Prickly Heat An Array of Rash Approaches
PRICKLY HEAT An Array of Rash Approaches
You are taking your two-week-old for her first ride in the stroller on a mild spring day. Although the thermometer is registering 61°F, the breeze feels chilly. So you carefully dress your baby in a long-sleeved T-shirt, overalls and a lovely pink angora hat and jacket knitted by Great Aunt Edith. You also tuck her under a blanket.
Your walk goes well, and you both enjoy the fresh air. But when you get home, it's a while before you divest your daughter of all those extra clothes. When you do, you notice a fine, pink rash on her neck and upper back. What you're looking at is called prickly heat, the end result of too much heat with no place to go.
'' When a baby gets hot, sweat must evaporate off the skin in order to cool her body down,'' says Scott A. Norton, M.D., a staff dermatologist at Tripler Army Medical Center in Honolulu. ''If you interfere with this process by covering the skin with lots of clothing, plastic pants or even heavy moisturizers, the sweat that needs to get out becomes trapped beneath the surface of the skin, resulting in an itchy rash.''
Newborns are particularly vulnerable to prickly heat because their sweat ducts are not mature, which makes it easier for the beads of moisture to be trapped, says Dr. Norton.
Although prickly heat is common in babies, who are unable to complain about being overdressed, older kids can get the rash, too. Fortunately, it's easy to treat and even easier to prevent. Here's how.
Don't overdress your child. '' While prickly heat can sometimes occur as the result of fever, the most common cause is overdressing or swaddling a baby tightly in warm blankets,'' says Dr. Norton. Dress your baby sensibly--preferably in layers that can be peeled away as conditions change--and you'll likely avoid the problem altogether, he says.
Avoid heavy moisturizers. Tender newborn skin tends to be dry and in need of moisturizing. But heavy, oil-based creams can be a problem, notes Dr. Norton. ''Moisturize with a light, water-based lotion instead,'' he advises. Moisturel, Lubriderm and Alpha-Keri body oil are some of the moisturizers you can use.
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| When to See the Doctor Properly treated, prickly heat should disappear within a few days, according to Betti Hertzberg, M.D., a pediatrician and head of the Continuing Care Clinic at Miami Children's Hospital. But there could be complications if bacteria get trapped under the skin, she says. This can occur when your child scratches the itchy rash. Dr. Hertzberg suggests you make sure that your child's nails are short and clean, and that you see a physician if there is pus, inflammation, red streaking or fever associated with the prickly heat. These are all signs of a secondary infection. |
Keep cotton in contact with skin. Plastic is a great material for keeping wetness out, but it also traps moisture in the skin. ''Let your child's skin breathe by using cotton rather than plastic diaper wraps, and by covering plastic mattress and playpen covers with cotton ones,'' says Sam Solis, M.D., chairman of the Department of Pediatrics at Children's Hospital, assistant professor of pediatrics at Tulane University School of Medicine, both in New Orleans, and a pediatrician in Metarie, Louisiana.
Bring the temperature down. The first step in treating prickly heat once it develops is to get your child to stop sweating. ''Remove some clothing, take her into an air-conditioned room or sit her in a tub of tepid water,'' suggests Dr. Solis. ( The water should be just a little warmer than skin temperature.)
Soak away the itch. To counter the itching that accompanies prickly heat, add some baking soda or a colloidal oatmeal product such as Aveeno Bath Treatment to a tub of tepid water, suggests Betti Hertzberg, M.D., a pediatrician and head of the Continuing Care Clinic at Miami Children's Hospital. ''Have your child splash around in the tub for a while,'' says Dr. Hertzberg. ''A good soak will soothe the skin and take away the itching.''
Try a cool compress. While a thin coating of mild, water-based moisturizing lotion may help stop the itching, cool compresses sometimes work better. Make a compress by dipping a washcloth in a mixture of one teaspoon of baking soda per cup of cool water, suggests Dr. Hertzberg. Apply to the rash for five to ten minutes or as long as your child can tolerate it. This should be done four or five times a day, Dr. Hertzberg says.
Bed down with an antihistamine. If your child is extremely itchy, give her an itch-relieving antihistamine such as Benadryl Elixir before she goes to sleep, suggests Dr. Hertzberg. ( Be sure to read package directions to make certain the product is recommended for your child's age. For the correct dosage, follow package directions or consult your physician. Some doctors don't advise Benadryl cream or spray because it could cause a reaction.) ''Kids are much more sensitive to itchiness at night, and more likely to scratch the rash, which can lead to infection,'' she says.
Apply a hydrocortisone cream. ''For kids aged three or older, soothe the itch with a light coating of 1 percent hydrocortisone cream,'' says Dr. Norton. '' You can apply this over-the-counter remedy twice a day for two days to soothe itching and relieve inflammation and redness,'' he says.
Screen the sun without grease. Older kids tend to get prickly heat when they use a heavy, oily sunscreen that clogs sweat pores, notes Dr. Norton. The answer to the problem is not to stop using sunscreen, however. ''Because of the problems associated with sun exposure, children should always use sun-screen, but it's best to avoid the oily, cocoa butter--laden preparations,'' says Dr. Norton. In his practice in Hawaii, he advises his patients to use less greasy lotions that are hypo-allergenic, block UVA and UVB sunlight and are marketed for young children.
