Rashes around children’s mouths are common. They can happen when an irritant touches the skin or through the overuse of topical products. Certain foods may also trigger eczema flare-ups. In rare cases, a food allergy causes the rash.
When a rash appears around the mouth, it can be itchy or cause a burning sensation. The rash may appear red on light skin but be skin-colored on dark skin.
Several substances may trigger a rash, but it is often difficult to identify the cause. Parents and caregivers can help a child avoid possible triggers, including food allergens.
This article reviews the possible causes of skin rashes around the mouth and the treatment options.
The American College of Allergy, Asthma, & Immunology notes that food allergies can cause skin reactions and rashes when a person comes into contact with an allergen.
However, a rash around the mouth is more likely to have other causes, such as perioral dermatitis.
Food allergy symptoms can range from mild to severe and appear either immediately or some time after contact with the allergen. A severe food allergy can cause anaphylaxis, which can be life threatening.
Quick reactions develop within 1–2 hours of eating a food. To test what causes a quick reaction, doctors use skin prick tests. When the test is positive, it means that the child has developed immunoglobulin E (IgE) antibodies in response to the food. It is easier for doctors to determine the trigger for quick reactions than for delayed reactions.
Delayed reactions develop over 24–48 hours and are probably due to immune cells in the skin reacting to the food. These cells are called T cells. Skin prick tests are often negative in these cases, as IgE antibodies do not cause the reaction.
To identify the cause of a delayed reaction, doctors often recommend eliminating foods from the diet one by one and monitoring any symptoms. This can take a lot of time and persistence.
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Various factors can cause children to develop a rash around the mouth. These include:
Perioral dermatitis
Perioral dermatitis is a rash that appears around the mouth. On light skin, it may appear red or pink, resembling an acne breakout. On dark skin, it may be skin-colored. It can cause itchiness, stinging, and burning.
There are several potential causes in children, which can vary among individuals. These include:
- the long-term use of topical steroid creams
- prolonged use of inhaled prescription steroid sprays
- the overuse of heavy face creams or moisturizers
- skin irritants, such as soaps and other substances
- fluoride toothpaste
- acidic foods, such as tomatoes, strawberries, and citrus fruits, touching the skin
Learn more about perioral dermatitis and see some pictures.
Eczema
Eczema is an inflammatory skin condition that typically causes the following skin issues:
- itching
- a raised rash
- dry skin
- oozing or crusting
- swelling
- discoloration
Eczema can develop at any age and sometimes affects the area around the mouth. Certain foods, particularly acidic foods, may trigger an eczema flare-up, but they are not the underlying cause of eczema.
Certain foods can trigger a systemic reaction, including a rash around the mouth. The following food groups are the most common triggers of allergic reactions:
The following foods are acidic and may cause irritation if they come into contact with the skin:
- tomatoes and tomato sauces
- citrus fruits, such as oranges, lemons, and grapefruits
- strawberries
If a child regularly experiences a rash around the mouth, healthcare professionals may recommend that they undergo testing for food allergies.
It may not be possible to avoid a rash around the mouth, as the causes can vary. However, people can lower the likelihood of this symptom by:
- avoiding using topical steroid creams and heavy moisturizers around the mouth
- avoiding eating foods that can cause an allergic reaction
- limiting exposure to chemicals or other irritants
- wiping a child’s face gently with a damp face cloth after eating to avoid leaving traces of food on the skin
In some cases, the rash may resolve on its own. A child may only need to avoid exposing their skin to the irritant.
In other cases, a child may benefit from visiting a dermatologist, who may recommend:
- stopping using corticosteroids, including hydrocortisone cream, if applicable
- switching to fragrance-free, soap-free skin cleansers
- keeping the skin clean and applying fragrance-free moisturizer regularly
A dermatologist can help determine the best course of action and develop a personalized treatment plan for each child.
A parent or caregiver should consider contacting a doctor if a child regularly develops a rash around the mouth.
It is essential to seek emergency medical care if a child develops symptoms of anaphylaxis.
Anaphylaxis: Symptoms and what to do
Anaphylaxis is a severe allergic reaction that can be life threatening. The symptoms develop suddenly and include:
- hives
- swelling of the face or mouth
- wheezing
- fast, shallow breathing
- a fast heart rate
- clammy skin
- anxiety or confusion
- dizziness
- vomiting
- blue or white lips
- fainting or loss of consciousness
If someone has these symptoms:
- Check whether they are carrying an epinephrine pen. If they are, follow the instructions on the side of the pen to use it.
- Dial 911 or the number of the nearest emergency department.
- Lay the person down from a standing position. If they have vomited, turn them onto their side.
- Stay with them until the emergency services arrive.
Some people may need more than one epinephrine injection. If the symptoms do not improve in 5–15 minutes, or they come back, use a second pen if the person has one.
A rash around a child’s mouth may clear on its own, but it could require changes to the child’s diet or skin care routine. In some cases, a doctor may need to prescribe medication to help treat any underlying infections.
By avoiding triggers, a person should see improvements in their rash.
A rash around a child’s mouth can have various causes. Certain foods can sometimes trigger an immune response that leads to a rash and other symptoms. Severe allergic reactions can be life threatening.
Common causes of a rash around the mouth include reactions to a long-term topical steroid, the use of certain skin care products, or skin contact with highly acidic foods.
Once a person stops their exposure to the trigger, the rash should clear. Identifying triggers can take time and persistence.