Definition

• A rash around the mouth from contact with food
• Mostly seen in babies and toddlers
• Medical name is perioral contact dermatitis

Health Information

Symptoms

• Local rash around mouth. Most common between the mouth and chin. The cheeks can also be involved.
• The rash can be red spots or sometimes raised hives.
• The facial rash is where contact with food has occurred.
• The young child may have smeared or drooled it there.
• Usually no itching.

Causes

• Usually follows skin contact with a food.
• Often the exact food that caused the rash is unknown.
• More common with adult foods (like ketchup) than with baby foods. Citrus fruits, tomatoes or berries are common triggers.
• Mainly in 6 month to 3 year olds. Reason: They get food on their faces and small amounts may go unnoticed. They also drool.
• Older children who are allergic to poison ivy can develop facial rashes. Poison ivy cross reacts with mango and cashews. This rash lasts much longer, up to several days.
• Frequent pacifier use can make the rash last longer. Reason: The pacifier can irritate the skin around the mouth. That makes it more sensitive to certain foods.

Care Advice

1. Overview:
   • Foods that touch the skin can cause a harmless local rash. It happens most with fresh fruits or tomatoes.
   • Sometimes, the rash looks like hives.
   • This doesn’t mean your child is allergic to that food.
   • Sometimes, a similar rash occurs around the anus.
   • Here is some care advice that should help.
2. Wash Off the Skin:
   • Wash any remaining food off the involved skin with soap and water.
   • Caution: Using soap too often can cause dry skin and some rash.
3. Steroid Cream:
   • For rashes that are itchy or last over 6 hours, use 1% hydrocortisone cream. No prescription is needed.
   • Apply it to the reddened area 3 times per day if needed. Don’t use for more than 2 days. Reason: could cause a rebound flareup of the rash.
   • Most food rashes don’t need a steroid cream.
   • Benadryl is not needed for this type of reaction.
4. Avoid the Suspected Food:
   • The food should be avoided for 1 or 2 months.
   • Then it can be tried again
   • This is probably not a food allergy.
   • In the future, your child should be able to eat the food without getting a rash.
5. Prevention of Recurrent Food Rashes Around the Mouth:
   • Rinse the face with warm water after meals and snacks.
   • Don’t use soaps on the area.
   • Reduce pacifier sucking time. If the pacifier has any food on it, rinse it off. If your child is over 12 months old, try to phase out the pacifier completely.
6. What to Expect:
   • This type of rash usually goes away on its own in less than 6 hours.

Call Your Doctor If

• Trouble breathing occurs
• Trouble swallowing or drooling occurs
• Widespread hives occur
• Rash lasts more than 24 hours
• You think your child needs to be seen
• Your child becomes worse

Author: Barton Schmitt MD, FAAP

Copyright 2000-2020 Schmitt Pediatric Guidelines LLC

Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it. The information contained in this handout should not be used as a substitute for the medical care and advice of your pediatrician. Listing of any resources does not imply an endorsement.

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