Dr Bernadette Carr answers your questions on prickly heat rash and nail abnormalities

I am a woman in my 40s and last year on holidays I got a rash on my neck. I think it was prickly heat. I will be going away in a couple of weeks and wonder if you have any suggestions?

Prickly heat rash can be very uncomfortable and I can understand your wanting to avoid a repeat.

Also known as miliaria rubra, it’s a common skin condition that occurs in some people when they sweat more than usual and the sweat glands become blocked.

There are thousands of sweat glands which lie just below the surface of the skin, these make sweat which travels though the sweat duct and out on to the surface of the skin.

However if the duct is blocked, perhaps through excessive sweating, the sweat becomes trapped in the skin. This produces a rash — made up of tiny red spots which look like blisters — and appears on the face, neck, back, chest or thighs as a result of exposure to heat.

Although anyone can develop prickly heat rash at any age it is more common in babies and children as their sweat glands have not developed fully. People often develop this rash within a few days of travelling to a warmer climate and sweat more than usual.

Here are some general suggestions which you may find useful:

  • Try to avoid hot, humid conditions.
  • If you do travel, spend a few hours each day indoors. preferably in an air-conditioned room.
  • Sun cream with UVA protection may help.
  • Wearing loose fitting clothes.
  • Avoid using oil-based topical lubricants as they can block sweat ducts.
  • Take a cool shower or bath.
  • Slowly acclimatise if you travel from one extreme of weather to another.
  • Calamine lotion can help to soothe and clam the skin.
  • Avoid synthetic materials and wear clothes made from cotton or breathable materials.

If you do have another episode of prickly heat, it might be useful to visit your GP to discuss how best to management this so that it does not interfere with future travel.

Over the past year, I have developed ridges on some of my fingernails. These run the full length of the nail. I have tried to hide it by constantly wearing nail polish but wonder if this might have made the problem worse. Should I be worried?

Vertical ridges in fingernails are very common, they are usually harmless and the most common causes are ageing, certain long-term medical conditions and damage to the nail bed following an injury.

As changes or abnormalities in either finger or toenails can tell a lot about your health, it is always important to show your GP any changes in the nails. He/she can check for an underlying cause for the ridges such as a vitamin deficiency or fungal infection.

In the meantime, I would suggest that you might try the following general suggestions:

  • Avoid using nail varnish. If you must use it, make sure that you use a protective base coat and avoid nail polish removers with acetone.
  • Always wear rubber gloves for any work involving water.
  • Avoid damaging the cuticles when manicuring your nails.
  • Only ever use the gentlest of nail brushes to clean your nails.
  • Don’t bite your nails.
  • Protect your nails if doing physical work such as gardening by wearing gloves.
  • Make sure you eat plenty of fruit and green vegetables.
  • Ensure that your diet includes foods that are rich in Omega-3; oily fish such as salmon, sardines, and mackerel are excellent sources.

It is possible that the ridges may be caused by a lack of moisture in either your nails or the cuticles. Apply an unscented emollient hand cream frequently throughout the day and massage moisturising oil, such as almond oil, into the cuticles every night.

I am sure that your GP will be able to reassure you.


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