Persistent rash at the corner of my child’s mouth, any ideas?

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My child has had this rash on the corner of his mouth for over 2 weeks now. I initially was using sudocrem for a week which made no difference, then got fucidin cream in case of impetigo but it's not working. It's just getting worse.

Im going back to the gp today but does anybody have any idea? Its is red and rough to touch. When it first appears it's almost like little spots. When it gets moist (he is a very moist boy for some reason so his mouth is always quite wet!) It gets a lot redder.

No yellow crusts to be seen. Sometimes some white skin flakes comes off.

Please help!

Impetigo, although if it's persistent enough to survive the acid then it would often look a bit crustier than that. Perioral dermatitis?

Does it appears after eating certain foods?

Would cleaning his mouth really well after eating help?

DS1 gets similar (he's a teen now) if he gets tomato based food around his skin - not common these days, but does happen.

Toothpaste can cause this. Make sure it's washed off thoroughly.

I'd say Impetigo, almost definitely ( I'm a ANP and seen this so many times), but it's so established now, that you'll need oral antibiotics, the ointment won't be enough.. ( Flucloxicillin, if not allergic to Penicillin). My own children have had it too. Did it emerge after a mild viral illness , OP?
You could also ask for a swab to be taken to ensure all colonising bacteria are targeted with the right antibiotic.
Best of luck.

My toddler had what I thought was a patch of sore skin on their cheek that was almost certainly impetigo - it progressed to cellulitis in their eye socket. Had I suspected it was impetigo, I would have got it treated much sooner! Unlikely this will happen to your DC but I think you need a trip to the GP.

That’s impetigo.

Did you get your poor old little chap's rash/Impetigo sorted, yesterday, OP, at the GP? I do hope so, you don't want it to spread all over. When it affected ours, we had to cancel a trip to Centre Parcs, because although it started small, they were then covered in it. Was thinking of you. X

I think it’s toothpaste. Are you using anything harsh or anything with bicarbonate of soda in? Try changing the toothpaste to a gentle brand. I’m not sure if you can name brands on here as it’s my first time posting. I just wanted to let you know as the same thing happened to me and it took me a while to work out what the issue was. From the position of the rash it looks like this may be the reason. It won’t resolve overnight, but if you do change to a different brand, something with ‘gate’ in it should hopefully help.

Going against the grain here because my DD had something that looked identical to that. I took her to the chemist who diagnosed impetigo but recommended a GP visit also. The GP said it wasn’t impetigo at all and diagnosed a fungal infection and gave her some cream which cleared it up in no time!

My son used to get this. Doctor said impetigo. We tried many things to clear it. Eventually he was diagnosed with crohns and the sores around the mouth were a symptom of an suppressed immune system/

Yes thank you so much everyone! GP does think impetigo and has now give oral antibiotics, soap wash and an ointment. Lets hope this does the trick!

I will be keeping the potential toothpaste culprit in mind!

That’s good news I hope it clears up soon, but if it doesn’t or it gets worse definitely consider the toothpaste issue. Keep clean and dry and change to a milder toothpaste.

Hurrah!

It's already madly improved and only been 24 hours for the wash and ointment. He's only had 2 doses of the antibiotic, surely it cant take effect so quickly?? Im worried im now giving him this antibiotic uneccessarily

Okay still in the same situation. It has been over 3 weeks now. Madly worried. Oral antibiotics fluxocillin are not getting rid of it and last day is tomorrow.

I am washing bedding everyday. Ive put away and cushions and blankets. Cleaning it with dermol 500 and patting dry 3 times a day. Was using hydromol cream but i read that can make the bacteria harder ti get rid of so i stopped that 2 days ago.

I am stressing out so much! 3 days ago we got bright white pimples again. Please does anyone have any advice???

It’s angular cheilitis.
It’s caused by bugs which are normal in the mouth and thrive in moist conditions - you said he was “moist”. Lots of Vaseline or another barrier cream should be enough and if not some antifungal cream will sort it out.

Updated photo.

Both times gp has just prescribed things through online consultation and photo and not seen him. Im gonna insist on a physical meeting. Im absoloutly terrified it might progress to celulitis or something! Ive noticed his ear lobe has a red mark now 😭😭😭

He's fine in himself mostly! We've all got a mild virus so that's probably not helping things!

It’s not impetigo and antibiotics are not the right thing.Nor is it anything to do with toothpaste. GPs are not great at oral conditions, they don’t cover dental issues on their course.
See my previous post- barrier gel should be enough and if it doesn’t settle in a few days then some anti-fungals.

Completely agree, I came on here to say this. V surprised it’s only being mentioned now

You think??? Maybe his ear mark is unrelated? God i hope it is this.

But if it is this, surely a week of sudocrem at the start of this process would have fixed it?

It needs to be on 24/7 because his saliva is probably washing the sudocrem away. Try the Vaseline for a couple of days and if no joy get some Daktarin or Nystatin. Some kids are prone to this, especially if they dribble or have a lot of saliva. It’s not serious and nothing to worry about.