Teething, a developmental stage, typically begins around 5 to 8 months and continues until about 3 years old. This process often leads to increased drooling. Prolonged contact of excess saliva with sensitive skin can cause irritation, known as a “teething rash” or “drool rash.” Though usually mild, it can cause discomfort.
How Teething Rash Appears
A teething rash typically appears as reddened skin, often with small, raised bumps or flat patches. Affected skin may also look chapped or dry from constant moisture. This irritation commonly occurs around the mouth, chin, and cheeks, extending to the neck and chest.
Excessive saliva produced during teething is the primary cause. This drool, especially with digestive enzymes, breaks down the skin’s natural barrier, leading to irritation. Friction from clothing, pacifiers, or a baby’s hands rubbing wet skin can worsen the rash. The rash may come and go over several weeks as teething continues.
How It Differs From Other Rashes
Distinguishing a teething rash from other infant skin conditions is important. While a teething rash is a type of drool rash, excessive drooling from other causes, like increased salivary gland activity around two months, can cause similar irritation. However, a rash around the mouth starting between 3 and 6 months, accompanied by other teething symptoms, is more likely related to teething.
Heat rash (miliaria) appears as tiny, clear, or red bumps, typically in skin folds or areas with blocked sweat glands, not drool-exposed areas. Eczema (atopic dermatitis) presents as red, dry patches, often involving very dry, scaly, intensely itchy skin. It can appear anywhere, including elbow creases and behind the knees, not just around the mouth.
Both are forms of dermatitis; eczema is often chronic with genetic and environmental factors, whereas drool rash is a contact dermatitis that clears once the irritant is removed. Food allergy rashes may appear suddenly after new foods are introduced, being more widespread or accompanied by other allergic symptoms like hives (bright red, itchy bumps that can occur anywhere). Unlike these, a teething rash is typically localized to the face, neck, or chest and usually coincides with other teething signs. If a rash appears on the baby’s arms, legs, or back, it is unlikely to be a teething rash and warrants pediatrician evaluation.
Caring for Teething Rash
Managing a teething rash involves minimizing skin exposure to saliva and protecting the irritated area. Gently wipe drool from the baby’s mouth, chin, and neck with a soft cloth, avoiding harsh rubbing that can exacerbate irritation. Use a soft, absorbent bib to catch excess drool and keep clothing dry, changing bibs frequently.
Apply a thin layer of barrier cream or ointment to protect the skin from further irritation. Products like petroleum jelly, lanolin-based creams, or Aquaphor are often recommended to create a protective barrier and lock in moisture. Choose mild, fragrance-free products to avoid additional irritation. Offering a cool teething ring or cold washcloth for the baby to chew on can also soothe gums and indirectly reduce drooling.
Most teething rashes are mild and respond well to home care. However, seek professional medical advice if the rash worsens significantly or does not improve after a few days of consistent home treatment. Signs of infection, such as pus, spreading redness, warmth, tenderness, or bleeding, warrant immediate pediatrician consultation. If the rash is accompanied by other concerning symptoms like fever, lethargy, poor feeding, or unusual distress, contact a doctor to rule out other conditions.