Miliaria in children - how to treat heat rash in a child, causes, care, types and prevention

Classification of the disease

There are four main types of miliaria, which differ in the nature of the rash, the duration of development and the severity of symptoms:

Crystalline. It is accompanied by the development of a blistering rash, which most often appears on the head, behind the ears, and on the neck. Other localization of rashes is also possible. 2-3 days after the appearance, the blisters dry out and begin to peel off. Since irritation is not accompanied by inflammation or infection, the crystalline form is the simplest and most harmless.
Red. A more complex type, in which sweat acts on the skin for a longer time and, accordingly, causes more severe irritation. A rash in the form of small inflamed tubercles provokes slight swelling and is accompanied by itching, burning, and discomfort. Lasts about two weeks.
Miliaria alba, or vesiculopustulosis. With this type, blisters with a whitish or yellowish filling appear on the skin. When the bubble bursts, it leaves behind a light coating. The presence of color in the bubbly fluid indicates that the rash is accompanied by an infection, often staphylococcal.
Deep. In most cases, prickly heat causes only superficial damage to the skin. With a deep form of pathology, the deep layers of the skin are affected. The disease is accompanied by blisters filled with light contents, which resolve or burst spontaneously.

Roseola

Roseola is a contagious viral infection. Symptoms include a pink rash on the baby's body, including the arms and neck. A child's body rash occurs after the child develops a fever and experiences symptoms that resemble a cold or flu. Roseola most often occurs in children under two years of age. The first signs of roseola appear ten days after infection. If your child has a temperature of 39 degrees or higher during the day, contact your doctor as soon as possible to get recommendations on how to bring down the fever. The doctor may also order a blood or urine test to confirm the diagnosis. While the baby has a fever, it is recommended to isolate him from other children to avoid the spread of infection. Once the rash disappears, the child is no longer contagious.

Symptoms

The main and most obvious symptom of the pathology is a rash. Most often, rashes appear on the head, chest, back, groin, armpits, and buttocks. The rash appears as scattered blisters with clear, white or yellow contents, or as small grains with an inflammatory outline.

During the day, the rash may intensify or decrease, and the severity of its manifestation depends on changes in temperature and care for the baby’s skin. In some cases, the child does not show concern, but sometimes may experience itching, pain and demonstrate discomfort with whims, unstable sleep, and lack of appetite.

In mild forms of the disease, other symptoms may not occur. But in more advanced cases, which are accompanied by complications and infection, clinical manifestations may be supplemented by:

elevated temperature up to 38 degrees;
the appearance of light plaque, ulcers, ulcers;
the formation of weeping cracks with an unpleasant odor;
general deterioration of condition.

When assessing symptoms, it is important to prevent the development of advanced forms of prickly heat and consult a doctor promptly, without waiting for complications to develop. Source: Skin care for a newborn. Solntseva O.A. Medical Council, 2014. p. 35-39.

Ringworm

Ringworm is a skin disease caused by a fungus and manifests itself in lesions of different sizes: oval, round or with clear boundaries. Such lesions can appear on the scalp and throughout the baby’s body. With lichen, brittleness and hair loss are observed if they are in the area of infection. The infection is transmitted from person to person and even from animals to people. If a child has ringworm, no one in the family should use his brush, hair accessories, or wear his hats. Ringworm can sometimes be confused with dandruff or crusty scalp. If your child is over a year old and has a scaly rash on the scalp, it is most likely ringworm rather than scabs. A doctor can make an accurate diagnosis. If you suspect your child has ringworm, contact a specialist. By following your doctor's instructions, you will most likely say goodbye to shingles in about a week. As a rule, external agents are prescribed for treatment.

Causes

Most often, parents who do not adhere to the basic rules of caring for the child turn to doctors with complaints about heat rash in their baby: they bathe him with soap every day, wrap him up excessively without taking into account the real ambient temperature. Children with skin allergies, diabetes mellitus, rickets, seborrheic dermatitis or frequent diarrhea are also at risk. Chubby, overweight and bottle-fed babies are especially at risk of developing rashes.

Among other reasons for the development of prickly heat in children are:

non-compliance with normal temperature conditions;
too hot, tight clothes or shoes that do not allow air to pass through and do not create natural ventilation;
excessive use of skin cosmetics that disrupt the acid balance and cause increased sensitivity (soaps, baby creams, oils, etc.);
rare change of diapers or their poor quality, lack of care;
viral diseases that are accompanied by fever.

