How to distinguish eczema from prickly heat
Disease description:
My child has developed many red spots on their back that are very itchy. I'm not sure if it's eczema or heat rash—how can eczema and heat rash be distinguished?
Doctor's answer (1)
Dr. Wang Xiaoyan
The differentiation between eczema and prickly heat (miliaria) can be made from the following aspects:
1. **Etiology**: Eczema is primarily caused by allergic reactions and is classified as an allergic inflammatory skin disease. In contrast, prickly heat is usually caused by high temperature and humidity, leading to inflammation around the sweat glands due to blocked sweat excretion.
2. **Rash morphology**: Eczema presents with polymorphic skin lesions, including erythema, papules, vesicles, erosions, and exudation. Prickly heat mainly manifests as small, pinhead-sized papules, papulovesicles, or vesicles, often densely distributed.
3. **Affected areas**: Eczema can occur on any part of the body and tends to be widespread. Prickly heat typically appears in areas prone to sweating and poor heat dissipation, such as the neck, armpits, and elbow creases.
4. **Symptoms**: The main symptom of eczema is itching, which may be severe. In addition to itching, prickly heat may also cause a burning sensation or prickling pain.
5. **Disease course**: Eczema is characterized by recurrent episodes and a prolonged course. Prickly heat usually resolves quickly once the weather becomes cooler or the environment improves.
