Ruam panas (heat rash, or prickly heat) is a rash of small, raised, itchy or prickly spots that appears when blocked sweat glands trap sweat in the skin, usually after sweating a lot in hot, humid weather. It is common in Malaysia's climate, especially in babies, and is usually harmless. It gets better on its own within a few days if you keep the skin cool: wear loose cotton clothes, take cool showers, drink plenty of fluids and pat rather than scratch. A pharmacist can suggest calamine lotion or other treatments. Heat rash is not contagious, but see a doctor if it does not improve after a few days, and get urgent help if a child with a rash seems very unwell.
What is ruam panas (heat rash)?
According to the NHS, heat rash is uncomfortable but usually harmless, and it usually gets better on its own after a few days. Doctors call it miliaria; it is also known as prickly heat or sweat rash.
DermNet, a dermatology resource, notes that heat rash is frequently seen in hot, humid or tropical climates, and can affect up to 30% of adults who move to a tropical environment. It can affect all age groups, and DermNet says most cases clear within a day or two after moving to a cooler environment.
Tanda ruam panas: what does heat rash look like?
According to the NHS, the symptoms of heat rash are:
- small, raised spots, about 2mm to 4mm across; some may be filled with fluid;
- an itchy, prickly feeling;
- mild swelling.
The rash looks red on white skin, but may be harder to see, or look grey or white, on brown or black skin. It can appear anywhere on the body and spread, but it cannot be passed on to other people. Symptoms are often the same in adults and children.
DermNet notes that in children, heat rash often appears on the trunk and the skin folds of the neck, armpits or groin; in adults, it often affects the upper body, scalp and neck, especially where clothing rubs.
Types of heat rash
According to DermNet, there are 3 main types, depending on how deep the sweat duct blockage is:
| Type | What it looks like | Who gets it |
|---|---|---|
| Miliaria crystallina | Tiny (1–2 mm) clear blisters that look like beads of sweat and break easily; not red or inflamed | Common in newborns (up to 9% of babies, usually around 1 week old); can also occur in adults with a fever |
| Miliaria rubra | Red, very itchy, prickly spots 2–4 mm across | The most common type; children and adults in hot climates |
| Miliaria profunda | Firm, skin-coloured bumps 1–3 mm across | Rare; usually adult men after repeated episodes of miliaria rubra |
Punca ruam panas: why does it happen?
According to the NHS, heat rash is usually caused by sweating a lot. Sweat glands get blocked, and the trapped sweat leads to a rash developing a few days later.
DermNet lists the main contributing factors as:
- immature sweat ducts in newborn babies;
- a hot and humid environment;
- intense exercise or physical activity;
- a fever;
- synthetic clothing or non-breathable dressings against the skin;
- lying in bed for long periods, for example on waterproof mattress covers.
Cara hilangkan ruam panas: how to treat it at home
According to the NHS, the main thing to do is keep your skin cool so you do not sweat and irritate the rash.
To keep your skin cool:
- wear loose cotton clothing;
- use lightweight bedding;
- take cool baths or showers;
- drink plenty of fluid to avoid dehydration.
To calm the itching or prickly feeling:
- apply something cold, such as a damp cloth or an ice pack wrapped in a tea towel, for up to 20 minutes;
- tap or pat the rash instead of scratching it;
- do not use perfumed shower gels or creams.
DermNet adds that sleeping in a ventilated, cool room and spending a few hours a day in an air-conditioned space can help the rash settle.
Ubat ruam panas: what a pharmacist can suggest
According to the NHS, a pharmacist can give advice and may recommend:
- calamine lotion;
- antihistamine tablets for itching;
- hydrocortisone cream, though not for children under 10 without a doctor's advice.
Our guide to gatal kulit explains more about itchy rashes and which creams suit which rash.
Ruam panas bayi: heat rash in babies
According to the NHS, babies often get heat rash because they cannot control their temperature as well as adults and children can. DermNet notes that the clear, blister-like type (miliaria crystallina) affects up to 9% of newborns.
To help your baby:
- dress them in light, loose cotton clothing, and avoid wrapping them in too many layers;
- keep the room cool and well ventilated;
- give a cool (not cold) bath;
- keep up their normal feeds so they stay hydrated;
- avoid perfumed creams on the rash.
The NHS advises seeing a doctor if your baby has a rash and you are worried. As a parent, trust your judgement if your baby seems unwell. Newborns can also have other skin and colour changes, such as kuning (jaundice), which need a different approach.
