Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
183 Doctors are Online

Sore lips, bruise under skin, no bump or blister. is this STD or cold sore?

User rating for this question
Excellent
Answered by
Practicing since : 2007
Answered : 1201 Questions
Question
I am a healthy 28 year old male. I do not engage in risky behavior and I had a full STD profile completed less than a year ago with all clean reports. I have only kissed one person since then and she is also STD free.

I woke up this morning with a "sore" lip area. It feels almost like a bruise under the skin in the right hand side, top lip corner of my mouth. I have felt this before but not to this degree. It seems the area is a little red...possibly from me messing with it. But nonetheless I am concerned that it could be something I thought I had no exposure to, such as a cold sore. I do not think this could be a possibility but I wanted to share some images and information to make sure.

The pain I'm feeling does not feel tingly. It only hurts to the touch. It spontaneously came on and is right where my lip meets my skin right above the corner of my mouth on my right hand side. There is no bump, no blister and nothing visual to indicate anything, other than redness which I could have brought on by touching the area. The pain feels like a bruise would when I touch it.

There is also possibility this was a result of shaving, which I did last night.

I have attached some photos of that area.
Posted Mon, 13 May 2013 in Sexually Transmitted Diseases
 
 
Answered by Dr. Jorge Brenes-Salazar 43 minutes later
Hi,

Thanks for your health concerns and providing great quality images.

The lesion DOES NOT look like a cold sore, since the main lesion of a cold sore is a fluid filled vesicle; given the location at the angle of the mouth, with some degree of tenderness it is likely an irritation of the local skin and superficial tissues (chelitis angularis); it could be very well related to shaving, particularly if you had some hair in the surrounding area and applied extra force. Sometimes, this can also be seen with chemical irritation from foods, or in females cosmetic products such as lipstick.

Hope this helps with your inquiry, wish you the best health.

Dr Brenes-Salazar
Mayo Clinic Rochester
Above answer was peer-reviewed by
 
Follow-up: Sore lips, bruise under skin, no bump or blister. is this STD or cold sore? 9 hours later
thank you very much for your great reply. You have eased my mind significantly. Is it Possible to Be Angular cheilitis even though it is only on one side of my mouth and is not perfectly in the corner of my mouth? also, could you educate me a little bit on what it would feel like if this was a cold sore coming on spontaneously? I again do not feel that I have been at risk to contract it, but I would rather be educated and safe than sorry. Thank you again
 
 
Answered by Dr. Jorge Brenes-Salazar 13 minutes later
Sure, it is good to consider it in the differential. Typically, cold sores are caused by herpes virus, which travels through the nerves. Just before the initial vesicles (fluid filled lesions) appear, there can be a tingling or burning sensation; pain can also occur. Mode of transmission is usually contact with fluids from a carrier; the tough part is that the person might not have a lesion at the time and still can shed the virus, let’s say with a kiss. More than 40% of Americans have been exposed to herpes simplex 1, so it is quite common.

Hope that helps.

Best regards,

Dr brenes salazar
Above answer was peer-reviewed by
 
Follow-up: Sore lips, bruise under skin, no bump or blister. is this STD or cold sore? 37 minutes later
Thank You. Is it Possible to Be Angular cheilitis even though it is only on one side of my mouth and is not perfectly in the corner of my mouth? Also, does the location add to the unlikelihood that it is a cold sore? It does tingle or burn a little bit at the moment, but I think its probably Because I keep touching it.
 
 
Answered by Dr. Jorge Brenes-Salazar 5 hours later
The location closer to the angle of the mouth makes angular cheilitis an appealing diagnosis; if you constantly rub it you might superinfect it (with the rubbing place skin bacteria into the disrupted area). Nevertheless, as I emphasized before, the key lesion for a cold sore is the presence of small vesicles (small fluid-filled blisters) that develop gradually after the initial symptoms of burning, pain or tingling. Also, as in many things in Medicine, time will tell once it heals; if it recurrs exactly on the same spot later on, the chances of it being a cold sore are higher.

