DermaTechRx Research Center

Archive for November, 2009

Infant Heat Rash

Heat rash is most common in babies and young infants when they become overheated, either because it is too warm outside or they are simply overdressed or have a fever. Although having an infant heat rash is common, it is likely not as common as many parents believe. It is typical to call any red rash kids may have when it is hot outside a heat rash.

Learning to distinguish heat rash from other common skin rashes, such as impetigo, eczema, folliculitis, and poison ivy, can be helpful so that you can properly treat and prevent this common rash. Though heat rash can affect anyone, newborns are most susceptible. As the name implies, infant heat rash is triggered in certain children when they become overheated, either because they are overdressed or because it is simply too hot outside. As they become hot and sweat, their sweat ducts become blocked and rupture.

Because a newborn’s sweat ducts aren’t fully developed, they rupture easily, trapping perspiration beneath the skin. This happens most often in hot weather, but it can occur anytime infants are dressed too warmly. Newborns who have high fevers or are in incubators can also develop blocked sweat ducts. The inflamed sweat ducts look like small bumps with a red halo around them and can usually be found grouped together under a child’s clothing and inside the folds of his skin, such as his neck, armpits, and groin. Infants who wear a hat may also get a heat rash on their forehead and scalp. Most often, heat rash goes away on its own. Severe forms of heat rash may need medical care, but the best way to relieve symptoms is to cool your skin and prevent sweating.

Mild heat rash doesn’t require any other treatment, but more severe forms may need topical therapies to relieve discomfort and prevent complications. Topical treatments may include things like calamine lotion to soothe itching or lanolin, which may help prevent duct blockage and stop new lesions from forming.  Topical steroids are often used in the most serious cases. Some anecdotal evidence supports the use of oral vitamin C supplements to help relieve heat rash also. However you should contact your health care provider if your child experiencing any of the following symptoms:

* A fever or other unexplained symptoms associated with the rash
* Any areas that look wet, oozing, or red, which are signs of infection
* A rash that extends beyond the diaper area
* A rash that is worse in the skin creases
* A rash, spots, blister, or discoloration and is younger than 3 months
* Blisters
* No improvement after 3 days of home treatment
* Significant scratching

Prickly Heat Rash

Prickly heat rash or miliaria rubra is the most common type of heat rash. In this form of heat rash, the sweat duct becomes red and inflamed, and may cause a ‘prickling’ or stinging sensation. This type of heat rash may also cause mild itching. There are three types of miliaria, which are classified according to where the sweat ducts are blocked.

§  Miliaria rubra. Occurring deeper in the outer layer of skin, miliaria rubra causes red bumps that are intensely itchy or prickly, giving rise to its common name, prickly heat rash. There is often little or no sweating in the affected areas. Adults can develop miliaria rubra shortly after they’re exposed to hot weather, but the rash more often appears after several months of exposure. Infants usually develop this type of heat rash between the first and third weeks of life.

§  Miliaria crystallina. The mildest form of heat rash, this affects the sweat ducts in the stratum corneum, the topmost layer of skin. Miliaria crystallina is marked by tiny, clear, superficial blisters and bumps (papules) that break easily but aren’t itchy or painful. It usually clears on its own in a few days but can come back if hot, humid weather persists. And though it’s most common in newborns, adults can develop it, too, especially if they’ve recently moved from a temperate climate to the tropics.

§  Miliaria profunda. A less common form of heat rash, miliaria profunda occurs mainly in adults who have had repeat bouts of miliaria rubra. It affects the dermis, a deeper layer of skin, and appears soon after exercise or any activity that causes sweating. The lesions are firm and flesh-colored, much like goose bumps. Though it’s not uncomfortable, miliaria profunda can cause a widespread lack of perspiration, leading to symptoms of heat exhaustion, such as dizziness, nausea and a rapid pulse.

The best treatment for any form of heat rash is to reduce sweating by staying in air-conditioned buildings or, when that’s not possible, using fans to circulate the air, wearing lightweight clothing made of fabrics that breathe and limiting physical activity. Once skin is cool, heat rash tends to clear quickly.

Occasionally, heat rash becomes infected with bacteria, causing inflamed and itchy pustules. This is especially common in children in diapers but shouldn’t be confused with diaper rash, which results from irritation to tender skin, not from blocked pores.  In hot weather, people with miliaria profunda are at risk of heat exhaustion, which can cause low blood pressure, nausea, headache and a rapid pulse. Untreated heat exhaustion can lead to heatstroke, a life-threatening condition.

Prevent Heat Rash

Hot, humid weather contributes greatly to miliaria or heat rash. It is more probable when you first move to the tropics from a different climate. Once your body becomes acclimated, which usually takes several months the problem typically disappears.  Physical activity, intense exercise, hard work or any activity that causes you to perspire extensively can also lead to heat rash.  You may develop heat rash if you consistently wear clothing that doesn’t allow perspiration to evaporate normally. Certain prescription medications have been linked to heat rash.

Some bacteria normally found on the skin, such as Staphylococcus epidermis, secrete a sticky substance that may block sweat ducts. Overheating in general will make you vulnerable to heat rash.  Things like putting on too many clothes in winter and sleeping under an electric blanket can lead to heat rash. So can using heavy creams and ointments, which block the sweat ducts. Heat rash can also occur in people who are confined to a hospital bed for long periods.

