Is It Heat Rash Or Eczema? How To Distinguish Between The Summer Skin Conditions

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Skin conditions and diseases are very common and affect millions of people each year, from acne and rosacea to eczema (also known as atopic dermatitis) and psoriasis. Acne, one of the most common skin conditions, affects up to 50 million Americans annually, while more than 31 million Americans have some form of eczema.

Even mild summers, as rare as they are nowadays with temperatures continuing to rise (the summer of 2023 was the hottest in 2,000 years), can spell disaster for those with sensitive skin. If you love the outdoors and recreational activities, heat rash may be a more common occurrence for you.

So how do you tell the difference between a heat rash and eczema? In the guide below, we’ll outline the similarities and differences between the skin conditions, and tips on treatment options to help keep your skin in top shape.

Is It Heat Rash Or Eczema? How To Spot The Difference

Atopic dermatitis, the most common type of eczema, is the result of an overactive immune system, and is not contagious. While the exact cause of eczema isn’t totally clear, flare-ups can be triggered by the environment (like dry air, extreme hot or cold, soaps, cleansers and metals), genetics, and stress.

Heat rash, also known as prickly heat, occurs when sweat glands become clogged (thereby trapping sweat in the deeper levels of skin), usually due to humid climates, hot weather and excessive sweating. In children, it might be caused by wearing sweaty clothing or wet diapers for long periods of time. Heat rash has short flare-ups and can be cleared up fairly easily.

The largest difference between the two conditions is that heat rash is a short-term skin condition, with symptoms fading after proper treatment. Eczema symptoms can last as little as a few days up to several weeks – or even years if left untreated.

Signs and symptoms of eczema

Eczema often has symptoms mistaken for psoriasis, but while both are immune-mediated conditions, there are some key differences.

Eczema can develop early in babies and children, and is often more itchy when compared to psoriasis. Eczema can appear as a scaly red rash or blistering, and usually appears in the creases and bends of elbows and knees, hands, feet and scalp.

Symptoms of eczema can include:

• Extreme itching
• Dry, sensitive skin
• Inflamed, discolored skin
• Rough or scaly skin, appearing as scaly patches
• Oozing or crusting over
• Bleeding from too much itching
• Swelling

On lighter skin, eczema will appear as red and inflamed. On darker skin tones, it can present as brown, purple, gray or ashen.

Diagnosing eczema

A biopsy may be taken to determine the type of skin irritation present, but several more factors should be considered, including medical conditions, family history and genetics, stress level and more.

There may be some persistent signs and symptoms in addition to those listed above:

• Visibly irritated skin in folds and creases
• Prior history of skin irritation
• Dry skin within the last 12 months
• Asthma or hay fever in adults; for children under four years old, an immediate relative with either condition
• Onset under the age of two years

Signs and symptoms of heat rash

Heat rash symptoms are more mild than eczema and should fade as the skin cools. It can appear and spread on the body but is not contagious. The appearance and symptoms may include:

• Red bumps or fluid-filled blisters across the skin
• Small, raised spots
• Itchy, prickly feelings
• Mild swelling

On lighter skin, it may look red and bumpy, and on darker skin tones, can present as dark brown bumps.

Treatment Options For Eczema

There is no cure for eczema, but there are options to help relieve the flare-up symptoms depending on the type of eczema.

Over-the-counter treatments

There are some eczema treatment options available over-the-counter at the pharmacy or local stores.

Use gloves at night if scratching (even in your sleep) is a problem. After bathing, do not scrub or dry the skin too hard, and apply ointments on damp skin.

Avoid irritating soaps, detergents, and textures (such as wool and lanolin). These can worsen drying and irritation symptoms.

Topical steroids

Topical corticosteroids, also called topical steroids, are creams and ointments that can help reduce inflammation, itching, redness and swelling during an eczema flare-up.

The severity of the eczema will determine the strength of the topical steroid needed for treatment. For moderate to severe eczema, you may need a stronger product that requires a prescription.

Be sure to check with your doctor or dermatologist frequently to ensure the treatment is working effectively, because there can be side effects, such as changes in skin color, acne, burning or stinging, and more.

Diet changes

According to the National Eczema Association, diet can play a significant role in your skin’s overall health.

There’s no one-size-fits-all treatment when it comes to diet changes, however, and elimination diets could actually be counterproductive, according to one expert. Some steps you can take toward a healthy diet include eliminating processed foods in general, and targeting fruits, vegetables and lean meat.

Treatment Options For Heat Rash

Since heat rash is usually caused by environmental factors, treatment options are simple and straightforward.

Cooling your skin

If a heat rash develops due to extreme heat, humidity and sweating, you’ll want to cool down your skin as quickly as possible. Steps you can take include:

1. Take a cool shower or bath
2. Drink more fluids to avoid dehydration
3. Wear loose clothing
4. Use lightweight bedding to avoid irritating the skin

If you have an itchy or prickling feeling:

1. Apply a cold compress for 20 minutes (such as a damp cloth or ice pack wrapped in a towel).
2. Do not scratch or rub - tap or pat the rash dry.
3. Avoid shower gels or creams with a lot of fragrance or irritating ingredients.

Topical and tablet treatments

If the itching and prickling sensation isn’t fading even as you cool your skin, there are a few over-the-counter topical treatment options you can explore.

Calamine lotion can help relieve mild itching and irritation, and if you have oozing or weeping wounds caused by the rashes, it will dry them out. It’s an over-the-counter medication that contains zinc oxide (commonly used to treat diaper rash) and 0.5% iron oxide (which gives it that distinct pink color).

Antihistamine tablets are commonly used to relieve symptoms of allergies (like hay fever, hives, and reactions to insect bites and stings). They’re designed to block the effects of histamine, which is released when your body detects something harmful and causes blood vessels to expand and skin to swell.

Learn More About Eczema

If you’ve been diagnosed with eczema (or wonder if you could be displaying the symptoms of eczema but have not been diagnosed), it's important to discuss your concerns with a physician, dermatologist or other specialist.

If you want to get more information about other chronic health and skin conditions, be sure to check out more of The Weather Channel’s health and wellness coverage, including guides and videos on important topics including psoriasis, diabetes, weight loss and healthy living.

The Weather Company does not provide medical advice, diagnosis, or treatment. Talk with your doctor before starting any new medicine, supplement, weight loss or exercise regimen.

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