Wish you the best health,

Dr Brenes-Salazar
Above answer was peer-reviewed by
 
Follow-up: Sore lips, bruise under skin, no bump or blister. is this STD or cold sore? 1 hour later
I put some leftover rx Clotrimazole cream I've had from another issue on the painful area last night as I hear that is the treatment of angular cheilitis and when I awoke this morning, most of the pain and redness had subsided. It no longer hurts to touch unless I push on it. That being said, I mentioned before that I've experienced this same pain before and it occurred previously in the same area, possibly the same spot. Should that be a concern? The feeling doesn't feel like what the first stage of a cold sore is described to feel like online. It feels like someone punched me in the mouth right there and I'm touching the sensitive bruise. The effect of touching it is burning pain that lingers for a bit. But, I imagine if this was a cold sore, it wouldn't have responded to the cream right? Thoughts? Thank you.
 
 
Answered by Dr. Jorge Brenes-Salazar 37 minutes later
Precisely; that specific treatment would improve cheilitis but have no impact on a herpetic lesion.

Glad you are already feeling better.

Best regards,

Dr Brenes Salazar
Above answer was peer-reviewed by
 
Follow-up: Sore lips, bruise under skin, no bump or blister. is this STD or cold sore? 7 hours later
Thanks Doctor. I feel actually as the day has progressed, the feeling is more like it was yesterday. Painful to touch, a little burn sensation. Still, there have been no bumps appear or anything like that. This is the 2nd day with this. Just for peace of mind, I have attached some new photos of the area. If you wouldn't mind having a look and passing along your thoughts I would certainly appreciate it. Thanks.
 
 
Answered by Dr. Jorge Brenes-Salazar 1 hour later
Hi,

I have looked at the new pictures which are better quality than the others. the issue that concerns me is that there are some of the bumps that appear vesicular or filled with fluid content; if it is a cold sore, the content if the lesions would increase and they would tend to coalesce

Even if it were a cold sore, they are benign lesions in immunocompetent patients.

Best regards
Above answer was peer-reviewed by
 
Follow-up: Sore lips, bruise under skin, no bump or blister. is this STD or cold sore? 1 hour later
Hi Doctor. Thank you again for your followup answer. I have attached some new, higher quality photos taken with my actual camera. I feel the bumps you're seeing were made to look fluid filled from the flash of the camera.

I have examined my skin very closely and do not see anything which appears to be filled with fluid. I have always had a pretty bumpy lip landscape around the edges. Everything bump-wise has been there just as it is for years. Also, nothing has grown in size the past 48 hours this has been going on. Hopefully these images help to determine one way or another. I trust what you are seeing.

I have also included a full picture of my mouth to compare one side to the other.

Thank you very much again.
Also note I have just attached one extra photo of the skin area there stretched to get a really good look at everything.
 
 
Answered by Dr. Jorge Brenes-Salazar 16 hours later
Dear XXXXXX

Thank you for uploading these higher quality pictures. Definitely, now I can see a couple of linear fissures in the affected area, which would be more consistent with chelitis; I agree with you, I don't see suspicious vesicles, and the little "bumps" you see are normal glands of the lips, and that is why they have been there "always" as you say.

Im glad we have worked on the case together. Most likely a neutral emolient such as Chap Stick, aloe vera or petroleum jelly will help with symptoms.

Wish you the best health,

Dr Brenes-Salazar
Above answer was peer-reviewed by
 
Follow-up: Sore lips, bruise under skin, no bump or blister. is this STD or cold sore? 1 hour later
Good news all around! Thank you.

I guess the question that remains is how could the chelitis be caused?
 
 
Answered by Dr. Jorge Brenes-Salazar 10 minutes later
Hi,

Sun exposure, wind chill exposure, local irritation as a form of dermatitis. Those would be common etiologies. In malnourished patients, iron and Vitamin B deficiencies as well, unlikely to be your case for the later.

Take care XXXXXX

Dr Brenes-Salazar
Above answer was peer-reviewed by
 
Share on Facebook
Share on Twitter
Share on Google+
Question is related to
Diseases and Conditions
Drug/Medication

The user accepted the expert's answer

Ask a Sexual Diseases

© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor