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Dermatology (Expert Forum)
Appearing/Disappearing/Reappearing Toddler Facial Rash
Answered by
Alan Rockoff, MD - dermatology, Child Skin Problems
The Rockoff Dermatology Center
Brookline - MA
This forum is for questions regarding Dermatology issues, such as: skin rashes, acne, birthmarks, skin infections, rosacea, and general skin care.
Appearing/Disappearing/Reappearing Toddler Facial Rash
by AngiS, Feb 07, 2006 12:00AM
My daughter has had a rash on her face since right before Christmas. It has stayed localized to around her mouth (under her nose and on her chin) and most recently her right eye (below and on the eyelid). It hasn't occurred on or under her left eye. It looks like little raised red dots (some larger than others), but there has been no seeping, oozing, or crusting. It does not appear to itch because I have not seen her scratch at it. The rash has never migrated to her cheeks, nose, forehead, or the rest of her body. Some days it's better, some days worse, and some days it is completely gone (like this past Sunday). At her 12-month appointment, it was barely there so the doctor had nothing to examine. I looked at pictures of impetigo and it looks nothing like that. She turned one on January 20th and is still breastfed. She has eaten adult food for several months now (lean protein, veggies, fruit, expressed breast milk), but we did not introduce any new foods (to her or myself) around the time of her initial outbreak or since then. Neither of us are on any medications. She does not eat the "usual outbreak culprits" - cow's milk, peanut butter, strawberries, pineapple, citrus, tomatoes, etc. I had originally chalked it up to a teething rash, but it will not go away. Just when I think it's clearing up, she wakes up the next morning and it's back again. There seems to be no rhyme or reason to it. Today, it's looking particularly fierce so that's why I'm writing to you. I'd have to sit in my pediatrician's sick clinic for her to be seen and I don't want her to pick up something else while she's there. If I have to, I will, but I thought I'd try you first. Also, when she was a few months old, she had a facial rash of unknown origin and our pediatrician prescribed a compounded ointment of 1% hydrocortisone cream and Aquaphor. What she has now is not the same rash as what she had then, but I even tried that again to see if it would work. No change whatsoever after several days. I have also tried Eucerin, Aquaphor, and vitamin E. Today, I washed her lower face with Dove and applied triple antibiotic ointment to see if that would help and I'm currently waiting it out. Other than the rash she is in great health (23lbs./30.5") so I'm trying not to be worrisome, but I'd really like to know what's going on so I can help her. Any information that you would be able to provide would be greatly appreciated. Thank you in advance for your advice!
Doctor's Answer
by Alan Rockoff, MD, Feb 09, 2006 12:00AM
, Feb 09, 2006 12:00AM
To start with, I can't think of anything serious that this could be. It isn't eczema (scaly) or impetigo (crusty.) It sounds like a mild form of urticaria (hives.) The word on the street is that hives are allergic, but in fact the vast majority of cases are not, and most of the time, the "usual outbreak culprits" that you mention are innocent bystanders. Hives come and go just as you describe your child's rash. They can itch but not always badly. In adults antihistamines are used, but in a child these can cause agitation, but in your case don't sound necessary. In time many cases resolve on their own.
Of course, you understand that this is just my best guess from a distance. I recommend that you set up an appointment with a dermatologist, and take good-quality photographs of the rash at its worst to bring along, since you have no way of knowing, of course, whether it will be there when you go.
Best.
Dr. Rockoff
Of course, you understand that this is just my best guess from a distance. I recommend that you set up an appointment with a dermatologist, and take good-quality photographs of the rash at its worst to bring along, since you have no way of knowing, of course, whether it will be there when you go.
Best.
Dr. Rockoff
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Dr. Rockoff
I also take 2,000 mg of wild sockeye salmon oil a day, eat avacados, nuts and seeds, lot's of natural nut butters (almond, cashew, peanut). My DD takes fish oil and uses intense moisurizers, DS is only 21 months and won't eat the fish oil but gets lots of good high omega 3 foods, and still requires a special cream from the dermatoligist to keep his cheeks healthy it is called Mometasone Furoate Cream USP, 0.1% Applied 3x's daily. I can use a Sesame Body butter from the Body Shop and I use Mother's Special Blend oil on him and myself. Both are available online and may seem expensive, but you use so little a container will last at least two months.
Bright Blessings and Good Luck!
I am reading your posts with great interest. My 22 month old son developed a similar rash just before Christmas. It seem to orginally start with a dribble rash and then tiny red pimples seemed to appear on his face interspersed with angry red patches. These patches are on his chin, cheeks, under his left eye. I went to the doctor who gave me antibotics, I want back a month later as they had no effect and she admitted she didn't know what the rash was and referred me to a skin specialist, I am now waiting on that appointment. In the meantime, I am tying to keep it under control with a 1% Hydrocortisyl skin ointmet. This has tended to keep the area from going angry red but it never gets rid of the rash and the skin is just waiting to flare up when I stop.I have stopped all dairy products but yesterday he woke up with the worst face rash he has ever had. It is now all over his forehead and under both eyes, on his chin and all over the check area. The little spots dispeared very soon after the rash appeared. I have to admit it is crusty in parts which leads me to think it may be eczema at times, however most of the red patches on the face feel soft and normal. He does not have it anywhere else barring a very small patch on the inside of his leg (which is crusty). I have every cream under the sun as my other son has eczema which I keep under contol with protopic. (Wonder should I try this on the 22 month old.) He does not seem to scratch his face. It is now February and this is not disappearing. He looks miserable and people are always asking whats wrong with his face and can't I do something. My biggest fear is that the dermatologist won't know either. Anyway, AngiS and CATHYZOM the conditions you speak about seem similar, have you had any update from your specialists.