Is it heat rash or something else?
Many rashes look similar. Clues that it may be something other than heat rash:
| What you notice | Possible cause | Our guide |
|---|---|---|
| Rash with a high temperature and feeling unwell, in Malaysia | Dengue fever (needs medical check) | Demam denggi |
| Blisters on the hands and feet with mouth ulcers | Hand, foot and mouth disease | HFMD |
| Itchy spots that turn into blisters, or a rash after cold-like symptoms | Chickenpox or measles | Cacar air & campak |
| Dry, cracked, itchy patches that keep coming back | Eczema | Ekzema |
| Intensely itchy spots, worse at night | Scabies | Kudis buta |
| Ring-shaped or patchy rash | Fungal infection | Kurap & panau |
Call 999 or go to the emergency department if a child is unwell with a rash and has any of these, according to the NHS:
- a stiff neck, or is bothered by light;
- seems confused, agitated or is not responding as usual;
- difficulty breathing, breathlessness or very fast breathing;
- pale, blue, grey or blotchy skin, lips or tongue;
- sudden swelling of the lips, mouth, throat or tongue;
- a rash that looks like small bruises or bleeding under the skin and does not fade when you press a glass against it.
Get an urgent appointment if a baby under 3 months has a temperature of 38°C or more, or a child aged 3 months or older has a temperature of 39°C or higher; see our guide to demam.
How to prevent heat rash in Malaysia's climate
Heat rash comes from sweating, so prevention is about staying cool. Based on NHS and DermNet advice:
- wear loose, breathable clothes made of cotton, and avoid tight or excessive clothing;
- take cool showers after sweating, exercise or being outdoors;
- sleep in a cool, ventilated room;
- drink plenty of fluids on hot days;
- avoid heavy, perfumed creams on skin prone to heat rash.
When should you see a doctor?
According to the NHS, see a doctor (at a klinik kesihatan or a GP) if:
- your heat rash does not improve after a few days;
- your baby has a rash and you are worried.
DermNet notes that heat rash can become infected with bacteria. See a doctor if spots become painful, swollen, hot or filled with pus, or if you develop a fever, as these may be signs of infection.
Frequently asked questions (FAQ)
What is ruam panas (heat rash)?
Ruam panas, also called heat rash, prickly heat or miliaria, is a rash of small, raised, itchy or prickly spots caused by sweating a lot. According to the NHS, sweat glands get blocked and the trapped sweat leads to a rash. It is uncomfortable but usually harmless and gets better on its own after a few days.
How do I treat ruam panas at home?
The main thing is to keep your skin cool so you do not sweat and irritate the rash. The NHS suggests loose cotton clothing, lightweight bedding, cool baths or showers, plenty of fluids, a cold damp cloth or wrapped ice pack for up to 20 minutes, and patting instead of scratching. Avoid perfumed shower gels and creams.
What cream or ubat is good for heat rash?
A pharmacist may recommend calamine lotion, antihistamine tablets or hydrocortisone cream. According to the NHS, hydrocortisone cream should not be used for children under 10 without a doctor's advice. See a doctor if the rash does not improve after a few days.
Why do babies get ruam panas?
According to the NHS, babies often get heat rash because they cannot control their temperature as well as adults and children. DermNet notes that a type of heat rash with tiny clear blisters (miliaria crystallina) affects up to 9% of newborns. Keep your baby cool with light, loose clothing, and see a doctor if you are worried about any rash.
Is heat rash contagious?
No. According to the NHS, heat rash can appear anywhere on the body and spread, but it cannot be passed on to other people.
How long does heat rash last?
Heat rash usually gets better on its own after a few days once the skin is kept cool. See a doctor if it does not improve after a few days, or if the spots become painful, swollen or filled with pus, which could mean an infection.
How can I tell heat rash from a serious rash?
Heat rash usually appears after sweating, in a child who is otherwise well. Call 999 if a child is unwell with a rash and has a stiff neck, dislikes light, is confused or unresponsive, has difficulty breathing, has pale, blue or blotchy skin, or has a rash that does not fade when you press a glass against it. A rash with fever may also be an infection such as dengue, measles or hand, foot and mouth disease.
Disclaimer
This article is for general information only and is not a substitute for advice, diagnosis or treatment from a doctor or pharmacist. If you are unsure what a rash is, especially in a baby or child, get medical advice. Health supplements are not intended to diagnose, treat, cure or prevent any disease.
