I have been suffering from heat rashes almost every summer for several years. I am slightly overweight, and these itchy rashes are more severe in areas of my body folds. Please help!

Prickly heat, medically known as miliaria rubra, can affect men and women of any origin. These rashes appear due to the blockage of sweat gland ducts at times of sweat over-production in response to exposure to excessive heat. Sweat glands are thermo-regulated – that is, an increase in the environmental temperature will cause an increased stimulation of the sweat glands, making them overactive and produce excessive sweat. The keratin filaments, which are the primary structural components of the sweat gland ducts, get partially dislodged and cluttered, blocking the sweat ducts. This results in formation of inflamed, severely itchy, papular skin eruptions known as ‘prickly heat’. These eruptions can get worse in people wearing tight dresses made of thick-knitted fabrics. In overweight or obese people, the same effect can be seen in their body folds. The most important step in the treatment is to avoid exposure to heat, and hence excessive sweating. The skin eruptions can be treated by frequent application of cold compresses on affected areas, and using zinc oxide (calamine) lotion for relief from itching. In more severe cases, application of potent topical steroidal creams are usually beneficial. We recommend that you wear thin, loosely fitted cotton dresses to enhance treatment success and a faster recovery.

Would you recommend a laser facial for acne-prone skin? I’ve also found facial hair getting thicker after undergoing laser hair removal treatments.

Let’s address the first issue about laser facials for acne-prone skin. It is hard to recommend a single particular laser type that can offer a direct therapeutic solution to your problem. However, certain lasers together with carbon peel have shown satisfactory results in many patients. It’s important to mention that many other treatments other than laser can also be effective in treating acne-prone skin. These can be used alone or in smartly designed combinations to get the desired results. You should also be aware that in many cases, in addition to the above treatment options, we also need to prescribe oral antibiotics, hormonal pills (in female patients only) or oral retinoids depending on the severity and responsiveness of acne in different group of patients. Now let’s address your second issue, of your facial hair getting thicker. This issue could be triggered by either a wrong selection of the type of laser machine or by treating the patient on unsuitable laser parameters.