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Have bump on lips, not fluid filled, does not hurt. HSV 1 and 2 negative. What is it?

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Practicing since : 2006
Answered : 2016 Questions
Hi there, I am 28 years old and healthy. I have an unusual bump partially on my lip, partially on my skin above.

I want to point out first and foremost this bump is constantly present and does not come and go. Also, I do not have HSV1 or 2 and have been recently tested for it (though I have kissed 1 person since testing so I suppose there's a miniscule risk involved).

The bump is not fluid filled, and feels more like scar tissue. Every now and then, it can get a little inflamed by something and that is the situation currently. It feels like the skin is being "stretched" there the way a scar would. It doesn't "move" with the rest of my skin necessarily. It feels warm and stings a little bit but does NOT hurt at all to the touch and is almost numb feeling to the touch. It has been present for as long as I can remember but as it is currently inflamed and noticeable, I wanted to seek advice.

It is difficult to photograph but I have tried my best and have placed arrows on the photo to show where it is. When the skin is stretched, it becomes white. The skin is very thick and callused but it is not like a wart or growth.

I'm not sure what to make of it. Any advice is welcome. Thank you!
Posted Fri, 31 May 2013 in Skin Hair and Nails
Answered by Dr. Kalpana Pathak 1 hour later
Thanks for writing to us.
I have gone through the attached images.
These look like inflammed fordyce spots of the lips. Fordyce spots are ectopic sebaceous glands which present as skin colored or pale yellow bumps.
To treat the same
Do warm water compresses of the area and apply steroid antibiotic cream twice over the affected area( one may apply fusidic acid hydrocortisone combination)
If lesions are too painful , warm or stinging take an antiinflammatory analgesic like Brufen( ibuprofen) or diclofenac

With the above mentioned suggestions it would take couple of days to settle the inflammation. Once the inflammation settles, treatment for fordyce spots can be taken.Unfortunately not much can be done for treating fordyce spots as such
Creams like tretinoin, sessions of trichloroacetic acid peels, lasers are said to be useful. Personally I feel these should be left as such if not symptomatic. If aesthetically unpleasant, then above treatment options can be tried.

Hope that helped.
Take care
Above answer was peer-reviewed by
Follow-up: Have bump on lips, not fluid filled, does not hurt. HSV 1 and 2 negative. What is it? 2 days later
Thank you for your great information. Are you certain this does not appear to be something scary like a cold sore? I do not have HSV1 as of testing late last year and certainly would not care to contract it.

The spot has become inflamed again and I have attached a new image that hopefully will provide further clarity. It it tough, callused feeling skin that is impossible to pop or get anything out of, yet when inflamed feels the pressure that it should. It's a little painful too.
PS - is there a chance this could be a flat wart on my lip? Or are you confident it is an inflamed fordyce?

Thank you again.
Answered by Dr. Kalpana Pathak 19 hours later
Thanks for writing back.
The lesion do not look like wart or cold sore for sure.
Herpes or cold sore is never persistent. The fluid filled lesions appear and resolve, only to reappear again at same spot.
I would still go with the probability of fordyce spots that most probably get inflammed due to over manipulation of the lesions.
I would advise that you follow the suggestions mentioned in my previous post to help the lesions heal. Let me know about the response in two to three days. I shall be available for follow up.
Take care
Above answer was peer-reviewed by
Follow-up: Have bump on lips, not fluid filled, does not hurt. HSV 1 and 2 negative. What is it? 28 hours later
Thank you for your great information. The bump seems to be maintaining its size and has some redness around it. It is back to being pain-free however. I just wanted to post these new photos to you before I close out the conversation to see if there is anything new to be alarmed about or if the diagnosis remains the same. Thank you again for your patience and wonderful information.
Answered by Dr. Kalpana Pathak 12 hours later
I would still stick to the possibility of fordyce spots. I would advise that you apply steroid antibiotic cream for few days and when the inflammation settles, you may start application of tretinoin cream/ gel application in night over affected area to reduce the spots( quantity used should be very less as tretinoin has an irritant potential)

Hope that helped.
Take care
Above answer was peer-reviewed by
Follow-up: Have bump on lips, not fluid filled, does not hurt. HSV 1 and 2 negative. What is it? 2 days later
Thank you doctor. Everything seems to be settling down but the bump/fordyce spot itself seems to just be flattening and not necessarily going away. Is there anything in particular that leads you to be certain it is not a flat wart? Thank you as always.
Answered by Dr. Kalpana Pathak 28 hours later
Flat wart never changes size ie does not enlarge to shrink again. Warts over a period of time can either remain same or increase in size.
With the use of steroid antibiotic cream , the inflammation will settle. After warts apply tretinoin cream to help reduce fordyce spots.

Hope that helps you.
Take care
Above answer was peer-reviewed by
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