What causes painful, itchy bumps on the skin after sweating?
Ask the expert
Q. When I sweat, it can be painful and itchy on my upper back and chest. Sometimes I see small pink spots on my chest. What causes this?
A. Sweating in hot, humid weather or under heavy clothing can result in poor function of the sweat glands. They act as though they are blocked, so sweat does not get to the surface of the skin. Evaporation of sweat is a key way for the body to cool when internal body temperature rises.
This obstruction of sweat can take place in different levels of the skin. If the sweat ducts within the upper level of the skin, called the epidermis, are blocked, it results in miliaria rubra, or prickly heat. This can cause tiny pink bumps on areas such as the neck, chest, or back. These bumps can be very itchy and painful. Areas of skin that are rubbed by clothing can be especially irritated.
Prickly heat can occur after any event that causes sweating, including hot weather, exercise, stress, or illness. People who move to a warmer climate may have excessive sweating and prickly heat until they adjust to the new climate.
Staying cool is the best way to prevent this problem. If you have a problem with prickly heat, wear loose clothing and stay in an air-conditioned environment when possible. Applying non-perfumed, over-the-counter lotions that contain menthol can be soothing to the rash.
If the rash persists, see your doctor to make certain that your symptoms are due to prickly heat and not some other disorder. Your doctor may also prescribe cortisone cream to apply to the rash to reduce redness, itching, and pain.
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