tiny spots or bumps that are surrounded by an area of red skin. The spots sometimes look like tiny blisters. They can cause mild swelling, itching and a stinging or intense prickling sensation.
Who gets Prickly Heat?
Anyone can get prickly heat but people who are overweight or obese are more likely to be affected. This is because they tend to sweat more than people who are slimmer. Babies and children are also more at risk of getting prickly heat because their sweat glands are not fully developed.
Symptoms of Prickly Heat
The main symptom of prickly heat is an itchy rash that is made up of small, raised red spots. The rash usually appears a few days after exposure to hot temperatures. Occasionally, the symptoms of prickly heat do not appear for several weeks or months.
Prickly heat rash can also sometimes occur on your tummy, groin, armpits, hands and feet.
Treating Prickly Heat
Prickly heat does not require any specific treatment and the rash usually disappears after a few days. Avoiding heat by staying in the shade and wearing loose cotton clothing, taking frequent cold baths, will help ease your symptoms. Applying calamine lotion will soothe the affected area of skin. You can also use hydrocortisone cream if your skin is particularly sore and itchy.
Prickly heat is not a serious condition and rarely requires specific treatment.
However, if you have prickly heat, there are several things you can do to ease your symptoms:
- Avoid excessive heat and humidity – if you need to go outside, spend time in the shade or take a small fan with you. Further exposure to the heat will cause you to sweat more and may make your rash worse.
- Wear loose cotton clothing – avoid wearing synthetic fibers, such as polyester and nylon, which trap heat more easily than natural fibers.
- Keep your skin cool – a cool bath or shower will cool you down, soothe your skin and help prevent further sweating. Staying in an air-conditioned room for a few hours a day will also provide considerable relief.
- Use calamine lotion – this is available at most pharmacies and will help soothe sore and irritated skin.
- Try hydrocortisone cream – low-strength hydrocortisone cream is also available from pharmacies and is effective at treating very itchy and irritated areas of skin. However, avoid using it on your face and always follow the instructions.
What sun protection factor (SPF) should I use?
- Use sunscreen with a sun protection factor (SPF) of at least 15.
- Go for broad-spectrum sunscreens, which protect against harmful UVA and UVB rays.
- Make sure the product is not past its expiry date.
How long can I stay in the sun?
Don’t spend any longer in the sun than you would without sunscreen. Sunscreen should not be used as an excuse to stay out in the sun. Instead, it offers protection when exposure is unavoidable. Summer sun is most damaging to your skin during midday. Spend time in the shade between 11 a.m. and 3 p.m., under umbrellas, trees, canopies or indoors.
Do wear white cotton or straw hats with a large brim.
Water washes off sunscreen and the cooling effect of the water can make you think you are not getting a sun burn. Water also reflects UV rays, increasing your exposure. Even waterproof sunscreens should be reapplied after going in the water.
What should I do if I get sunburn?
Painkillers, such as paracetamol or ibuprofen, will ease the pain by helping to reduce inflammation caused by sunburn. Sponge sore skin with cool water, then apply soothing after sun or calamine lotion. If you feel unwell or the skin swells badly or have blisters, seek medical help. Stay out of the sun until all signs of redness have gone.
Are children more at risk of sunburn?
Young skin is delicate and very easily damaged by the sun. Choose sunscreens that are formulated for children and babies’ skin, as these are less likely to irritate their skin. Some sunscreens may aggravate eczema.
What are the symptoms of heat exhaustion?
Heat exhaustion occurs when the body cannot lose heat fast enough. If it is not treated quickly, it can lead to heat stroke, which is a much more dangerous condition.
Signs of heat exhaustion include:
What should I do if someone has signs of heat exhaustion?
Get them to rest in a cool place, ideally a room with air conditioning. Give them plenty of water. Avoid alcohol or caffeine as this can increase levels of dehydration. Cool their skin with cold water. Use a shower or cold bath to cool them down or, if this is not possible, wet flannels and face cloths in water and apply to their skin. Loosen any unnecessary clothing and make sure that the person gets plenty of ventilation. Monitor their condition closely. Call an ambulance.