Summertime means outdoor fun, but it also means dealing with summertime rashes. Prevention is key to avoid heat rash, which is caused by excessive sweating and the inability to stay dry and cool. Heat rash commonly develops in the skin folds of the neck, armpits, groin and thighs. Children should dress appropriately for the environment: light-colored, loose-fitting, cotton clothing. Frequent cool baths help can remove dirt and sweat, a skin irritant.
To treat heat rash, keep the skin cool and dry. Avoid putting lotions and ointments on the rash, especially in skin fold areas as that might worsen the rash. Simple cleansing of the skin with a gentle soap and applying an absorptive powder such as cornstarch may help absorb excess moisture. If your child has a lot of itching associated with the rash, give diphenhydramine (Benadryl®) by mouth. Avoid using topical agents with diphenhydramine as it might cause increased sensitivity (to sunlight, for example) and worsen the rash.
For plant-associated rashes, learn to recognize poisonous plants and avoid them as best you can. As multiple plants can cause sensitive skin to break out, it is important to wash the area with cool water immediately after being exposed, for instance after spending time gardening or weeding. If you know you have been exposed to poison ivy, rinse the area with cool water, then cleanse with alcohol and take a cool bath using soap.
If a rash develops, cool, wet dressings help with itching – but are not very practical. “Oatmeal baths” that are available commercially also help reduce the itching. Various topical creams for itching are available, but as stated before, lotions containing diphenhydramine should be avoided. Applying a topical corticosteroid cream may be helpful, and in severe cases, oral steroids will help reduce the symptoms.
Charles A. Welborn, MD, MPH, FAAP, FACEP, Medical Director, After Hours Pediatrics Urgent Care.