When your core temperature rises, your autonomic nervous system stimulates the eccrine glands to secrete perspiration. The perspiration travels through ducts to the surface of your skin, where it cools your body as it evaporates. Heat rash develops when some of the eccrine sweat ducts become plugged. Instead of evaporating, perspiration remains trapped beneath the skin, causing inflammation and rash. To help protect yourself or your child and prevent heat rash try the following suggestions:

·         In summer, dress in soft, lightweight, cotton clothing. Avoid excessive bundling up in winter, children should wear the same amount of clothing that an adult would wear to stay comfortable.

·         Avoid tight fitted clothes that can irritate skin.

·         When it’s hot, stay in the shade or in an air-conditioned building or place a fan at a safe distance to gently circulate the air.

·         Keep your sleeping area cool and well ventilated.

·         Bathe in cool water with a nondrying soap that doesn’t contain fragrances or dyes. Many companies make gentle, natural products especially for infants and children.

·         Avoid using powders, creams or ointments because they don’t prevent heat rash and can block pores.

·         In hot weather, dress in loose, lightweight clothing that wicks moisture away from your skin.

·         Spend as much time as possible in air-conditioned buildings.

·         After bathing, let your skin air-dry, instead of toweling off.

·         Use calamine lotion or cool compresses to calm itchy, irritated skin.

·         Avoid using creams and ointments, which can block pores further.

Rash

A rash indicates an abnormal change in skin color or texture. Rashes are usually caused by skin irritation, which can have many causes. A rash is any bumps or spots on the skin. The rash can be red, skin-colored, or slightly lighter or darker than skin color. Prickly heat causes rash or blotches during hot weather or in a hot environment just like a heat rash.

Hives are red welts that appear to move around on the body. They differ in size and shape and are usually very itchy. The most common cause of hives is a viral infection. There is no treatment for the virus, and the hives may last for a few weeks. You can use antihistamine medication for the itching. Sometimes bacterial infections cause hives. These are treated with antibiotics. Sometimes hives can be a sign of an allergy. This is best determined by your health care provider.

Milia/miliaria are tiny white, clear or red bumps on the skin.  These usually occur on the face and chest. Usually the white or clear ones are seen in newborns. The red ones are also called heat rash or prickly heat.

Baby acne is caused by exposure to the mother’s adult hormones. Little white dots often seen on a newborn’s nose represent an abnormal amount of normal skin oil that is a result of these hormones. Acne usually occurs between 2 and 4 weeks of age, but may appear up to 4 months after birth and can last for 12 – 18 months.

Eczema is a condition of the skin in which areas are dry, red (or darker than normal skin color), and itchy. When it goes on for a long time the areas become thickened. It is often associated with asthma and allergies, although it can often occur without either of these. Eczema often runs in families.

Cradle cap causes greasy, scaling, crusty patches on the scalp that appear in a baby’s first 3 months. It usually goes away by itself, but some cases may require treatment with medication.

Erythema toxicum can cause flat red splotches. These splotches are usually with a white, pimple-like bump in the middle and appear in up to half of all babies. These blotches rarely appear after 5 days of age, are usually gone in 7 – 14 days, and are nothing to worry about.

Most baby rashes cause no harm and go away in time on their own.

Folliculitis

Anyone can develop Folliculitis wherever hair follicles are present on the body. The lesions in Folliculitis most often affect the chest, back, and legs. Other common locations include the face, neck, thighs and buttocks. Although not impossible, it is rare to have it widespread all over the body. It does not affect the eyes, mouth, palms, or soles, where there are no hair follicles. Folliculitis is estimated to affect more 10%-20% of people at some point in their lives.

Folliculitis is a common skin condition that appears as numerous small red or pink little bumps at hair follicles. It can cause a “chicken skin” appearance on the skin. Folliculitis can affect any part of the skin, including the chest, back, arms, legs, buttocks, and cheeks.

Folliculitis usually looks like red pimples with a hair in the center of each one. The pimples may have pus in them, and they often itch or burn.  Folliculitis often appears as very small, slightly smooth bumps are scattered in a body area like the back. Some of the bumps may be slightly red or have an accompanying light-red halo indicating inflammation. Sometimes, scratching off the top reveals a small trapped or coiled hair within.

Razor-burn Folliculitis is very common on women’s legs and is caused by shaving. It may also be seen on the faces and necks of men.  Some people are simply more prone to developing Folliculitis because of their overall health, possible altered immune status, exposure history, and other predisposing skin conditions like eczema or severely dry skin. You are more likely to get Folliculitis if you use a hot tub, whirlpool, or swimming pool that is not properly treated with chlorine. Wearing tight clothes, using antibiotics or steroid cream for long periods and if you use or work with substances that can irritate or block the follicles you are more prone to develop this condition. Also if you have an infected cut, scrape, or surgical incision the bacteria or fungi can spread to nearby hair follicles. Having a disease such as diabetes or HIV that lowers your ability to fight infection could also put you at risk.

Overall, Folliculitis is often not a pretty sight but is medically harmless. Many cases of Folliculitis may resolve on its own without any treatment. Folliculitis frequently affects otherwise healthy people. Treatment may typically include one or a combination of antibacterial washes, antibiotic creams or lotions, and antibiotic pills.