Appearing/Disappearing/Reappearing Toddler Facial Rash

[AngiS]

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!

[Alan Rockoff, MD]

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

[AfricanGrey]

I am anxious to hear the reply to your letter, my daughter has the same exact thing, but on the back of her calves and now above her knees.  I had terrible eczema when I was young so I hope that is not it.  AND I don't want to go to the dr's office right now either, stomach virus is rampant right now and we sure don't want that.

[AngiS]

It's officially the worst it's ever been this morning - - it has spread to under her left eye (where it's never been before) and now under her right eye, it's just one patch of red (barely any visible dots). And there are a few tiny, pinpoint dots around her mouth that have a little whitehead on them. That hadn't happened before. It hasn't spread to anywhere else on her face or body though. My 6-month old nephew has eczema and I'm almost positive it's not that. I've never had any skin conditions either other than a pimple now and then. Help!

[CATHYZOM]

i can not believe this:  my son who is 6 yrs. old also has a red rash on his face, around his lips and his cheeks.  he started with dry chapped lips about three weeks ago and slowly his face mainly his lower cheeks and around his mouth started looking severly red (just like a carpet burn) and its dry and itchy.  i took him to dr. 3 wks ago and he gave him Bactroban Cream, twice a day.  it went away after a week but on monday, he came back home from school with red cheeks and dry chapped lips.  i thought he was coming down with a cold but the next day (yesturday)it got worse, so today we went back to the dr. and the nurse practitioner said to use Aquaphor every two hrs. and if it dose not go away by monday to go back to the dr.  she did not know what it could be but she said may be its exema but i dont think so. i also tried Bactroban Cream again, but this time his face was burning from the cream so i stopped using it.   i would appreciate it if you guys would share your ideas of how to get rid of this nasty rash.  i feel realy bad for my boy, he says its dry and his face itches at all times.   thank you

[AngiS]

It does sound like your son has eczema. My dad, my sister, and her son all have eczema and it sounds exactly like what you're describing. My sister's son is only six months old and his is pretty bad. Very itchy, dry, and fiercely red. It looks almost like crusty windburn. His seems to be localized to his cheeks, tips of his ears, and wrists. The cold severely aggravates it. When she came to visit me last month, we used a compounded ointment of one part Aquaphor to one part 1% hydrocortisone (by weight) - - something my daughter's pediatrician told me to use when she had a rash of unknown origin at two months old. The salve, in combination with our very mild climate (I live in southeastern coastal North Carolina), worked wonders. We applied it three times a day and in only one day it cleared up so much that we were all amazed! By the time they went home, it had dramatically improved. But once they went back up north in the cold wind, it came back, but not as badly. Also, she has been trying to control it with diet and that seems to be working. Good luck with your son!

[Alan Rockoff, MD]

Eczema is common, but this does not sound like it.



Dr. Rockoff

[o2bzen]

I have very sensitive skin and so do my two children. We all suffer from outbreaks of hives as described by the DR. The use of homeopathics for hives help us a great deal. My DS and I also suffer from eczema in the winter. I could never use soap to wash his face nor did I use it on DD until she about 7 and even then only when she was really dirty. I know Dove to be a major irritant to my own tender skin. Babies don't need their faces washed with soap a warm soft wash cloth should be good. Over washing is a major problem for sensitive skin.

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!

[cmprnt]

CATHYZOM. My 4 and 1/2 yr old daughter also has the same problem. The dark red at the corner of her mouth and lower cheek area just won't go away. It turns bright red, looked inflamed in the evening after a day at school. She kept licking and wiping it with her hand, which makes it worse. She also has some pale (white) discoloration on her lips at the corner of her mouth. Her doctor diagnose it as eczema, and prescribed the expensive Elidel cream three weeks ago, but it does not seem to help so far. She is seeing the doctor again tomorrow. I hope they can figure out something to make her feel better. It is driving her nuts.