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Sweating in a child: what does it look like, how to treat at home?
Medical expert of the article
Last reviewed: 04.07.2025
Among dermatological problems, prickly heat in children from the first days of birth up to two or three years of age is one of the main reasons why parents contact pediatricians.
Prickly heat is classified as a disease of the skin appendages – small sweat (eccrine) glands located throughout the body.
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Epidemiology
Domestic clinical statistics of infantile prickly heat are unknown. But, according to the American Academy of Family Physicians, this skin pathology affects up to 40% of infants and usually appears during the first months of life. In 3-4.5% of cases, the so-called crystalline prickly heat is diagnosed by pediatricians in newborns aged 7-10 days. This subtype or type of the disease is the most common.
Also, some studies note that prickly heat in newborns most often appears in those with a high birth weight, as well as in infants born prematurely or by cesarean section.
Causes baby sweats
The main causes of prickly heat in children are considered to be overheating - due to hot weather and heat, as well as due to errors in child care, in particular, when they are dressed too warmly or swaddled too tightly. This often causes skin problems such as prickly heat and diaper rash in children.
As a result, sweat production by the eccrine glands increases, while its exit to the surface of the epidermis and natural evaporation are hindered. Thus, conditions arise for partial obstruction of the sweat glands' excretory pores.
Often, prickly heat appears after a child has a fever, when hyperhidrosis during fever is caused by one or another acute infection.
This skin lesion is more often observed in hot weather, but excessive insulation and the “greenhouse effect” created by clothing lead to the fact that prickly heat may appear in a child in winter.
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Risk factors
Pediatricians identify the following as unconditional risk factors for the development of prickly heat:
- in high air temperatures - indoors or outdoors during hot seasons, especially in combination with high humidity;
- in clothing and bed linen made of synthetic, air-impermeable fabrics that do not absorb sweat and block skin gas exchange;
- in excessive treatment of the skin in the warm season with non-breathable oils or fat-based creams, which leads to clogging of sweat pores on its surface;
- in the child's excess weight and a large number of deep skin folds, the skin in which constantly sweats without timely evaporation of the secreted sweat.
Pathogenesis
To reduce body temperature when overheated, small children, like adults, sweat. But why does prickly heat appear so often in early childhood?
To a large extent, the pathogenesis of prickly heat in children is caused by the thermoregulatory system of the body of children from birth to one and a half to two years of age, which is not fully formed and adapted to the conditions of the external environment. The physiological characteristics of their skin also play a large role: a thin stratum corneum of the dermis, the absence of a full-fledged hydrolipid (water-fat) and acid mantle of the skin, which are insufficient to protect the skin.
When prickly heat develops, the eccrine sweat glands (which are tube-shaped) located in the skin throughout the body and their not fully developed excretory ducts that open into the superficial pores of the skin become blocked.
According to experts, the development of prickly heat in children, especially prickly heat in infants, is caused by the opportunistic bacterium Staphylococcus epidermidis, which lives on healthy skin (i.e. is part of the skin microbiota). It is believed that the substance produced by this microorganism, which forms a film, closes the excretory pores. And the release of accumulated sweat directly through the walls of the glands manifests itself in rashes on the skin and its irritation.
By the way, another type of sweat glands – apocrine (located deeper than eccrine and localized in the armpits, perineum and groin, in the pubic area and navel) – finish developing in childhood and “turn on” with the onset of puberty. Their excretory ducts open, like those of the sebaceous glands, into the hair follicles.
Symptoms baby sweats
The first signs of prickly heat are skin rashes. And what prickly heat looks like in children depends on its type.
Crystalline miliaria manifests itself in vesicles - small transparent bubbles filled with liquid; the skin does not turn red, and the rash does not cause itching or other unpleasant sensations. Each vesicle develops until spontaneous perforation, followed by drying and desquamation. How long does miliaria last in children? Crystalline miliaria usually resolves on its own (the scales peel off within a few days), but - if the effect of causative factors continues - the rash may reappear.
If prickly heat is localized on the head and forehead of a child, appeared on the neck (in the folds, behind the ears, along the hairline) or on the body - on the back, on the stomach, and also appeared on the arms (in the bends of the elbow joints and in the forearms) and on the legs (in the bends of the knee joints), then in 85-92% of cases this is a crystalline type of pathology. See also - Prickly heat in a newborn on the face and neck
With red prickly heat, the child's skin is first covered with itchy red-pink spots, on which reddish nodules form literally within a few hours. They last for several days, often transforming into pustules, which is why a parallel name appeared in dermatology - "pustular prickly heat". The places of its rash are the bends of the limbs, the scalp and neck; such prickly heat in children often occurs under the armpits.
Red prickly heat may also appear on the feet (between the toes and on the arch of the foot), in the groin and on the buttocks, i.e. on the bottom. The area of the rash can be quite extensive, maceration of the epidermis often occurs; itchy skin irritates the child, which affects his behavior, sleep and feeding.
If deep miliaria occurs, a rash in the form of pink or red spots and bright papules of different sizes spreads over the whole body, but is mostly concentrated in the neck and back; fever, general malaise, itching and irritation of the skin are noted.
Forms
Types of prickly heat distinguished by dermatologists:
- crystalline (miliaria crystallina) - superficial, most frequently diagnosed;
- red (miliaria rubra) - deeper, more common in newborns, usually developing between the first and third weeks of the baby's life;
- deep (miliaria profunda) - the rarest, as it mainly affects adults living in tropical climates. At the same time, it is the most serious, as it is caused by complete obstruction of the apical sections of the eccrine glands; it is often a complication of repeatedly recurring miliaria rubra.
