Overview

Heat rash (miliaria) occurs when sweat ducts become blocked and sweat is trapped under the skin. In Kuwait's extreme summer heat it is one of the most common dermatological complaints in both children and adults, ranging from mild clear blisters to severe flesh-coloured bumps with reduced sweating.

Symptoms

• Miliaria crystallina (mildest): tiny clear blisters that burst easily; no itching
• Miliaria rubra (prickly heat, most common): red bumps, intense prickling or itching in skin folds
• Miliaria profunda (severe): flesh-coloured bumps, reduced sweating — overheating risk
• Most common on neck, armpits, groin, chest, and under breasts

Causes & Risk Factors

• Hot humid weather — primary trigger in Kuwait; immature sweat ducts in newborns
• Physical activity, fever, tight non-breathable clothing
• Thick ointments or creams that block pores

Complications

• Bacterial superinfection
• Miliaria profunda can impair sweating causing heat exhaustion or heat stroke — serious risk in Kuwait's summer

Diagnosis

Clinical diagnosis based on characteristic appearance and location. No tests needed for typical presentations.

Treatment

• Move to a cool air-conditioned environment immediately
• Calamine lotion and cool compresses soothe itching
• Mild topical corticosteroids for severe itching; topical antibiotics if secondary infection develops
• Avoid thick occlusive creams; rash typically resolves within days once skin is kept cool and dry

Prevention

• Stay in air-conditioned environments during peak heat hours (10am-5pm in Kuwait summer)
• Wear loose lightweight breathable cotton clothing; shower after sweating and pat skin dry
• For infants: keep cool, dress lightly, and avoid overdressing

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