Teething rash explained: What causes it and how to treat it

What is a teething rash?

A teething rash, also known as a "drool rash," is a common skin irritation that occurs when babies begin teething—typically between 4 and 7 months of age. “Teething rashes are caused by excessive drooling during teething, which irritates the skin around the mouth,” says Marcy Borieux, MD, FAAP, pediatrician at Summer Health.

As new teeth push through the gums, babies tend to drool more than usual. This excess saliva can collect around the mouth, chin, cheeks, and neck, leading to constant moisture that irritates the skin and causes a rash.

The rash usually appears as small, red spots that may be slightly raised. Although mild, it can make your baby uncomfortable and contribute to fussiness and irritability during the teething process.

Teething symptoms

Not all babies develop a teething rash, but it’s a common side effect of the teething process. Understanding the signs of teething can help you recognize what’s going on and take steps to comfort your baby. Here are some of the most common symptoms to watch for:

• Increased biting and chewing: Babies often try to relieve the pressure in their gums by biting or chewing on toys, fingers, or anything within reach. This behavior helps soothe the discomfort caused by emerging teeth.

• Fussiness: Teething can be uncomfortable and painful, which can lead to cranky, fussy babies. You may notice more crying, clinginess, or restlessness.

• Excessive drooling: One of the most noticeable signs of teething is increased saliva production. This drooling can be constant and may lead to teething rash if the skin isn't kept dry.

• Gum-rubbing:  Babies may rub their gums with their fingers, toys, or even while nursing. Their gums may appear swollen or red where a tooth is about to erupt.

• Sleep disturbances: Teething discomfort may interrupt your child’s normal sleeping patterns. 

• Loss of appetite: Eating or suckling can irritate the gums, and some babies eat less during this time. 

How to treat a teething rash 

While teething rashes can be uncomfortable and cause irritation or itchiness, they’re usually mild and manageable with some simple care. Here are effective remedies to help soothe your baby’s skin:

• Keep the face dry: Excess drool is the main cause of teething rashes, so gently wipe your baby’s mouth, chin, and neck regularly using a soft cloth. Pat the skin instead of rubbing to avoid further irritation.

• Apply a barrier cream: Use a gentle, fragrance-free cream or ointment, like petroleum jelly, to create a protective layer on the skin and prevent moisture from irritating it.

• Keep the area clean: If the rash causes open sores or looks raw, wash the area gently with mild soap and water to reduce the risk of infection. Be sure to pat it dry afterward.

• Use a cool compress: Apply a cool, damp cloth to soothe the irritated skin and prevent redness and swelling.

• Avoid harsh products: Don’t use scented lotions, alcohol-based wipes, or other products with strong chemicals, which can exacerbate the rash.

• Keep the baby’s hands clean: Since babies often touch their faces, keeping their hands clean helps prevent the rash from becoming infected or more irritated.

How to prevent teething rash

Along with the treatment methods mentioned above, many of the same practices are also effective for preventing teething rash in the first place. Here are additional strategies to prevent teething rash:

• Use a bib: Put a soft, absorbent bib on your baby to catch excess drool. Be sure to change it frequently to keep the skin dry underneath.

• Keep your baby upright: Positioning your baby upright during play can help minimize drool pooling on their face and neck.

• Early intervention:  Monitor your baby’s skin regularly for redness, bumps, or signs of chafing. 

• Avoiding harsh chemicals: Use fragrance-free laundry detergents, baby shampoos, body washes, and skin care items to reduce the risk of irritation.

Teething remedies for babies

In addition to causing rashes, teething can lead to gum pain and overall discomfort for your baby. Fortunately, there are several safe and effective ways to help soothe them during this stage. Always supervise your baby while using these remedies.

• Massage gums: Gently rub your baby's gums with a clean finger to provide relief.

• Offer cold objects: A cold teething ring, chilled (not frozen) washcloth, or cold spoon can help soothe their sore gums and ease irritation.

• Offer teething toys: BPA-free teething toys give babies a safe way to chew and ease discomfort.

• Try breastfeeding: Nursing can offer comfort and relief during teething

• Provide distraction: Engaging activities or toys can help take your baby’s focus off the pain.

• Offer chilled solid foods: If your baby (6+ months) has started solids, cold purees or yogurt can be soothing.

• Administer medication: Acetaminophen or ibuprofen (for babies 6+ months) as needed for pain relief.

Teething remedies to avoid

While many teething remedies can help soothe your baby, it's important to be aware of misinformation and unsafe advice commonly found online. The following teething remedies are not safe and should be avoided:

• Topical anesthetics: Numbing creams or teething gels containing benzocaine or lidocaine can cause serious side effects, including methemoglobinemia, a life-threatening blood condition.

• Teething tablets and gels: Teething tablets and teething gels can have unsafe ingredients, like belladonna or alcohol, and can also pose a choking risk.

• Teething necklaces or bracelets: These pose a choking and strangulation hazard and are not recommended.

• Homeopathic remedies: Their safety and effectiveness are not well-established, and they may contain harmful ingredients.

• Unapproved pain relievers: Avoid medications not approved by your pediatrician, such as aspirin, which can be dangerous for infants.

• Sugary substances: Products containing sucrose can contribute to tooth decay and should be avoided.

When to consult a pediatrician 

While teething rashes are usually mild, there are times when medical attention is needed. You should contact your pediatrician if:

• The rash is severe, persistent, or gets worse.

• You notice signs of infection, such as increased redness, swelling, warmth, or pus.

• Your baby appears unusually fussy or in distress.

• There are additional symptoms like fever, lethargy, or poor feeding.

If you're ever unsure, it's best to consult your local or Summer Health pediatrician for professional guidance and peace of mind.

FAQs

What is drool?

Drool is excess saliva that comes out of the mouth unintentionally. According to the American Academy of Pediatrics (AAP), drool is super helpful for babies and can help with:

• Keeping their mouth moist

• Making swallowing easier

• Washing away leftover milk and food

• Protecting teeth against tooth decay and bacteria

• Softening food

• Breaking down starchy foods

• Digestion

What’s the difference between regular and excessive drool?

Every baby is different and some babies drool more than others. If you have a super drooly baby they may have something called hypersalivation, and their body produces more saliva than usual. 

Be aware that any sudden excessive drooling could be a sign of choking or difficulty swallowing. If your baby shows any signs of choking, call 911 immediately.

When does my baby need to see a dentist?

Once your baby grows their first tooth, they should see a pediatric dentist within 6 to 12 months. This is an important habit to get into to have routine pediatric care to ensure their teeth are strong, healthy, and to answer any of your questions. 

If you have questions about teething rashes or general teething, reach out to your local or Summer Health pediatrician for support. Summer Health is a pediatric telehealth platform offering 24/7 care, providing answers for everything from urgent concerns to everyday questions about your child’s health. 

When do teething rashes go away?

Teething rashes typically resolve within a few days to a week once the excessive drooling subsides. 

Does teething cause sleep regressions?

“Teething rashes do not cause sleep regression based on objective evidence,” explains Dr. Borieux. “Alternative causes should be considered for persistent rashes or sleep disturbances.”

If you have questions about your child’s teething rash, reach out to your local or Summer Health pediatrician for support. Summer Health is a pediatric telehealth platform offering 24/7 care, providing answers for everything from urgent concerns to everyday questions about your child’s health.