How to get rid of heat rash

Q: I get a rash when the weather turns hot. What’s the best way to get rid of it?
In her mid-seventies, Donna developed redness and itching in her groin area during a recent heatwave. She tried applying Gold Bond® powder, but it didn't seem to help. She asked me, “What will make it go away?”
Heat rash, also called prickly heat or miliaria, can happen to anyone with active sweat glands. It's estimated that at least 40% of infants will get a heat rash at one point. Heat rash also afflicts physically active and sweating people in the summer heat, doing strenuous physical work, performing sports or exercise, even gardening.
Prickly heat or heat rash is caused by clogged sweat glands. When sweat builds up under your skin, it can become trapped, causing your pores to swell and rupture. This creates small red, raised lesions that burn or itch that cluster in small clumps or spread out over larger areas. 
Outbreaks can occur anywhere you tend to sweat: your armpits, chest, upper back, belly, and groin. If the blockage is severe enough, it creates inflammation, pustules, or a yeast infection.
Heat rash or prickly heat can also happen to people who have been treating their dry, itchy skin with heavy creams or ointments. This works well during the winter months, but during a hot, sweaty summer, those thick balms and butters plug up their hard-working sweat glands.
The first key to relieving the itching and burning of prickly heat to keep your skin dry. One of the best ways to do that is by maximizing airflow to your skin to discourage excess sweating. Wearing loose, lightweight clothing during hot weather is critically important, along with using fans to improve airflow. Fevers can cause profuse sweating and should be treated with appropriate doses of acetaminophen to decrease excess moisture next to the skin.
The second key to treating heat rash is avoiding applying lubricants like creams or oils to your overworking sweat glands in areas that perspire heavily. Keep your underarms, chest, groin, behind your knees, and skin folds as dry as possible. 
The third key to treating prickly heat is to avoid applying medicated or plain powders to red, broken, or irritated skin. Powders can clog inflamed pores and sweat glands, so it's best to stay away entirely until your skin has calmed down.
Heat rash can cause intense itching and an almost uncontrollable urge to scratch. Scratching feels good but only provides short-term relief and instead triggers more inflammation and itching. Instead, apply cloths dampened with cold water along with a non-prescription steroid cream containing 1% hydrocortisone. 
Hydrocortisone 1% cream is safe to use on small areas of broken skin or larger areas of unbroken skin in adults but avoid putting it on the broken skin of children or infants.
Be sure to avoid using hydrocortisone ointment because ointments can block your sweat glands. If these strategies don't help the itching and irritation of heat rash, contact your doctor. Other conditions may look like heat rash at first but need to be treated differently.
Here are 6 Tips for Treating Prickly Heat or Heat Rash:
1. Increase airflow to the affected area.
Wear lightweight, loose clothing, or no clothing at all. House fans can help circulate air over your skin.
2. Lukewarm sponge baths increase evaporation, helping to cool and dry the skin. 
Avoid hot water for showers or baths, which can increase inflammation. Adding oatmeal or a similar product like Aveeno® can also help soothe irritated skin.
3. Avoid using powders like Gold Bond® on irritated or broken skin.
Powders can clog your sweat glands and irritate broken skin.  Avoid them until the acute symptoms of redness and itching subside. 
4.  Stay away from topical Benadryl® cream or spray. Use 1% hydrocortisone cream instead.
Although Benadryl® (diphenhydramine) capsules and liquid can help relieve itching, diphenhydramine cream or topical spray should be avoided.  Benadryl® can be absorbed into the bloodstream from areas of broken skin. When combined with the capsules or liquid, it can cause drowsiness and confusion.  
5. Keep your skin dry.  
Keep your armpits, groin, and chest plus any skin folds as dry as possible. Tucking a light cloth like a pillowcase between skin folds and changing it frequently absorbs perspiration. Avoid using heavy creams and ointments that can trap moisture next to the skin.
6. Cool it before you use it. 
For additional soothing power, refrigerate your hydrocortisone cream or aloe vera gel before applying it.
Dr. Louise Achey, Doctor of Pharmacy, is a 40-year veteran of pharmacology and author of Why Dogs Can’t Eat Chocolate: How Medicines Work and How YOU Can Take Them Safely. Check out her NEW website for daily tips on how to take your medicine safely. 2020 Louise Achey


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