Impetigo

Impetigo is a contagious skin disease that usually affects the nose, mouth and ears. The infection is caused by staph or streptococcal bacteria, and a baby who gets impetigo will need to take antibiotics. The doctor will order a test to find out what bacteria is causing the infection and then determine the course of treatment. Impetigo is contagious as long as the child has the rash, which sometimes forms blisters and eventually crusts over. At this stage, you need to avoid the baby's contact with other children. Avoid touching the rash to prevent the infection from spreading.

How to distinguish heat rash in a child from allergies and other diseases

When a rash appears on the skin, the most difficult thing for parents is to distinguish prickly heat from other diseases: allergies, chicken pox, measles, etc.

First, you should examine the location of the rash. In the first case, the rashes are located in hard-to-reach places: in the area under the diaper, in the folds of the skin, in the hairline. In this case, the rash almost never appears on open areas of the skin that are well ventilated. But if the rash appears on the face, open parts of the arms and legs, most likely it is an allergy.

A simple home test will also help make a differential diagnosis. You just need to undress the baby and leave him without clothes or a diaper for several hours. If the rash appears as a result of prickly heat, during this time it will decrease and become paler. If it is an allergy, no changes will occur to it.

Additional symptoms will help distinguish the disease from measles, chickenpox and other viral pathologies. With infectious diseases, the temperature always rises, intoxication appears, and the rash quickly spreads throughout the body. In turn, the main symptom of prickly heat is just a rash.

Diaper rash

Diaper rash, or diaper rash, is a reddish rash that appears on your baby's skin under and around the diaper. The structure can be either flat or convex. Can cause significant discomfort to the baby. Diaper rash can occur if your baby spends too much time in a wet diaper or if the diaper is too small. If the cause of diaper rash is eliminated, it usually goes away in three to four days. Therefore, try to change your baby's diaper as often as possible. Clean the area under the diaper with wet wipes or a cloth soaked in water and, if possible, give your baby air baths. It is also recommended to use diaper rash cream to create a protective barrier on the skin.

Atopic dermatitis

Atopic dermatitis (or itchy rash) sometimes appears in babies after the first month of life. You may notice your baby's cheeks are red and there are red, dry, flaky patches of skin on the elbow or behind the knees. In infants, atopic dermatitis appears more often on the body than on the face. The rash can be mild, but can also be accompanied by severe itching and cause great discomfort to the baby. If you suspect your baby has atopic dermatitis, consult your pediatrician - he will be able to prescribe an ointment or cream for treatment and care. To get rid of this unpleasant condition or prevent its recurrence, use mild, unscented soap to care for your baby, choose clothes made of soft fabric, and bathe your baby no more than three times a week. To wash children's clothes, use unscented products.

Diagnostics

You should not self-medicate or try to diagnose your child yourself. Before you begin to treat prickly heat in a child, when the first rash appears, you should contact a pediatric dermatologist or pediatrician. The specialist will conduct an examination and distinguish the pathology from other diseases that are accompanied by a skin rash. For an experienced pediatric specialist, this is not difficult even with an initial visual examination.

In some cases, additional examination is necessary for a comprehensive diagnosis. The doctor may prescribe scraping for pathogenic fungal infections, as well as bacterial culture for microflora.

Rash associated with food allergies

When introducing complementary foods, try to add one food item to your baby's diet every three to five days to rule out food allergies. If any product causes an allergy in your baby, you may notice red cheeks on your baby and a rash on your baby's body. Other possible symptoms of food allergies are vomiting and diarrhea. If you notice any of these symptoms, consult your doctor.

Treatment

The main method that allows you to remove rashes and cure skin pathologies is hygienic care. It is important to change the diaper immediately after a bowel movement and every three hours, washing the baby with running water. Between shifts you need to give air baths and leave the baby without clothes for a few minutes. At the same time, it is necessary to abandon synthetic clothing and low-quality children's cosmetics.

Bathing is carried out in water with a decoction of medicinal herbs. You can add chamomile, yarrow, and string. After bathing the child, dry thoroughly and powder the skin with powder.

In some cases, the doctor also prescribes treatment of rashes with drying antiseptics (“Furacilin”, “Chlorphilipt”), and creams containing panthenol (“Bepanten”, “Dexpanthenol”). White, red and deep miliaria are treated with antifungal and antibacterial ointments. However, it is not recommended to use any medications without prior consultation with a doctor. Source: Modern dermatological and cosmetic products for caring for the skin of children. Kotlukov V.K., Kuzmenko L.G., Antipova N.V. Medical Council, 2013. p. 8-12.

