ZocdocAnswersIs this prickly heat rash?

Question

Is this prickly heat rash?

I have a rash of hundreds of little red bumps with whiteheads all over my uper chest and shoulders. I just broke out in this rash a few days ago after working out in a new t-shirt - maybe a reaction to that? My girlfriend says it looks like prickly heat rash, but I have no idea. What should I do?

Answer

This sounds a lot like folliculitis, which is an infection of the base of the hair shafts in the skin, leading to small reddened areas around the base of the hairs sometimes with small whiteheads forming, like you describe. Folliculitis can be caused be many things, but is especially common when the skin is irritated by sweating, shaving, or perhaps a new fabric (you describe a new t-shirt, for example). Folliculitis like this is usually self limited and doesn't require any treatment other than keeping the skin clean and dry. Prickly heat rash is very similar to folliculitis. It occurs when sweating and rubbing of the skin leads to blocking of sweat glands, causing red bumps sometimes also with whiteheads. The difference is that the bumps tend to be smaller and there tends to be more itching. Again, this rash is self limiting and usually gets better if you can just keep the skin clean and dry. If the rash is not getting better within a few days, or if the areas of swelling and whiteheads begin to coalesce, get larger, or if there is pain or fever, then you should see your primary care doctor right away.

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