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What is a perioral food rash?
This is a rash that occurs around the mouth after contact with a food.
This is usually seen in infants and toddlers.
This is considered a form of perioral contact dermatitis.
A perioral food rash by itself is not a food allergy.
This rash usually resolves within six hours or less.
What causes a perioral food rash?
This is caused by direct contact with a food.
It may not always be the food itself, but sometimes something in the food.
So, exact causes are not always known.
Some examples of foods that may be more likely to cause a rash are citrus fruits, tomatoes, ketchup, and berries.
This is because they have more acid in them and for some the acidity is what irritates the skin.
The rash occurs more when infants or toddlers start to feed themselves as they are messy eaters, so there is more food that gets on the skin.
As infants grow, they drool more as well. This drooling can irritate the skin, and then when eating a food with more acid, it may irritate the skin even more.
Pacifiers can also irritate the skin around the mouth, so the acidic foods may be more likely to irritate the skin if your child uses a pacifier.
Good to know: children with an allergy to poison ivy or poison oak may get a perioral food rash if they touch the skin of a mango, or a mango tree, its leaves, or its sap.
Your child can eat the flesh-fruity part of the mango without any risk of developing a rash.
What are the symptoms of a perioral food rash?
Your child will have a rash around the mouth.
The most common place for the rash is between the mouth and the chin.
You can see the rash on the cheeks as well or other places on the face where the food touched.
The rash is usually red and spotty, but can be raised with hives.
The rash doesn’t usually bother your child.
However, if the skin has been irritated in the area from drool or pacifier use, the rash may be mildly itchy or feel like a sting to your child.
Sometimes the skin around the anus is irritated or red as well.
How is a perioral food rash prevented?
Keep your child’s skin hydrated with lotions, creams, or thick emollients like petrolatum (Vaseline or Aquaphor).
Avoid scented products as scented products can irritate the skin in some people.
Wipe your child down gently after meals and avoid scrubbing or rubbing the area more than is needed to clean.
Rubbing and scrubbing can irritate the skin.
You don’t need to use soap to clean your child’s face after eating or drinking. Warm water is fine.
If the rash is only around the mouth in areas where the food touched the skin, try applying Vaseline around the mouth before trying that food again. The goal is to create a barrier between the skin and the food and saliva, to prevent the perioral food rash.
Avoid any foods that have caused your child to have a rash all over their body.
Ask your child’s CPCMG healthcare provider about further guidance on when to try the foods again.
Clean pacifiers regularly and try to avoid or lessen your child’s use of them to keep the skin around their mouth as healthy as possible.
When your child reaches the age of 12 months, that is a good age to work on decreasing pacifier use.
What is the treatment for a perioral food rash?
Gently wipe the face with warm water to remove any remaining food from the face.
Avoid using soap as that can irritate the skin more.
Avoid scrubbing or rubbing as that can irritate the skin.
If your child’s rash seems itchy or they are bothered by it, you can use a 1% hydrocortisone that is available over-the-counter.
It is helpful to take a picture so you can further discuss this at a visit with a CPCMG healthcare provider.
Avoid giving your child the food again until seen.
Do your best to minimize your child’s pacifier use until the rash resolves, as it may irritate the area more.
It is okay to leave the area alone, or you can apply non-scented creams, lotions, or thick emollients like petrolatum to help soothe the skin.
When to contact your CPCMG healthcare team:
Your child has a perioral rash from food.
Your child is having any other symptoms with the rash.
Your child has a rash and you don’t know why.
Your child’s rash is getting worse or not improving.
Your child has hives.
You would like to have your child seen.
You have any other questions or concerns.
📚 References
Article written by TT DO. Reviewed by: TT, DO, JW MD, Patient Education Committee.
This content was adapted from National Institutes of Health, AAP Pediatric Patient Education, American College of Asthma, Allergy, and Immunology, healthychildren.org
Images from https://community.whattoexpect.com/forums/babys-first-year/topic/rash-after-solids-125622489.html