Doctors recommend setting the air temperature in the nursery at 20-22 degrees and monitoring the humidity, which should not exceed 50-70%. A good solution would be to purchase an air humidifier that will help create the right microclimate. These simple steps can help you get rid of the conditions that increase your risk of developing heat rash.

Prevention

Effective prevention consists of proper and thorough hygienic care of the child: regular bathing, frequent changing of diapers or diapers. During the hot season, you can bathe your baby up to 2-4 times a day, but it is important not to use soap, oils, lotions and other products with each water procedure that can disrupt the acid balance and clog the glands.

It is also important to select clothes from natural, breathable fabrics and avoid synthetic and semi-synthetic fabrics that do not ensure normal evaporation of sweat. You need to dress your baby appropriately for the weather and not wrap him up in a warm blanket on a summer night. Source: Skin care for infants. Prevention of diaper dermatitis. Starostina L.S. Medical Council, 2022. p. 41-49.

Sources:

Skin care for infants. Prevention of diaper dermatitis. Starostina L.S. Medical Council, 2022. p. 41-49
Newborn skin care. Solntseva O.A. Medical Council, 2014. p. 35-39
Modern dermatological and cosmetic products for the care of children's skin. Kotlukov V.K., Kuzmenko L.G., Antipova N.V. Medical Council, 2013. p. 8-12

Date of publication: 10/20/2017
The information in this article is provided for reference purposes and does not replace advice from a qualified professional. Don't self-medicate! At the first signs of illness, you should consult a doctor.

Allergic rash

In any case, parents are recommended to consult a doctor to determine the cause of the rash on the baby’s body. If a specialist discovers an allergy, then it is necessary to identify its form and irritant. Typically, the causative agent may be the following:

the body's reaction to the weather (sun or cold);
food allergies (in which the allergen product can be consumed by both the baby and the mother, if the former is breastfed);
heredity (a child is at risk if at least one of his parents is predisposed to allergies);
cosmetical tools;
animal hair, dust, pollen;
vaccination vaccines.

Once the cause of the rash is known, the next important step is to completely eliminate the irritant. It will be easier to do this in cases where the reason lies in external factors that they simply stop using (if they are creams, powders, detergents and other hygiene products). In the case where skin manifestations are the result of consuming certain products, it is important to exclude the product itself. The first signs may appear as early as an hour and a half after eating the allergen. Breastfeeding mothers must follow a diet and avoid spicy, fatty, chocolate, brightly colored fruits and vegetables, and alcohol. In such cases, it will be more difficult to get rid of the rash, since the product must be digested by the intestines, leave the baby’s body, and only after that the spots on the body will begin to disappear. You should know that when the pathogen reaches the baby through mother's milk, the process is delayed and recovery occurs after two weeks. Parents who themselves suffer from allergies should be extremely attentive to what their child is surrounded by and what he eats. Unfortunately, such babies are more prone to skin diseases than others. In this case, the irritant of an adult and an infant can be completely different. At the genetic level, only the predisposition itself is transmitted.

Almost always, allergies as a disease can be prevented. To do this, you will need to fulfill simple requirements:

maintaining ideal cleanliness in the room, frequent wet cleaning and ventilation;
introduction of complementary foods no earlier than four months from birth, and in some cases no earlier than six months. At the same time, it is important not to overdo it: if the introduced product is not suitable, then it should be offered to the baby again after one or two weeks;
Diet compliance by a nursing mother. Drinking large amounts of liquid, broths and soups. Complete exclusion of harmful products;
You should not self-medicate and try to prevent this or that reaction with the help of medications without appropriate doctor’s recommendations;
maintaining hygiene and sharing a healthy lifestyle between mother and baby.

Walking in the fresh air, swimming, and hardening will have a positive effect on the health of all family members.

Urticaria and dermatitis are also types of allergic reactions. In the first case, there is a sudden appearance of itchy blisters on any part of the body. Such symptoms can occur from insect bites, from interactions with chemicals, and from eating strong allergens such as cow's milk, nuts, and honey. It is important to consider that prolonged exposure to the pathogen can worsen the baby’s condition, develop into edema and, at the same time, complicate breathing. Therefore, it is necessary to get rid of the presence of the irritant as quickly as possible and consult a doctor. Treatment occurs with the help of antihistamines and sedatives.

