Prickly Heat

(Miliaria)

ByShinjita Das, MD MPH, Massachusetts General Hospital
Reviewed/Revised Mar 2024
VIEW PROFESSIONAL VERSION

Prickly heat is an itchy rash caused by trapped sweat.

(See also Introduction to Sweating Disorders.)

Prickly heat develops when the narrow ducts carrying sweat to the skin surface get clogged. The trapped sweat causes inflammation, which causes irritation (prickling), itching, and a rash of small bumps or very tiny blisters. Occasionally the bumps can cause pain.

Prickly heat is most common in warm, humid climates and in people who sweat more, but people who are overdressed in cool climates and people who are hospitalized can also develop prickly heat. It tends to occur on areas of the body where skin touches skin, such as under the breasts, on the inner thighs, and under the arms. It also occurs when the skin is covered by clothing or rests against another surface for a prolonged period of time, such as people in the hospital who lie with their back against the hospital bed.

What Causes Prickly Heat?

Prickly heat results when sweat glands are clogged and sweat is trapped below the skin.

Prickly Heat
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This photo shows the rash of small bumps typical of prickly heat.
Photo courtesy of David M. Pariser, MD.

Diagnosis of Prickly Heat

  • A doctor's evaluation

Doctors diagnose prickly heat based on the appearance of the rash and whether the person has been in a hot environment, overdressed, or hospitalized on bedrest.

Treatment of Prickly Heat

  • Measures to cool and dry the skin

  • For the rash, corticosteroid creams or lotions

Treatment of prickly heat includes keeping the skin cool and dry. Use of powders and antiperspirants often helps. Conditions that increase sweating should be avoided, and an air-conditioned environment is ideal.

People should avoid overdressing and using thick ointments.

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