A topical antifungal cream has not cleared the red, bumpy rash on a 6-year-old girl’s chin and paranasal area.
This child had perioral dermatitis. Acne generally does not occur before age 9; rosacea rarely affects children. The sudden onset of atopic dermatitis in a 6-year-old would be highly unusual. Contact dermatitis is more pruritic. The most common cause of perioral dermatitis in children is an ingredient that is added to toothpaste, such as a tartar-control agent, baking soda, whitener, flavoring, or coloring. Typically, removing the offending dentifrice and substituting a plain, white toothpaste is all that is needed.