Managing heat rash and ‘prickly heat’ in babies

On warmer days, it’s not uncommon for babies to develop heat rash. Here, Dr Bhavna Singh, a dermatologist based in Durban, shares all you need to know about how to handle it. 

What is heat rash?

“Heat rash is also known as prickly heat or the more clinical dermatological term miliaria. It occurs when sweat glands become blocked,” explains Dr Singh, adding that it is characterised by red bumps on the skin that may be fluid-filled. On darker skin types, the rash may appear as pale, white spots.

“Heat rash occurs especially in areas that are prone to moisture, like the folds of the neck or joints and nappy area, though it can occur anywhere on the body such as the back and chest, especially in very hot, humid conditions,” she says. 

Why is heat rash common in babies?

Babies and toddlers are more prone to heat rash as their sweat ducts are immature and easily blocked, explains Dr Singh. 

“In addition, they have not yet developed the ability to regulate their own body temperature, which is naturally higher. Often, babies are dressed in many layers or swaddled in blankets. They may initially be inactive and have prolonged periods of sleeping and immobility that risk overheating and increased sweating. Also, increased activity such as crawling, walking or playing leads to increased heat and, in turn, sweating,” she says. Babies’ skin is more sensitive than adults’ and is, therefore, prone to irritation by excess sweat. 

Can heat rash be prevented and treated?

Heat rash is commonly accompanied by some discomfort and may cause itchiness. Fortunately, there are methods you can try at home to prevent and manage heat rash, which include keeping your baby cool and dry.

Dr Singh shares a few ways parents and caregivers can prevent heat rash:           

• Change sweaty clothes and nappies regularly. Dry the baby’s body, especially the skin folds, well after washing or bathing. Use lukewarm water, not hot water.

• Avoid the use of heavy ointments, creams or oils. Instead, opt for lightweight options. 

• Dress babies in cool, loose, cotton clothes and avoid covering them in too many blankets, especially in hot, humid conditions. 

• Use bibs and barrier creams to protect against drool. This is especially important when baby is eating or teething as excess drool can accumulate in the neck folds. 

• Ensure baby is well hydrated. 

If your baby does show signs of heat rash, know that there are ways to manage it at home. “A cool, damp washcloth can be applied to inflamed areas to soothe it. Affected areas should be left uncovered when possible, and you can make use of cooling appliances such as fans or air conditioners,” says Dr Singh. 

She also advises that parents and caregivers moisturise baby’s body using non-fragranced, lightweight moisturisers. Soothing creams with ingredients such as panthenol or centella may be applied to affected areas. Keep baby's nails short to prevent scratching. 

Is it necessary to see a doctor?

Dr Singh says that a heat rash should clear within a few days but if it persists more than a week, you may need to seek medical attention. “This is necessary in circumstances where the lesions may become more inflamed, infected or pus-filled blisters develop and there is an associated fever or significant discomfort,” she says. 

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