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I am getting a cold sore in the same spot on my cheek. What treatment do you suggest?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

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Published At June 5, 2017
Reviewed AtJuly 7, 2023

Patient's Query

Hi doctor,

I was told that this thing on my cheek is a cold sore (photo attached). It comes in the same spot on my cheek every time. It has been coming and going for several years. Now, it showed up last week and progressed to this level. What is your opinion on this? I know you probably cannot tell by a picture, but I figured I would show you what it looks like. It itches a little bit at times. My glans are swollen and are tender to the touch on my right side (the same side as the outbreak) and also my ear aches on the right side. Also, you can tell the right side of my face is a little bit swollen. It blisters and oozes, and at that point, I cover it with a band-aid if I have to work or if I have to go out into the public. I have a perception of Valacyclovir twice a day. I put clean and clear persa-gel on it at night to help dry it out, but I do not use anything during the day unless I have a band-aid over it like today and I put Apexicon cream on it. Please help I cannot accept that this is a cold sore. I have also been told it is a Staph infection and treated for it, but it kept coming back in the same spot. I was supposed to get a biopsy, but my dermatologist is faithful it is a cold sore and refused to do one.

Hi,

Welcome to icliniq.com.

From your history and clinical images (attachment removed to protect patient identity), the diagnosis would be more in favor of a furuncle (Staph infection) or acne with secondary infection. It does not appear to be eczema or contact dermatitis. It seems infective rather than eczematous. I would advise you to try a course of Doxycycline to cover for MRSA (Methicillin-resistant Staphylococcus aureus) as you have mentioned that yourlesion has been recurrent.

Treatment plan

I suggest the below prescription for a week. Consult your specialist doctor, discuss with him or her and take medicine with consent. 1) Tablet Pantoprazole 40 mg once daily before breakfast. 2) Capsule Doxycycline 100 mg twice daily after food. Continue Persol gel at night.

Preventive measures

Do not prick at it and no repeated touching of the face. Also, avoid nose-picking with fingers.

Regarding follow up

Revert after a week to a dermatologist online.---> https://www.icliniq.com/ask-a-doctor-online/dermatologist

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Rakesh Kumar Bahunuthula
Dr. Rakesh Kumar Bahunuthula

Dermatology

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