Suggest Treatment For Red Skin Patch On Lower Lip
No real pain, although I've been fiddling with it. Does not sting. Tingles a little bit but not constant. Not raised or very slightly raised. I have never had a cold sore so I do not know how it would feel pain wise.
What could this be? Thanks.
Fordyce spots & Post inflammatory hypopigmentation
Detailed Answer:
Hello,
Welcome and thanks for posting your query to the forum.
I can understand your concern for the patch on the lower lip.
I can understand your apprehension for the whitish spot. After analyzing the pictures with best clinical acumen let me reassure you that all your conditions are quite normal and there is no disease state or abnormality in the same at present .
Let me explain all your issue : The light spot is basically known as “Post inflammatory hypopigmentation" or PIH. To tell you simply, our skin is multilayered structure. There are certain color producing cells are present in the skin layers.
These melanocytes are the cells which regularly produces color/pigment known as melanin in the skin. These are superficially present in the upper skin known as epidermis.
There is a tendency in us to get higher or lower activity of these melanocytes after any minor to major irritation or injury. The lip skin is prone increased or decreased pigmentation as is most thinnest skin and therefore can cause over production or decreased production of melanin in the skin. In yourself it is hypo (decreased o light spots) pigmentation" or PIH..
This in general doesn’t require any kind of treatment because of thin nature of the skin. But in some cases I prefer to use Tacrolimus ointment.
The other whitish beads on the lower lip are known as Fordyce spots or glands. These are pinhead size or slightly larger bumps present over mainly the lip area. Basically these are proliferation of the normal oil glands which are present over this area. These are totally asymptomatic (without any problem). There is no need of any treatment for the same. If at all some person are panicky then we do remove these with radiofrequency ablation.
I further suggest you to not to pinch, pop or fiddle with the area as this is one of the important cause of redness and then whitish appearance of the skin.
I hope these information's will help you. If you have further queries I will be happy to help.
"Wish you good health"
Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology)
Could this PIH be attributable to kissing and/or smoking? And would that explain some of the tingling, general mouth soreness and other sensation?
Also, a main concern would be a cold sore. I recently had a blood test after 7 weeks from a prior possible HSV1 exposure, and it came back negative. I understand that this test would have shown antibodies present at 7 weeks even if I had no obvious sore? Is this correct? So I can assume I did not have an HSV1 infection prior to this. I also understand the kissing from last night would not result in a possible cole sore this soon so I know it's not that. I've attached another picture that I would ask you to look at it and confirm. Appears on the left hand side that there are a few slightly distinct but not really raised round cells (?) that are right below the lip line.
My lips are typically very sensitive and I use a lot of lip balm, so I'm somewhat used to not having full sensation in my lips .
You do not have herpes. Relax yourself;Don't worry
Detailed Answer:
Hello young buddy,
Welcome again and thanks for your swift follow up.
I have analyzed the recent picture sent by you and also the rest of the pictures again. I can understand your concern for the possibility of herpes in yourself.
After reading your complete query, analyzing and interpreting all the pictures with diligence I reassure you fully that you do not have herpes.
Let me tell you certain important facts related to herpes:
To tell you medically - Herpes lesions manifest itself as small vesicles (fluid filled blisters) which remains for just a day or two and then forms ulcers which are quite painful. These ulcers then heals in next 5-7 days.
To begin with also these vesicles are quite painful and itchy with discomfort and once the vesicles burst in a day or two then the ulcers which are formed are quite painful for next 4-5 days. So the symptoms can never go unnoticed.
In yourself I can make out that no such symptom is present matching with the above symptoms.
So you can rest assured regarding the rarest possibility of herpes. You can make out that you do not have any of the symptoms which match with herpes or its symptoms or any other Sexually Transmitted Diseases.
You can notice that it is almost 7 weeks since the possible prior exposure and there are no symptoms of grouped vesicles or painful ulcers. Your herpes test results further confirms the same.
In case of kissing: The infection is transferred only if the kissing is wet type with vigorous friction, only during active stage of the infected person where there must be open ulcers or sores for the transmission of the virus.
I also want to suggest you to not to apply a lot of lip balm as these contains fragrances and preservatives which can cause mild irritation and tingling as well as the hypo-pigmentation of PIH. The tingling sensation and sensitivity could also be due to excess of stress in case of you are paying more attention and taking more stress for herpes.
So just relax yourself and do not worry. I reassure you completely that your condition is not at all related to herpes or any other Sexually transmitted infection.
I hope above informations will relax you completely. If you have further queries I will be happy to help.
