Miliaria crystallina, or sudamina, is a mild form of heat rash caused by blocked sweat glands that results in small, fragile blisters. It can be prevented by allowing sweat to evaporate and avoiding overheating the skin. Treatment includes cold compresses, calamine lotion, and topical steroids in severe cases. It is common in tropical climates, excessive exercise, certain fabrics, heavy creams, and sunscreens. It can also be a side effect of certain prescription drugs and is common in newborns.
Miliaria crystallina, also known as sudamina, is the mildest form of heat rash and is characterized by small, fairly fragile, fluid-filled blisters. It is caused by blocked sweat glands which force the accumulated sweat to flow into the epidermis and erupt as blisters. This condition is prevented by allowing sweat to evaporate and avoiding conditions that overheat the skin.
Many conditions can lead to blocked sweat glands and cause miliaria crystallina. Tropical climates with high heat and humidity, as well as excessive exercise in hot weather, can put extra strain on the sweat glands by reducing evaporation from the skin, leading to blocked pores and pooling of sweat in the surface layers of the skin. Certain fabrics, heavy creams, and sunscreens can impede the natural evaporation of sweat, causing the sweat glands to become clogged.
Sudamine is a side effect of the prescription drugs bethanechol, clonidine, isotretinoin and doxorubicin. Also, people on bed rest with limited movement can develop this form of rash when the skin is covered and excessive sweat cannot evaporate. This condition is also common in newborns who are often wrapped tightly, even in the summer or while in an incubator, and have incompletely matured sweat glands.
Miliaria crystallina blisters can develop anywhere on the body. The most common places for these blisters are where the skin retains heat and sweat, such as skin folds, or where clothing wears against the skin. On children, sweat blisters most often develop in or near the armpits, around the groin, or along the neck.
The best treatment for miliaria crystalline is to prevent it by limiting sweating and allowing the skin to breathe and perspiration to evaporate. This means not exercising excessively in hot weather, wearing appropriate clothing in hot weather, and taking advantage of air conditioning in hot and humid weather. Heavy creams should be avoided in hot and humid weather to allow perspiration to escape and promote better evaporation from the skin.
If miliaria crystallina develops, it can be treated and relieved with cold compresses. If this doesn’t work, calamine lotion will often be enough to provide comfort. In severe cases, topical steroids may be needed. If the blisters rupture and become infected, a topical antibiotic ointment may be needed.
Heat rash, clinically known as miliaria, comes in four grades of increasing severity. Miliaria crystalline is the most benign form of heat rash, miliaria rubra and miliaria profunda are the intermediate forms, and miliaria pustular is the most severe. Each form of milia is characterized by a more severe blockage of the sweat glands and causes more skin damage and a longer recovery time.
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