| Three tools to beat the heat: water, regular bathing and proper clothing
India is sweltering under relentless heat. Everyone seems to be exhausted, covered with prickly heat and rendered inefficient. The longing for the cooler monsoon days is palpable. There might be amenities such as fans, coolers and air conditioners to help us cope, but in the face of frequent power cuts and inadequate voltage, we are in the same situation as our forefathers. At least our ancestors lived in wide, open, tree-filled spaces and not in heat-radiating concrete jungles!
Human beings are sensitive to heat. We have to maintain our body temperature at an even 98.4 ° F irrespective of the external temperature. In order to cope, the skin is adequately provided with sweat glands located a little below the surface. These glands are conditioned to promptly respond to rising environmental temperature by secreting sweat. The latter is released through torturous tubes that open out through the skin pores. As the sweat evaporates, the body cools down. The mechanism breaks down if humidity is high and sweat cannot evaporate, the undertaken activity is physically taxing and performed in an exceptionally hot environment, or fluid intake is inadequate. This can lead to heat cramps, exhaustion and eventually, heat stroke. Painful cramps usually occur in the leg muscles. The condition eases if salt and water levels are replenished.
Heat illness or exhaustion is heralded by weakness, dizziness, fainting, palpitations, rapid breathing and fainting. Infants, too, can suffer from heat exhaustion. This occurs if they are dressed inappropriately in thick garments and not given enough water to drink.
If the body temperature continues to rise to 104 ° F or higher, heat stroke can occur. The skin becomes hot and dry, and sweating may not take place. The brain cannot cope with such a condition and there may be confusion, coma or seizures. Heat strokes can be fatal.
If heat stroke is suspected,
• Place the person in a shady area
• Spray cool water or cover with damp sheets
• Give the person cool water to drink (not ice).
• Readymade ORS (oral rehydration solution) packets can be reconstituted or 25 gm of salt (five teaspoons) can be added to five litres of water.
The summer months also cause other less dangerous yet irritating problems like prickly heat. This occurs in covered areas where the sweat cannot evaporate easily. Such a condition arises when the openings of the sweat glands get blocked with dead skin, dirt, bacteria or talcum powder. If left alone, it resolves spontaneously in a day or two changing into a light brown, scaly, itchy rash.
Primetime television programmes are interspersed with advertisements of various medicated “miracle” prickly heat powders. These products contain combinations of finely powdered zinc stearate and silicates. When they combine with sweat, they form a chalky precipitate that actually blocks skin pores and aggravates the problem.
Talcum powder applied to the groin and genital areas can migrate through the vagina, uterus and fallopian tubes to the ovary. It is carcinogenic to the lining of the ovary. Some scientific studies have found a relationship between the use of talcum powder and ovarian cancer.
Also, the size of the particles is so small that they can easily be airborne. Inhaled talc can reach the smallest areas of the lung, causing pneumonia or inflammation and swelling of the airways. This can be fatal in babies.
Prickly heat can be prevented without using talcum powder:
• Stay away from direct heat of the sun as far as possible
• Wear loose-fitting, airy cotton clothes that “breathe”
• Make sure school uniforms are made of natural fabric or a 60/40 mixture of polyester and cotton.
• If you are already suffering from prickly heat:
• Do not scratch. The more you scratch the more it will itch
• Use a mild dose of antihistamine to control itching. The newer antihistamines are less sedating
• Do not apply thick, oil-based creams or talcum powder. They will only block the pores further
• Bathe two or three times a day in tepid water
• Add a teaspoonful of sodium bicarbonate to a bucket of water before bathing. This will make the prickly heat disappear
• Use soap containing trichlorhexidine (for example, Dial or Neko) and 15 per cent TFA (total fatty acid)
• Do not apply the soap directly to the skin. Use a moist piece of cloth, herbal scrubber or a loofah
• Lightly moisturise the skin with baby oil or an aloe vera-based lotion.
If the rash becomes red and pustular, has a changed appearance or if the temperature rises, consult a doctor immediately.
Water, regular bathing and proper clothing are the answer to prickly heat, not liberal dusting with dangerous talcum powder.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at firstname.lastname@example.org