Lots of babies and toddlers have problems with recurrent rashes around their mouths. It is most bothersome to their parents…who think it is “unsightly, especially in pictures”. The problem is,due to the fact that babies and toddlers drool and they also always have their fingers and/or hands in their mouths. Remember, a child is in their “oral phase” from birth through the toddler years….and everything goes into their mouths.
On top of the safety issues with a child putting everything into their mouths and the risks surrounding choking….all of this hand to mouth often leads to a rash which is a type of “peri-oral” dermatitis. It is usually a bit red (erythematous) and bumpy (papular) and will have good and bad days. So how do you get rid of it?
It is not and “easy” fix but here are some things that help. Pacifiers are one of the biggest rash causing culprits as a child sucks and the drool accumulates around the outside of the mouth and under the pacifier. I love pacifiers for younger children (<12-18 months), but if your child (like the one in the picture) still has a pacifier and is over 12 months of age taking away the pacifier (another post ) will absolutely help.
Another reason for the rash is frequent face washing and wiping. What parent is not constantly wiping their child’s face? In fact, one night when I was seeing a mother with her child for this very rash and I “suggested” that she wipe his face less frequently she said to me rather emphatically “I do not wipe his face!! “ Well, I wonder why he did not have all sorts of leftover carrot, pears, peas and yogurt on his face? At any rate, the less frequently you wipe off the “schmutz” the less drying and irritation to the skin. Still hard to do as your child finger feeds often missing their mouth.
So the mainstay of treatment is a barrier/moisturizer as well as a topical steroid cream. I usually recommend something like Aquaphor or Vaseline and I apply it often and generously. Especially when your child is heading to bed, coat the area…even under that pacifier if necessary. On days that it looks especially inflamed, I add an over the counter steroid cream, such as Cortaid or Cortizone. When using the steroid a tiny amount “pea sized” is all you need, put that on first, followed by the layer of Aquaphor or Vaseline. The steroid cream will help “get the red out” but it is not to be used daily. Use the steroid for several days, take the Christmas card picture and stop the steroid for awhile. I use the steroid “as needed” rather than daily.
I recently learned that an occasional child is “allergic” or reacts to the lanolin alcohol in Aquaphor and the rash might get worse instead of better. If that seem to be the case and you have been using Aquaphor you might switch to simple pure petrolatum like Vaseline.
The best news is that most of these rashes clear up on their own over time when your child moves out of the oral, messy mouth stage and won’t be drooling and having their face wiped all of the time….but next up is the “anal phase”!