"Wish you good health"
Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology & Sexually Transmitted Diseases)
I am appreciate you calming me down. I know that it is too early to be concerned about the most recent experience. I did not observe any open sores or cuts on the girl this weekend. I know there is always a risk, but I'd imagine this would be very low risk if there were no open sores on her lips, correct? Just assuming there was a risk, I should be on the lookout over the next two weeks or so, as this would be the timeframe for a new possible infection to present itself, right? There were no really open cuts or sores on my lip, besides normal wear and tear and a little spot from a pimple I popped. Any reason for concern there?
Thanks for your help .
No chances of herpes as per my experience.
Detailed Answer:
Hello young buddy,
Welcome again to the forum and thanks for your follow up.
As I guided you in the previous mail that if you or your partner do not have any open sores or cuts and if your partner do not have any active lesion then there is nothing to be worried about.
In my view you would not have anything after 2 weeks also. You can wait and watch for your satisfaction.
I quite often counsel your kind cases whee young people like you are quite terrified. In the follow ups they they are totally fine and never had shown any lesions. So based on my experience if reassure you fully that your recent experience would not be causing any problems.
I hope you must be relaxed now. I will be glad to guide you any further.
With regards,
Dr Sanjay Kanodia
I appreciate you taking the time to counsel and explain this to me. I know that a lot of people have HSV1, but I also know that I have passionately kissed a lot of girls without ever developing oral herpes. I don't think this recent incident will have any problems and appreciate you answering questions and helping me understand better.
It has been about 2 days since my interaction. I have read that symptoms will not develop that quickly. True? So, it is safe to assume that all the little variances and small bumps on my lips are not breakouts? I ask so that I can be mindful of what was there beforehand if something were to show up.
Also, what are the odds of assymptomatic shedding infecting me? Again, considering I have kissed dozens of girls, I would imagine that I have kissed someone who has HSV1 but have thankfully never gotten it. So, I am mindful that there are always risks, but this would be a very low one right? I always have little cuts and bumps on my lip from a number of things, but also know my recent Igg blood test indicated I was not infected before.
Finally, just in general, would the blisters just show up for a first primary infection? Or would there be tingling and itchiness in the spot before the blisters? I have read about prodomes but want to understand how/when first outbreaks might occur. And based on your above comments, I imagine I would be in obvious pain when blisters show and after they break? Also, the other symptoms like the flu typically occur with active lesions and not just by themselves, right?
Again, thank you very much. I feel much better and would like to just understand this more, even though I'm confident nothing will be wrong with me .
My all best wishes for your good health.
Detailed Answer:
Hello young buddy,
I am happy to know that you are relaxed to know the simple medical facts and your events do not fulfill any of the criteria for contracting the infections especially herpes.
I can get that you have had kissing episodes with so many females and despite that presently your IgG status is clean and negative. This shows that you never have had any exposure of herpes virus before.
Now for the last episode: As I said previously that in every episode of herpes there are multiple fluid filled vesicles are present which are quite painful. These forms raw ulcers and then the scabs of brownish black color falls off in around 7-14 days.
To add to above information, the first episode is the most severe of all. It means along with above symptoms there are flu like symptoms with other systemic complaints which are never missed. This is due to high immune response in first episode.
The vesicles always are present in first episode and are never missed. In case of prodromes of tingling or itching or burning- it remain only for a day or two and is then succeeded by the vesicles. SO you can get that you have never experienced such symptoms till now, making you completely free previously as well as presently.
As I guided you that in my experience your last episode would also not lead to anything. I reassure you completely that you are totally fine and therefore do not worry and just relax. DO give me a follow up after two weeks.
My all best wishes for your good health. I will be glad to guide you any further or if not then can close the discussion and rate the answer.
With regards,
Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology & Sexually Transmitted Diseases)
A few more questions as I want to keep this thread open for a while so that I can follow up if need be. I have been watching my lips carefully and noticed two things today that I would appreciate your guidance.
1) There was a white, shiny patch of skin right in the middle of my upper lip, where the two sides meet. Does not feel raised. I guess one of my questions is that I feel it is hard to visually tell the difference between irritation, fordyce spots or something else. This spot is not raised from what I can tell, but what might it be?
2) To the right of that spot, also on upper lip is an obvious red spot right at the lip line. Looks red at some angles and pinkish at others. Also, shiny. What do you think this is? More PIH? Again, having never had a cold sore, it is hard for me to know what it might present like or feel like, besides what you have explained above. If a sore were present, is it fair that it would be painful to touch, itch, tingle, etc.? Or could it initially present as not painful?
I have attaches more pictures. Again, just trying to understand as much as I can and to keep this avenue of conversation open if needed. Thanks .
Till now there is no sign of herpes in you.
Detailed Answer:
Hello young buddy,
Welcome to the forum again. I have gone through all your recent pictures and can make out that all the patches as well as spots are quite normal and are not related to herpes.
