[Medical Q&A] How to identify baby’s prickly heat?

Author: Wang Shan Beijing Children's Hospital, Capital Medical University

Reviewer: Ma Lin, Chief Physician, Beijing Children's Hospital, Capital Medical University

Miliaria, commonly known as "prickly heat", is also called heat rash or miliary rash. It is a skin disease caused by excessive sweating due to high temperature and humidity in the external environment, which makes it difficult for sweat to evaporate and causes blockage of sweat ducts. It is most common in children, especially newborns whose sweat glands are not fully developed.

The most important feature of prickly heat is that it often occurs in areas prone to sweating, such as the forehead, neck, chest, back and wrinkles. It is more common in summer when the temperature is high and the humidity is high. The shape of prickly heat is generally small, densely packed, needle-sized bumps of the same size. Prickly heat is mainly caused by sweat duct obstruction. According to the location of the sweat duct obstruction, it is generally divided into white prickly heat, red prickly heat and deep prickly heat from shallow to deep. White prickly heat is generally small, clear and transparent blisters, which are not red in color and do not cause discomfort. It often occurs in people with immunosuppression and excessive weakness. Red prickly heat is the most common type. There is a red halo around the needle-sized blisters, and the children will have discomfort such as burning and itching. Sometimes, small white or yellow pustules appear on the top of the prickly heat, which we call purulent prickly heat. Deep prickly heat is a type of deeper damage. It is not obvious when not sweating, and it is a small papule of skin color. It becomes significantly larger when sweating, and there is usually no discomfort.