Miliaria (heat rash) are very tiny clear or red bumps on the skin which are nothing more than plugged sweat glands with accumulated dead skin cells. They appear when the child has experienced intense sweating, usually, in my experience, in the winter rather than the summmer. I assume this is because the glands have been in disuse so long they are relatively constricted at the skin surface.

As is our habit in medicine, we give Latin names to simple things to justify our fees: miliaria crystallina means clear little itchy heat rash bumps; miliaria rubra means red little itchy heat rash bumps. If sweat and debris leaks out of the sweat glands into the surrounding tissue, these foreign materials produce some inflammation.

I usually just tell Mom to wash the child with a rough washcloth when she bathes him; this seems to help open up the pores. Hydrocortisone cream 1% is useful if the rash is very itchy - apply it about three or four times a day. I am not sure cornstarch or talcum powders and such accomplish much.

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