The small white shiny patch of skin right in the middle of upper lip is simple raised vermillion border of lip. The red spot is the prominence of underlying blood vessels. As the skin over lips is very thin so the blood vessels are quite prominent if looked closely.
I already guided you for the symptoms of cold sore. In first episode it is always painful and then form a raw area which can never be missed. It is such a raw ulcerated area that the person suffering from it immediately seeks medical attention.
I reassure you fully that till present date there is no sign of herpes. And as per my experience you would not have any chance of the same. So just relax and do not worry.
My all best wishes for your good health. I will be glad to guide you any further.
With regards,
Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology & Sexually Transmitted Diseases)
I will continue to assume that in the absence of noticeable pain, the small variances and different color patches/spots in and around my lips are not a concern.
What are the odds of transmission from assymptomatic shedding on the lips if a partner were infecte? Is it safe to assume that exposure does not necesarrily result in infection?
Thanksd
Exposure does not necesarrily result in infection.
Detailed Answer:
Hello young buddy,
Most welcome to the forum and thanks a lot for you swift follow up.
I am happy to know that you are relaxed to know all the simple facts and your anxiety level has came down after getting all the facts.
For the part of asymptomatic shedding of viruses by the infected person and further transmission: There are multiple factors involved in both the things. These things depends upon:
: Stage of infection of the person: If a person is in active stage of infection then viral shedding is quite high. Active stage of infection means if you see any frankly raw area or vesicles on the lips.
If a person is not in active stage of infection then the irla shedding is very low and therefore the chances of infection are on its least of side.
: Abrasions or cuts or sores on non-infected person: It is quite important the non-infected person must have abrasions or cuts or sores on the lip or around the lip area. There should be exchange of fluids from one person to another to transfer the infection.
: Dose or amount of viruses: It is one of the very important factor in the transmission of the infection. There should be minimum of the amount of viruses to cause the infection which is known as "Infective dose". If the infective dose is not achieved then the chances of infection are unlikely.
:Immunity of a person: It is probably the most important factor in the tramsmsssion of the infection. If a person has good immunity then the despite of all the above factors he/she might not catch the infection.
I have seen so many couple where one partner is infected and even without any prophylaxis the other person do nto catch the infection. The whole of the thing lies with the immunity of the person.
SO you can get all the factors involved in the transmission and therefore can very well get that exposure does not necesarrily result in infection.
I hope the above information will relax you. I will be glad to guide you any further or if not then can close the discussion and rate the answer.
With regards,
Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology & Sexually Transmitted Diseases)
An update: still no obvious outbreak. Small purple/red spot with clustered fordyce spots. Can these become inflamed because one is pinkish and circular with a little white center? I'm assuming the red/purple spot is blood vessel. Neither is Npainful though I do have some tingling in the area.
It is often difficult to distinguish between a cluster of fordyce spots/oil glands and something else.
Thank you for your time.
Outbreak most commonly occurs within 1-5 days.
Detailed Answer:
Hello young buddy,
It is really a good sign that you still do not have any obvious signs of outbreak. I am pretty confident that you would not have anything in future too !!!
If at all any outbreak had to happen then most commonly occurs within 1-5 days. It is almost 5 days since your exposure and you have not seen or observed anything related to herpes (which I mentioned as clear vesicles or ulcers with pain). SO it is a very good indicator that you would not have been exposed to herpes.
Just relax and do not worry. I am with you to solve any issue and to guide you best regarding your concerns.
All the best.
Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology & Sexually Transmitted Diseases)
Just a quick update. We are at day 8 with no issues. I actually saw my dermatologist today for a check-up and she did not note any issues. I have a minor case or perioral dematitis that she gave me some medication for dryness.
I am hopeful that without any symtoms to date, there was no exposure. Should I be on the lookout for another week or two
Thank you for your help. ?
It is a very good indicator and positive sign.
Detailed Answer:
Hello young buddy,
Welcome to the forum again and thanks for your follow up.
I am happy to know that till 8th day there are no signs of herpes. It is a very good indicator and is quite enthusiastic to know the same. As I guided you earlier that most of herpes cases occurs within a 1st week and less commonly after 2nd week. As it is 8 days since your incidence so it is one the best sing and you can very well relax that there was no exposure.
You can lookout for another one week or at the maximum 2 weeks which in my view would not show anything but just for the part of surety.
I am quite confident that you are totally alright and there is nothing to be worried about.
Just completely relax and do not worry. I will glad to guide you any further.
All the best.
Regards,
Dr Sanjay Kumar Kanodia
MD (Dermatology & Sexually Transmitted Diseases)