My daughter is 8 1/2 years old. For at least a year she's had a rash all around her mouth. I've used gasoline thinking she was drooling it finishes and comes back again. I took her to her PCP which told us to wash her face twice daily and prescribed her fougera 1% but it's not helping. I don't understand why this is happening. Can you suggest something else to try?
Thank you!
E
Dr. Santos,
Thank you for your input. I took my daughter to her pediatrician. She was concerned about tinea capitis based on looking at a sample of scalp scale under the microscope. She sent a sample of scale and hair to be cultured and started her on oral griseofulvin. Her facial rash was diagnosed visually as perioral dermatitis and she prescribed Metronidazole cream.
After an internet search on tinea capititis (ringworm), I was surprised by her assessment. My daughter is caucasian and has no hair loss or hair breakage. I guess she is being cautious? I also was shocked when I had to pay for the griseofulvin ($138/month) and Metronidazole cream ($45/tube). I certainly feel that I want to treat my daughter appropriately, but I would have liked some forewarning from the pediatrician that these two products tend to be more expensive!! I also wish she had given some recommendations as to prevention of spreading/reinfection of the possible tinea capitis.
Thanks for your help!
Hi,
Cradle cap is a yellowish, patchy, greasy, scaly and crusty skin rash that occurs on the scalp of recently born babies and tends to recur in adolescence and persists into adulthood. The cause is possibly due to an overactive sebaceous glands. There may also be a relationship with skin yeasts. Applying petroleum jelly liberally overnight may be done to soften the scales and can be brushed off in the morning. Keratolytic or dandruff shampoos are generally not recommended as they sting eyes and may worsen the dermatitis.
Fungal infection or tinea capitis and scabies can mimic cradle cap. It is important to know the underlying cause to determine which treatment is suitable. The facial rash may not be related to the cradle cap. but it can also be due to a fungal infection or dermatitis. Perioral dermatitis which presents as groups of itchy or tender small red papules that may appear round the mouth, upper lip, nose, chin or cheeks. The surrounding skin may be pink, and the skin surface often becomes dry and flaky.
This condition responds well to antibiotic treatment but can recur at a later date or when the antibiotics are discontinued. It is important to wash the face with warm water alone while the rash is present. Finish the full course of antibiotics prescribed by your doctor to prevent recurrence.
It would be best to have this evaluated further for proper diagnosis and management. Take care and keep us posted.