Perioral contact dermatitis rashes appear around the mouth, but they don’t mean your little one has a food allergy. Learn how to tell the difference between this rash and a food allergy rash. Plus, we’ll cover how to treat perioral contact dermatitis.
If your baby has a rash around their mouth after eating fruits or vegetables, and no other symptoms, that doesn’t mean they have a food allergy. Instead, they likely have a different kind of rash, known as perioral contact dermatitis. Here’s how to tell the difference between this rash and the rashes associated with food allergies. Plus, we’ll cover how to treat perioral contact dermatitis.
What is Perioral Contact Dermatitis?
Perioral contact dermatitis is a rash that typically occurs around the mouth after
eating acidic fruits and vegetables like oranges, tomatoes, and strawberries. It is also known as a perioral food rash. The name perioral describes how the rash goes around the mouth (“peri” means “around” and “oral” means “mouth”).
A perioral contact dermatitis rash may look like hives, but it does not mean that your child is allergic to the food that caused it. This rash is completely harmless, and baby doesn’t need to completely avoid the food that caused the rash. It is also different from eczema (atopic dermatitis).
What Causes Perioral Contact Dermatitis?
A perioral contact dermatitis rash usually occurs after certain foods contact baby’s skin. Usually, foods that cause this rash are acidic, like citrus, tomatoes, or berries.
This rash is mainly seen on kids 6 months to 3 years of age, because they often get food on their faces that can go unnoticed for long periods of time. Sometimes, this happens after smearing food or drooling.
If your child uses a pacifier frequently, this can make the rash last longer, since sucking on a pacifier can irritate the skin around the mouth and make it more sensitive to certain foods.
What Does a Perioral Contact Dermatitis Rash Look Like?
A perioral contact dermatitis rash will be concentrated around your baby’s mouth, usually between the mouth and chin. It might also appear on the cheeks. Usually, it appears where there was contact with food.
- On lighter skin, the rash will look like red or pink spots, similar to acne.
- On darker skin, the rash will look skin-colored.
- On any skin color, it may sometimes resemble raised hives.
- Most of the time, the rash will not be itchy.
- It should go away in less than 6 hours.
Perioral Contact Dermatitis Rash Vs. Food Allergy Rash
A perioral contact dermatitis rash is different from a food allergy rash. Here’s how to tell the difference.
Where does it appear?
A perioral contact dermatitis rash only appears around the mouth area. But a food allergy rash could appear anywhere on the body, and could be in multiple locations on the body. Mild food allergy rashes appear concentrated on one area of the body, and severe food allergy rashes are spread across several areas of the body.
What does it look like?
Perioral contact dermatitis is a spotty, acne-like rash that’s sometimes raised and that circles the mouth. It usually isn’t itchy, but it can be. Food allergy rash is an itchy, raised, bumpy rash that could appear anywhere on the body. Both rashes tend to be red on babies with lighter skin and skin-colored on babies with darker skin.
What causes it?
Food allergy rashes are caused by an immune system reaction to food that is eaten, because the immune system mistakes the food for a harmful invader and over-defends the body against that food. They appear seconds to hours after eating a food.
Perioral contact dermatitis can be caused by eating acidic fruits and vegetables, but the rash “reaction” usually isn’t specific to one food like an allergy. Plus, the rash is caused by food coming into contact with the skin around the mouth, not by an adverse reaction to eating the food.
How long does it last?
Perioral contact dermatitis rashes usually go away in 6 hours or less. Food allergy rashes can last for up to 24-48 hours.
Are there other symptoms?
Perioral contact dermatitis only causes the rash. It doesn’t cause other symptoms. But food allergy reactions can cause several other symptoms in addition to a rash. Vomiting is the most common symptom of food allergies in young children, along with the hives. Other possible food allergy symptoms include swelling, itchiness, congestion, stomach pain, and nausea (see our article on what food allergy reactions look like for the full list.)
In the table below, we break down the differences between a perioral contact dermatitis rash and other rash types:
|
Cause |
Appearance |
Itchy? |
Raised? |
Other symptoms? |
Where does it appear? |
|
|
Perioral contact dermatitis |
Contact with acidic food at mouth |
Spotty, acne-like, inflamed |
Sometimes |
Usually |
No |
Around mouth, chin, and neck |
|
(Other) contact dermatitis |
Skin contact with irritants/ allergens |
Bumps or inflammation in one area |
Usually |
Usually |
No |
Anywhere that contacts a “trigger” |
|
Food allergy rash |
Immune system reaction |
Hives (inflamed, raised bumps) |
Yes |
Yes |
Yes |
Could appear anywhere |
|
Eczema |
Unknown, but irritants/ allergens cause flare-ups |
Dry, scaly, crusty, inflamed patches |
Usually |
No |
No |
Usually forehead, cheeks, scalp, knees, elbows, joints |
How Do I Manage My Child’s Perioral Contact Dermatitis?
If your baby has a perioral contact dermatitis rash, wash your baby’s skin with soap and water to get all the remaining food off (be careful, though, as using soap too often can cause dry skin). The rash should go away on its own, in less than 6 hours.
For rashes that are itchy and that last over 6 hours, talk to your pediatrician.
You might also use 1% hydrocortisone cream, which you can apply to the reddened area 3 times per day if needed.
Protecting your baby’s skin by using a thick emollient cream like Aquaphor
can prevent future rashes. You shouldn’t need any prescription steroid cream to treat this kind of rash.
You do not need to stop feeding the trigger food due to perioral contact dermatitis, but if you are concerned that a food allergy may be present, an allergist can help sort out the difference. You can also try reducing your baby’s pacifier time, as it may be making the rash worse.
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These statements have not been evaluated by the Food and Drug Administration. Products are not intended to diagnose, treat, cure or prevent any disease. If your infant has severe eczema, check with your infant’s healthcare provider before feeding foods containing ground peanuts.