Treatment of Miliaria

For persons predisposed to miliaria, light clothing, rest and avoidance of hot humid environment and stimulating, heating foods such as alcohol and spices are advisable. Sodium chloride should also be avoided. Air conditioning with dehumidification and proper air circulation are desirable but usually unobtainable. Soothing, cool baths containing Linit starch or Aveeno oatmeal, 1 cup to the tub, may give comfort. Immersion for ten minutes in a cool bath containing 1 pound of starch and 1 teaspoonful of a 25 per cent alcoholic solution of menthol is beneficial. The starch is added to 2 quarts of water and boiled, before adding the mixture to the tub. Ice packs are necessary in severe cases to relieve the pruritus. Soap is undesirable. In adults a single fractional dose of unfiltered x-rays gives relief within three or four days.

       Prantal 0.05 gm. every three hours, or Banthine 0.05 gm. every four hours is preferable to atropine, and if well tolerated may give considerable relief.

       Locally hydrophilic ointment U.S.P. or Aquaphor (Duke) helps to dissolve the keratinous plugs and facilitate the normal emergence of sweat.

       Mild cases in infants and adults may respond to dusting powders such as corn starch or baby talcum ( J. & J.). More severe eruptions may be relieved by shake lotions, especially if they produce desquamation. The following preparation has proved effective when applied hourly with a paint brush:

              R    Resorcinol  . . . . . . . . . . . . . . . . .     2.0

       Sulfur, precipitated . . . . . . . . . . . .     5.0

       Zinc oxide . . . . . . . . . . . . . . . . .  .   20.0

       Starch . . . . . . . . . . . . . . . . . . . . .    20.0

       Glycerin . . . . . . . . . . . . . . . . . . . .   10.0

       Alcohol (95%) . . . . . . . . . . . . . . . .     35.0

       Water . . . . . . . . . . . . . . . . .  q.s. ad 120.0

         
      Sulzberger recommends menthol and glycerin, each 1 per cent, salicylic acid 4 per cent, dissolved in alcohol 95 per cent. This should be dabbed on the affected areas several times a day until desquamation sets in. Shelton prefers a 4 per cent solution of tannic acid in 60 per cent alcohol (for infants 1 or 2 per cent tannic acid in 20 per cent alcohol). This is applied twice daily and allowed to dry, when the skin is dusted with talcum powder.