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DOCTOR AT THE DESK

Prickly Heat

"Itchy summer rashes"
By: Lourdes Nena A. Cabison-Carlos, MDPrickly Heat

Because we live in a tropical country where summer months can pump up the temperature to 32°C or higher, heat rash or prickly heat is a childhood norm. Medically speaking, prickly heat is called miliaria, which is basically caused by the obstruction of sweat glands. Because their sweat glands have not yet fully developed, miliaria is commonly seen in babies and children.

Miliaria is classified into different types. Miliaria crystalline is a mild condition characterized by tiny, clear (hence, crystalline), blister-like lesions which do not produce itching. Miliaria rubra is the most commonly encountered form and is very well-known among Pinoys. This is the typical bungangarawof summer, which presents with very itchy, minute, reddish (hence, rubra) vesicles on the back, neck, armpits, and other areas of the body. Repeated episodes of miliaria rubra may lead to a severe form commonly seen in adults called miliaria profunda.

So, how do we deal with these itchy rashes?

First, you need to be 100 percent sure that that rash on Junior’s back is really just the benign prickly heat rash and not chicken pox or shingles in disguise.

Second, most cases of miliaria resolve without intervention, so the best that we can do is to keep our children calm and comfortable. This can be done simply by keeping them as cool and dry as possible. Avoid putting children in humid rooms with poor ventilation, and when outdoors, keep them under a shaded area. Give them cool showers using mild anti-bacterial soap, and avoid applying unnecessary lotions or oils. Avoid occlusive clothes—summer is the best time to take out those sandos and shorts from the closet. Anti-itch preparations such as calamine, menthol, and camphor-based products are helpful and easily available, but choose the water-based ones (oil may cause further blockage of the sweat glands). Applying regular talc powder, while not effective in reducing redness, increases comfort by soothing the itch. If the rash seems to be getting worse, or your child develops other symptoms, have your child checked by your doctor.

 

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