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What Do Bumps Below The Lips Indicate?

Posted on Mon, 6 Nov 2017

Question: About a month back I developed a single bump on a corner of my mouth on the skin just below the lips. It appeared with intense burning sensation. I visited the dermatologist he gave me multivitamin tab, Zinc tab and a lip balm and hifenac-D. Aftr a day or two my lips started turning dry n chapped I got worried n I visited him again. I asked him if it was herpes! He said it wasn't . He said I just needed a moisturiser and he gave me capsules fr moisturing. And I went back coz even though the bump went but the irritation all over the mouth on both lips and suddenly corners of my mouth would burn and small grain like very small lesions appear and they disappear on hydration and then I visited another dermatologist he asked me to apply spf 30 sunscreen and it has improved but the uneasiness is still there and I feel I'm having irritation when I open my mouth at te corners something like stickiness. I have asked both if it was herpes. They have denied it. I even asked if investigations were needed they said it's natural and due to sunlight n wind and for few days wasn't able to eat spicy food. Now I'm able to have them and the area where the lesion was for few days it was red n lower lip have little torn appearance at vermilion border which reduce on applying moisturiser and appear when dry. Not able to figure out about what the problem is and not able to focus on my work because of it.

Answered by Dr. Dr. Kakkar (26 minutes later)

Brief Answer:
Cheilitis, Not herpes simplex infection

Detailed Answer:
Hello. thank you for writing to us.

I am Dr. Kakkar(Dermatologist and Venereologist). I have noted your concern and I have viewed the images.

You seem to have cheilitis - inflammation of lip.
I can make out some drynes and cracking at lower lip vermilion. Perhaps it is due to irritation to toothpaste or due to vitamin deficiency or change in weather.
ts definitely not herpes simplex infection. Herpes usually presents as grouped/ grape like cluster of fluid filled vesicles and it is unilateral.
If i was tge treating doctor i would suggest that you apply a moderately potent topical steroid cream e.g either fluticasone propionate 0.05% or mometasone furoate 0.1% cream, twice daily for a week.
In addition I would have suggested you to take an oral B-complex vitamin supplement once a day for 1 months.

Regards

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Dr. Kakkar (18 minutes later)

He has been suggesting me moisturing capsules and sunscreen for one month and suddenly i feel heat around the mouth n small lesions appear out of no where around the mouth. If u want i could send u few more images

Answered by Dr. Dr. Kakkar (1 hour later)

Brief Answer:
Cheilitis

Detailed Answer:
Thank you.

The images and clinical history is clearly indicative of Cheilitis - inflammation of lips which is manifesting as discomfort and cracking. It is not simple dryness. I would normally manage such cases with a moderately potent topical steroid cream e.g fluticasone propionate 0.05% or mometasone furoate 0.1% cream, twice a day for 7 days. In addition I usually ask my patients to take a B Complex vitamin supplement as vitamin deficiency is an underlying cause of Cheilitis. These are prescription medications and I suggest that you talk to your doctor for the needful. I don't think that your symptoms are sun induced and therefore I suggest you to discontinue sunscreen.

Regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr. Kakkar (23 minutes later)

Wt about the lesions below the vermilion border apart from the lips? This one was just taken a while back.

Answered by Dr. Dr. Kakkar (14 hours later)

Brief Answer:
Acneform eruption

Detailed Answer:
Thank you.
Even this does not seem like herpes simplex. They are most likely an acneform eruption. For them I suggest you to use clindamycin 1% gel twice daily.

Regards

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Dr. Kakkar (33 hours later)

My dermatologist doesnt want to go for all f it cause of side effects! Hes advicing me its not that severe maybe i am just overthinking. But i dont know what else to do. Im getting tired of it. And now its just the corners and small acneform eruptions in groups under the lips on the jaw area the last pic which i sent u. Still using episoft moisturiser and a moisturising capsule n b-complex capsule

Answered by Dr. Dr. Kakkar (5 hours later)

Brief Answer:
Cheilitis and acneform eruption

Detailed Answer:
Thank you.

You may use hydrocortisone 1% cream(cortisone cream), twice daily for lips. It is available over the counter(OTC) and doesn't require a prescription. Use it twice daily.

For acneform eruptions, you may use either one of these topical antibacterial creams eg. either Mupirocin 2% cream or Fusidic acid 2% cream or Clindamycin 1% gel or Neosporin ointment, twice daily. Kindly check if you can find one of these ointments OTC from a drug store near you.

Continue with B complex vitamin as suggested by your Dermatologist.

Regards

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Arnab Banerjee