Leva

View Original

Heat Rash in Babies

by Dr. Pamela Bandelaria, pediatrician

Heat rashes can be difficult to deal with.  In addition to keeping your little one up all night, scratching those itchy bumps, it can be uncomfortable and downright painful.  In this article, you will learn about heat rashes, what to do when your baby has a heat rash, and how to avoid them. 

Once babies are born, their bodies adjust to living conditions outside the womb. Some vital organs of the baby are still immature, making them prone to jaundice or yellowing of the skin. Similarly, the baby’s skin, the protective barrier of the body, also has immature structural elements that can cause sensitivity. Moreover, babies have smaller pores, and so they more likely to experience blockages and clogging. Heat rashes are therefore common in the first month of life. Other names for heat rash include prickly heat or a sweat rash. In medical terms, heat rashes are known as Miliaria. Different types of Miliaria exist and are classified according to how deep the inflammation and blockages are. Heat rash, known medically as Miliaria Rubra, is a blockage that occurs deep in the sweat glands.

What causes a heat rash?

Miliaria or heat rash occurs due to the blockage of sweat glands from excessive sweating during hot weather. Because perspiration cannot escape, it is trapped under the skin, leading to inflammation. It also occurs if babies are covered with a lot of warm clothing during cold weather or have a fever.

What are the symptoms of heat rash?

The rash appears as red bumps on the skin measuring around 1-3mm and has a red blister-like or acne appearance. Heat rash commonly appears on the face, neck, armpits, chest, abdomen, groin, nappy-line, and other areas in close contact with clothes.  Your baby may be a little more irritable and harder to soothe than usual because of the prickly, itchy feeling. He may also have more trouble sleeping than usual. 

How can you distinguish a heat rash from other rashes?

Aside from the rash character and distribution, there are other symptoms that will alert you to the fact that it is a heat rash. These include symptoms related to heat, such as flushed cheeks and the presence of sweat on your baby's head, neck, or chest area.  Other causes of heat rash include anything that causes a baby to sweat excessively.

Should I see a doctor if my baby develops a heat rash?

If you notice a rash in your baby, it is usually unnecessary to consult a doctor if your baby is well, active, and feeding. On its own, heat rash is not dangerous and is fairly common in babies. As mentioned earlier, babies are more predisposed to these types of rashes because their skin is sensitive and their pores are smaller. The worst that can happen is that your baby will be irritable due to discomfort and itchiness, which can be unsettling. However, if your baby is feeding poorly, or is more subdued than usual, it is best to have your baby checked. Other symptoms that warrant a doctor’s visit include accompanying symptoms such as fever, chills, vomiting, cough or colds, swollen lymph nodes, skin peeling, or worsening of the rash.

How can you prevent and treat heat rash?

Despite it being common among babies, there are specific ways you can prevent this type of inflammation or alleviate it once it occurs. By reducing excessive sweating and lowering your baby’s body temperature, you can decrease the chances of your baby developing this heat rash. 

The following methods are helpful for reducing its occurrence:

  • Remove your baby from a heated, humid environment. If you are outside, place your baby in the shade.

  • Keep your baby away from sources of heat such as lamps or heaters.

  • Remove excessive layers of clothing. When replacing your baby’s clothes, make sure they are made from light materials and are loose-fitting. If the clothes are too tight, it might worsen the rash or further irritate the skin.

  • If your baby has a fever, give him or her medications to bring the fever down.

  • Wipe your baby with a washcloth to help remove heat from your baby’s body, but make sure the skin is dry before you put on a new set of clothes.

Because heat rashes are itchy, babies often scratch the blisters.  Place mittens on your baby’s hands or trim their fingernails to prevent them from scratching the rash. Open blisters can be an entry point for bacteria, leading to infection. However, creams and ointments are usually not recommended as they may worsen the rash. 

Conclusion

Rashes are a common occurrence in babies because their skin is extra sensitive and their pores are smaller. While heat rash is usually not a cause for concern, if it is not properly cared for, open blisters can predispose babies to infections. It is best to consult a doctor if more serious symptoms accompany the rash.

+ References

  • Kliegman, R. St Geme, J. Blum, N. Shah, S. Tasker, R. Wilson, K. Behrman, R. (2019). Nelson textbook of pediatrics (Edition 21.). Philadelphia, PA: Elsevier.

  • Kutlubay Z, Tanakol A, Engýn B, Onel C, Sýmsek E, Serdaroglu S, Tuzun Y, Yilmaz E, Eren B. Newborn Skin: Common Skin Problems. Maedica (Bucur). 2017 Jan;12(1):42-47. PMID: 28878836; PMCID: PMC5574071.

  • O'Connor NR, McLaughlin MR, Ham P. Newborn skin: Part I. Common rashes. Am Fam Physician. 2008 Jan 1;77(1):47-52. PMID: 18236822.

  • Orchard D. Rashes in infants. Pitfalls and masquerades. Aust Fam Physician. 2001 Nov;30(11):1047-51. PMID: 11759454.

  • Rayala BZ, Morrell DS. Common Skin Conditions in Children: Neonatal Skin Lesions. FP Essent. 2017 Feb;453:11-17. PMID: 28196316.

  • The Royal Children’s Hospital Melbourne. Neonatal & Infant Skin Care. Retrieved from the World Wide Web dated February 15, 2021: https://www.rch.org.au/rchcpg/hospital_clinical_guideline_index/Neonatal___infant_skin_care/

  • Zuniga R, Nguyen T. Skin conditions: common skin rashes in infants. FP Essent. 2013 Apr;407:31-41. PMID: 23600337.