What are the treatment options for miliaria?

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

No compelling reason to treat miliaria crystallina exists because this condition is asymptomatic and self-limited.

Miliaria rubra can cause great discomfort, and miliaria profunda may lead to heat exhaustion. Treatment of these conditions is warranted.

The prevention and treatment of miliaria primarily consists of controlling heat and humidity so that sweating is not stimulated. Measures may involve treating a febrile illness; removing occlusive clothing; limiting activity; providing air conditioning; or, as a last resort, having the patient move to a cooler climate.

Topical treatments that have been advocated involve lotions containing calamine, boric acid, or menthol; cool wet-to-dry compresses; frequent showering with soap (although some discourage excessive use of soap); topical corticosteroids; and topical antibiotics.

The topical application of anhydrous lanolin and isotretinoin has resulted in dramatic improvement in patients with miliaria profunda. [25]

The prophylaxis of miliaria with oral antibiotics is reported. Patients have also been treated with oral retinoids, vitamin A, and vitamin C, with variable success. To our knowledge, no controlled trials have been conducted to demonstrate the effectiveness of any of these systemic therapies.

Antimicrobial agents are effective in suppressing experimentally induced miliaria.


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