My child has a rash around his mouth. Is it a food allergy?

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Rashes around children’s mouths are common. They can occur when an irritant touches the skin or through the excessive use of topical products. Certain foods can 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 flesh-colored on dark skin.

Several substances can 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 rashes around the mouth and 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 immediately or some time after contact with the allergen. A severe food allergy can cause anaphylaxis, which can be life threatening.

Rapid reactions develop within 1-2 hours of consuming a food. To test what causes a quick reaction, doctors use skin tests. When the test is positive, it means that the child has developed immunoglobulin E (IgE) antibodies in response to food. It is easier for doctors to determine the trigger for rapid reactions than for delayed reactions.

Delayed reactions develop over 24 to 48 hours and are likely due to immune cells in the skin reacting to food. These cells are called T cells. Skin tests are often negative in these cases because IgE antibodies do not cause the reaction.

To identify the cause of a delayed reaction, doctors often recommend eliminating foods from the diet one at a time and watching for any symptoms. It can take a lot of time and perseverance.

Various factors can cause children to develop a rash around their mouth. These include:

Perioral dermatitis

Perioral dermatitis is a rash that appears around the mouth. On fair skin, it may appear red or pink, resembling an acne breakout. On dark skin, it can be skin-colored. It can cause itching, stinging and burning.

There are several potential causes in children, which can vary between individuals. These include:

  • long-term use of topical steroid creams
  • prolonged use of prescription inhaled steroid sprays
  • excessive use of heavy facial 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 photos.

Eczema

Eczema is an inflammatory skin condition that typically causes the following skin problems:

  • itch
  • a raised rash
  • dry skin
  • oozing or crusted
  • swelling
  • discoloration

Eczema can develop at any age and sometimes affects the area around the mouth. Certain foods, especially acidic foods, can trigger an eczema flare-up, but they are not the underlying cause of eczema.

Learn more about eczema in children.

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 can cause irritation if they come into contact with the skin:

If a child regularly has a rash around their mouth, healthcare professionals may recommend they have food allergy testing.

Learn more about common foods that cause allergies.

It may not be possible to avoid a rash around the mouth, as the causes can vary. However, people can reduce the likelihood of this symptom by:

  • avoid using topical steroid creams and heavy moisturizers around the mouth
  • avoiding eating foods that can cause an allergic reaction
  • limit exposure to chemicals or other irritants
  • gently wiping a child’s face with a damp washcloth after eating to avoid leaving food marks on the skin

In some cases, the rash may go away 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:

  • stop using corticosteroids, including hydrocortisone cream, if present
  • switch to fragrance- and soap-free skin cleansers
  • keep skin clean and apply 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 attention if a child develops symptoms of anaphylaxis.

A rash around a child’s mouth may go away on its own, but it may require changes in the child’s diet or skin care routine. In some cases, a doctor may need to prescribe medications to help treat underlying infections.

By avoiding the triggers, a person should see improvements in their rash.

A rash around a child’s mouth can have a variety of 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, use of certain skin care products, or skin contact with highly acidic foods.

Once a person stops being exposed to the trigger, the rash should go away. Identifying triggers can take time and perseverance.

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