Zinc oxide or erythromycin for drool rash?

Dec 01, 2025 Source: Cainiu Health

Dr. Liu Wenmin

Introduction

In general, drool rash is a skin inflammation in infants caused by irritation from saliva. The choice between zinc oxide ointment and erythromycin ointment depends on the specific condition of the rash. If discomfort occurs, prompt medical consultation is recommended. Gently dab the infant's mouth corners and chin with soft tissues or gauze to remove saliva, avoiding rubbing. Use pure cotton bibs for the infant and change them frequently to keep the area dry.

Generally, drool rash is a skin inflammation in infants caused by irritation from saliva. The choice between zinc oxide ointment and erythromycin ointment depends on the specific condition of the rash. If discomfort occurs, prompt medical consultation is recommended. Detailed analysis is as follows:

When the rash appears only as redness, dryness, and slight roughness, zinc oxide ointment is recommended. It provides a protective barrier that reduces ongoing irritation from saliva and helps repair the skin's natural barrier. In such cases, erythromycin ointment should not be used, as it is an antibiotic ineffective against non-infectious inflammation. Indiscriminate use may disrupt the normal skin microbiota.

If the rash shows broken skin, oozing, or signs of infection such as swelling and pustules, erythromycin ointment may be used under a doctor’s guidance to control the infection. In these cases, using zinc oxide ointment alone is inappropriate, as its occlusive nature may increase stress on damaged areas, hinder drainage of exudate, and potentially worsen local irritation.

Gently dab the infant’s mouth corners and chin with soft tissues or gauze to remove saliva promptly, avoiding rubbing. Use pure cotton bibs and change them frequently to keep the area dry. After cleansing, apply a gentle baby moisturizer to maintain skin hydration. Clean the area around the lips promptly after feeding to reduce dual irritation from milk residue and saliva, thereby lowering the risk of developing rashes.

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