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Complications and consequences
If skin care with prickly heat is not high enough, or the child scratches the itchy areas, then the consequences and complications - in the form of bacterial or fungal infection of the damaged skin - will not take long to appear. First of all, the above-mentioned epidermal staphylococcus is activated, which is slightly virulent in favorable conditions and quite aggressive with any damage to the superficial layers of the skin.
Most often, advanced prickly heat is complicated by staphylococcal or streptococcal pyoderma – pustular inflammation, as well as periporitis – an inflammatory process directly in the pores of the eccrine sweat glands.
Deep heat rash after prolonged overheating, which caused the child to sweat heavily, can lead to heat stroke: with fever, hyperemia and dry skin, vomiting, weakness, rapid shallow breathing and even loss of consciousness. But this can only happen in extreme cases.
Diagnostics baby sweats
At first glance, diagnosing prickly heat in a child does not cause any particular difficulties, and is usually carried out by a local pediatrician, carefully examining the child, recording and analyzing the nature and location of the rash on the skin.
But there are many diseases with similar symptoms, and a child may have a rash similar to prickly heat from chickenpox, rubella or measles.
Differential diagnosis
Therefore, differential diagnostics must accurately determine what skin problem has actually arisen: pemphigus neonatorum, atopic dermatitis, diaper erythema, allergy or prickly heat in a child.
Who to contact?
Treatment baby sweats
Treatment of prickly heat in children is carried out at home, and the key therapeutic method is the exclusion of heat exposure to the child's skin (reducing the intensity of sweat secretion) and proper skin care. There is usually no need for drug treatment.
However, parents often ask the same question: what to apply to a child's prickly heat? Doctors strongly recommend not to apply anything to the rash right away! First of all, treatment of prickly heat in children includes bathing the child in water with a weak (pale pink) solution of potassium permanganate and then thoroughly drying the skin (moisture should not be wiped off, but gently blotted). Air baths will help to achieve absolute dryness of the skin, which is necessary to get rid of prickly heat: the child should be without clothes for several minutes.
Skin folds, redness and rashes are powdered with baby powder; also acceptable antiseptics for prickly heat in children: 0.5-1% ethyl solution of boric acid (boric alcohol), 1% solution of salicylic acid (salicylic alcohol), furacilin solution.
It is important to use any ointment or cream for prickly heat in children with caution: fat-based products (most often Vaseline) clog pores and only worsen the situation.
To relieve skin redness (if there is no maceration), you can use D-Panthenol and Bepanten creams (with D-panthenol) or Pantestin gel (which also contains miramistin).
When a child over one month old itches from prickly heat, only as prescribed by a doctor can use the antihistamine drug Dimetindene (Fenistil), used for allergic dermatitis and urticaria, in the form of a gel, which is applied to the problem area two to three times a day.
If the symptoms persist for more than a few days and the skin becomes wet, then an antiseptic and drying suspension with zinc oxide - Tsindol - can be used (by applying to the affected areas). This is a better remedy than the usual (Vaseline-based) zinc ointment. It is more advisable to use zinc ointment with white paraffin (it is available in tubes, not in jars).
Judging by the presence of the item "rashes of various etiologies" in the list of indications for use, Calamine lotion can be used to relieve itching and irritation of the skin, disinfect and dry out rashes. In addition to zinc oxide and the zinc-containing mineral calamite, the composition of this product (declared as a children's lotion that soothes the skin) contains a very strong bactericidal substance - phenol, used to treat purulent skin diseases, penetrating through the skin into the blood and... contraindicated for children.
Antibacterial agents for external use - Levomekol or Cortomycetin, as well as liniment of synthomycin with the antibiotic levomycetin - are prescribed by the doctor when prickly heat in a child does not go away due to inflammation of the skin that occurs when it is infected.
If the situation gets even more complicated, then it may come to topical corticosteroids - to relieve inflammation and itching. However, the serious side effects of most of these drugs are well known to many. And if someone was recommended Advantan cream, then you need to keep in mind the following: according to the instructions, this product with methylprednisolone aceponate (a synthetic analogue of prednisolone) is allowed to be used for dermatitis, neurodermatitis, eczema, psoriasis, etc. from the age of 4 months (and for the drug in the form of an emulsion, there are no age restrictions at all). But methylprednisolone is contraindicated for children under 12 years of age.
Glucocorticosteroids are absorbed by children's skin and enter the bloodstream, increasing the undesirable systemic action of synthetic adrenal cortex hormones. In addition, the use of such drugs in children without extreme necessity causes dermatosis and epidermal atrophy.
Folk remedies
A folk treatment for prickly heat that has long become a classic is herbal treatment, that is, bathing the child in water, adding decoctions of medicinal plants to it: chamomile flowers and calendula officinalis, plantain leaves, three-part succession grass, cinquefoil or lovage, as well as coriander seeds.
Rinsing the skin or applying slightly warm compresses with a decoction of oak bark, elecampane roots, horsetail grass or marsh cudweed will help with their anti-inflammatory and astringent effect.
For the same purpose, you can use natural apple cider vinegar diluted with boiled water (1:1) - spraying the resulting solution onto the skin and allowing the moisture to dry completely.
And to relieve itching and prevent inflammation, it is recommended to treat the area of prickly heat with a soda solution (one teaspoon per glass of warm water) or fresh aloe juice diluted in half with water.
Forecast
The prognosis for blockage of small sweat glands, leading to the development of prickly heat, is favorable: the problem can be solved quickly if you dress the child correctly and wash him more cleanly.
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