Dermatitis , like other types of allergies, is provoked by prolonged exposure to an irritant, increased sensitivity and predisposition to similar manifestations. Symptoms include inflammation of certain areas of the child’s skin (most often the hands, groin, cheeks), possibly burning and discomfort. Dermatitis is divided into several types:

diaper (long-term interaction of delicate skin with irritants, such as wet diapers, diapers. Here you should change the diaper more often and wash the baby with running warm water before each change.
Use wet wipes only when necessary, and apply a special protective cream under the diaper.);
atopic (an outbreak occurs at the immune level, as the body’s response to respiratory and contact irritants. Localized on the cheeks, thighs, arms. Characterized by peeling lesions.);
allergic (lack of vitamins in the body, consumption of allergic pathogens in food, lack of fresh air, moodiness, hyperactivity).

As in other cases, it is very important to make a diagnosis as quickly as possible and begin treatment in order to prevent transition to a chronic form. All allergenic foods should be excluded from the baby's diet; to reduce itching, the doctor will prescribe the use of a cream or ointment, and also prescribe the necessary medications to eliminate the causes. It is worth understanding that the problem always lies inside, and it is important not only to eliminate external symptoms, but also to completely destroy the original cause of the disease. When an allergy manifests itself against the background of vaccinations for a child, it is important to take into account the child’s predisposition in advance, notify the doctor about this and follow a number of measures prior to vaccination. Such events include the following:

taking tests;
use of antihistamines two to three days before vaccination;
close observation on the day of vaccination and refusal of new products.

Parents need to know that any vaccine contains a potential pathogen. It can be chicken egg white, gelatin and other components that make up the drug. Therefore, after the vaccination has already been done, you need to stay with the child in a medical facility for about half an hour, in order to observe and take measures, if necessary. Most often, doctors do not recommend going for walks on the day of vaccination, especially if the baby is still very small and fragile. It will be necessary to monitor the general condition and possible changes for two weeks.

Rash caused by infections and viruses

Only a specialist can recognize the etiology of the formation of a rash on the baby’s skin and prescribe the need for treatment. But in cases where skin manifestations are accompanied by fever, stool disturbances, vomiting, and difficulty breathing, then most likely the nature of the disease is directly related to infection. Infectious rashes are caused by diseases such as:

chickenpox (caused by the appearance of blisters containing liquid inside. The areas of spread itch and itch, and the temperature rises to critical levels. Throughout the maturation of the blisters, the child is a carrier of the infection. The affected areas are treated with brilliant green. If all the doctor’s instructions are followed, recovery occurs after 21 days.);
rubella (this type of infection is characterized by cough, fever, enlarged lymph nodes, intestinal dysfunction, and, as a result, diarrhea and vomiting. The rash is usually not palpable, but appears in the form of redness of the skin. Most often, this disease occurs in children older than two years, but infants can also be infected, especially those who do not have the appropriate vaccination. The disease proceeds without complications and does not require special measures. It is only important to maintain bed rest and reduce the risk of rubella infection for other small family members, since five to seven days, an infected infant can infect unvaccinated children.);
measles (the main reason for its appearance is the lack of vaccination. Infection occurs by airborne droplets, and symptoms begin to appear no earlier than a week later. As a result, it is not possible to notice the disease in time. Only after a few days do the symptoms of the disease make themselves felt : the temperature rises, a small rash appears first on the inside of the cheeks, head, and then throughout the body.The child’s immunity weakens, so it is necessary to feed it with vitamins during this period, and allow the body to cope with the disease on its own.

It is recommended to help the baby during this period, based on the symptoms that appear: antipyretics, throat sprays, nasal drops, as well as bed rest and frequent fluid intake. Treatment can take place both at home and in a hospital, under the supervision of a doctor, in order to eliminate the possibility of complications). A dermatologist or allergist will help you make the correct diagnosis. To do this, you need to undergo tests and, if necessary, skin scraping. An important role is played by external factors, the nature of the rashes, their localization, as well as the accompanying deterioration of the baby’s condition. In any case, it is necessary to follow all the doctor’s instructions regarding treatment and compliance with certain rules. The duration of allergies is also particularly influenced by the child’s immunity: the stronger it is, the sooner it will cope with the disease. Parents are required not to panic, but to notice the slightest manifestation of symptoms in time and contact a doctor as soon as possible.