What is the prognosis of miliaria?

Updated: Mar 27, 2020
  • Author: Nikki A Levin, MD, PhD; Chief Editor: Dirk M Elston, MD  more...
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Answer

Most patients recover uneventfully within a matter of weeks, once they move to a cooler environment.

The complications of miliaria are altered heat regulation and secondary infection (see Complications).

Miliaria crystallina is generally an asymptomatic self-limited condition that resolves without complications over a period of days. It may recur if hot, humid conditions persist.

Miliaria rubra also tends to resolve spontaneously when patients are moved to a cooler environment. Unlike patients with miliaria crystallina, however, those with miliaria rubra tend to be symptomatic; they may report itching and stinging. Anhidrosis develops in the affected sites and may last weeks. If generalized, anhidrosis can lead to hyperpyrexia and heat exhaustion. Secondary infection is another possible complication of miliaria rubra; this appears as either impetigo or multiple discrete abscesses known as periporitis staphylogenes.

Miliaria profunda is itself a complication of repeated episodes of miliaria rubra. The lesions of miliaria profunda are asymptomatic, but compensatory facial and axillary hyperhidrosis may develop. [25] The widespread inability to sweat, the result of eccrine ductal rupture, is known as tropical anhidrotic asthenia; this condition predisposes patients to heat exhaustion during exertion in warm climates.

Some authors believe that subclinical miliaria is an initiating step in development of atopic dermatitis. Their evidence is histopathology showing PAS-positive material and bacteria present in the acrosyringium in cases of atopic dermatitis, whereas no blockage of eccrine ducts was seen in controls. [26]


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