Even though most babies don’t start sporting toothy grins until between 6 months and 12 months of age, the tooth eruption process — commonly referred to as teething — can begin as early as 2 months old. In addition to disrupted sleep, increased gnawing, and general fussiness, your child may begin drooling once they start teething, which might result in a rash.
“When my daughter was 5 months old — before she even had a tooth! — I noticed a dry, red rash on her chin and at the corners of her mouth,” says Hillary McAfee, of Matawan, New Jersey. “Given that it was my first kid, I ran to the doctor, and lo and behold, it was a teething rash! The pediatrician gave me a few tips, and thankfully, it was gone within a week without any extreme measures.”
Wondering if your toothless cutie has a teething rash? From simple at-home treatments to signs of infection, here’s everything you need to know about drool rashes.
1. What is a teething rash?
Teething rash, which most commonly occurs between 3 months and 12 months of age, is caused by your baby’s (often abundant!) drool. That’s why most medical professionals use the broader term “drool rash” to describe this malady.
“Some babies get a little more drooly when they are teething — though, in fact, many babies have plenty of drool even when they’re not teething, too!” says pediatrician Dr. Roy Benaroch, the creator of Pediatric Insider and author of “Solving Health and Behavioral Problems from Birth through Preschool.” “In any case, drool can sometimes contribute to a rash on the chest and neck, from macerated, wet skin, [which is] sometimes called a teething rash.”
Because drool can get on the neck and chest, a rash can develop in both these areas. This rash often consists of red splotches and bumps and can be foul-smelling as well.
“Often, teething rashes appear as a flat or scaly redness around the mouth,” says Dr. Anna Leah Grossberg, a pediatric dermatologist and assistant professor of Dermatology at Johns Hopkins. “But sometimes they can extend to the cheeks, neck crease and chest, since drool can pool down when baby is sleeping or playing.”
Teething rash is essentially a form of eczema, Grossberg says. “It’s a contact dermatitis caused by the moisture of your baby’s drool,” she explains.
She notes that drool rash can also be the result of constant wiping and rubbing, which strips their sensitive skin of natural oils, causing irritation and dryness.
2. Preventing teething rash
There are a few simple ways to prevent teething rash on face, neck and chest — the main one being to keep your baby’s skin dry as often as possible.
“Teething rash is more likely to occur if baby’s skin stays wet for an extended period of time,” says Dr. Nick DeBlasio, medical director of Pediatric Primary Care at Cincinnati Children’s. “Quickly wiping saliva off of the skin, changing baby’s clothing when it’s wet and using fresh, clean bibs will all help keep the skin dry and drool rash at bay.”
Also, keep in mind, when wiping baby’s skin, do so gently with a soft cloth, as harsh rubbing can aggravate a teething rash or even cause the skin to break open, which can cause an infection.
In addition to keeping baby’s skin dry as often as possible, both DeBlasio and Grossberg recommend applying an ointment to any areas that are usually wet with drool throughout the day.
“After wiping baby’s skin, follow up with a heavy, bland ointment, like petroleum jelly or zinc oxide,” says Grossberg. “It’s important to choose an ointment rather than a lotion because, in addition to it being moisturizing, ointments will provide a physical barrier against the drool.”
For babies who use pacifiers, preventing teething rash can be a little trickier because a small pool of saliva often forms around the area of the mouth where the pacifier sits, effectively “locking” it against the skin. Again, keep the area dry as often as possible and periodically apply an ointment, but also aim to restrict pacifier use.
“If you can, limit pacifier use to sleep periods only, or do away with it altogether after 6 months [old],” Grossberg says. “And if that’s not feasible, try to minimize the amount of time your baby uses his pacifier during non-sleep periods.”
In a nutshell, to prevent teething rash:
- Keep your baby’s skin dry as often as possible.
- When needed, wipe baby’s skin gently and with a soft cloth.
- Apply a barrier-type ointment to affected areas.
- Limit pacifier use.
3. Treating teething rash at home
Sometimes, regardless of how diligent you are about wiping baby’s skin and ointment application, a drool rash will occur. For the most part, teething rashes aren’t cause for alarm and a few things can be done at home to treat them.
“For teething rashes with a more mild presentation, you can simply continue to keep the area dry and apply ointment, and it will likely go away on its own,” says Grossberg. “If the area seems particularly inflamed, you can try applying a non prescription-strength hydrocortisone cream, as well as continuing to wipe the area and apply ointment.”
4. When to see a doctor
It isn’t often that a teething rash becomes infected, but if you’re concerned — or if the drool rash is resistant to at-home remedies — talk to your doctor.
“If a rash begins weeping, oozing, crusting, cracking or generally worsening, see your doctor or dermatologist for an evaluation,” says Grossberg. “If you’re worried about an infection, your child’s doctor can take a look and determine the appropriate course of action. In some cases, a topical antibiotic, or even an oral antibiotic, may be administered.”
Grossberg also adds that it’s important to call the doctor when at-home measures have proven to be ineffective because, in some instances, over-the-counter antibiotic ointments can actually worsen an infection.
Ultimately, though, an infection from a teething rash isn’t something that should keep you up at night, as it’s pretty rare.
“It would be unusual for a teething rash to become infected, especially if there aren’t any breaks in the skin,” DeBlasio says. “That said, if your child develops a fever, or if the skin gets very red and starts spreading, oozing, or becomes painful to touch, talk to your child’s pediatrician.”
Bottom line, your baby’s teething rash may need a doctor’s attention, if your baby has a fever and/or the rash is:
- Weeping or oozing.
- Crusting or cracking.
- Very red or painful to touch.
- Getting worse.
- Your baby has a fever.