Why do my lips get tender and swollen every two months?

Question

Hi doctor,

I would like to give an insight into my problem, with started ending of last year. I noticed that I have some dry skin on my lower lip and a very small scab just underneath it. I ignored the same and thought it is due to winter. Five months back, I had a tender lower lip, which eventually dried off and the old skin peeled off. It left a scab on my lower lip border.

I had a fever due to the weather change, and as soon as my fever went off, I had a tender, fluid-filled lower lip. It became so tender due to the fluid beneath it and as usual, the scab formed underneath it at the border. This time, I went to a dermatologist and asked if it is herpes because I started checking my symptoms online. The doctor told me that it is a cold sore, and I was advised to have Acyclovir for seven days. The doctor did not examine it and was just listening to my symptoms. I would also like to tell you that for the past five months, my chin area stays red and a bit flaky, and sometimes I feel like there is some wound. The doctor prescribed me antibiotics and fungal creams, but nothing happened.

Four days back, I had a stomach infection and had a fever, which went away after two days. But my lower lip border area started itching and then my lower lip was swollen. Later, only the lower lip and its border got soggy and tender this time. And no blisters were formed. This time I visited a senior doctor, and I told him the entire scenario, He asked me to get a few tests done, like an IgM test for herpes, ELISA test, IgG test for herpes, urine test, TLC, etc., when I told him that it is happening for the fourth time.

The thing is that all the herpes tests came negative. The urine test came back normal, and even TLC and DLC are balanced and normal. All reports were concluded to be normal. He asked me to have Valacyclovir for two days. I would also like to tell you that whenever this thing is going to happen, I get ulcers in my mouth a week or 10 days before this happens. I have always taken pictures of my lip from the first instance to the latest, which I am attaching. What is this thing which keeps reoccurring on my lip every two months? What is the redness (like whiteheads) on my chin, which sometimes dries up like flakes and again returns? Do I have herpes or something else? And this process usually lasts not more than seven days.

Answer 1

Hi,

I am glad you chose icliniq for your medical-related queries.

I understand your concern and will try to help you with it.

Your clinical image (attachment removed to protect patient identity) is more for folliculitis over the chin area with cheilitis over the lips. From your image, the lesions do not appear herpetic at present. The investigations also support the same. Also, the repeated use of Acyclovir and Valacyclovir would have helped in clearing the herpetic infection. Your skin problem is mainly caused by staphylococcal infection of the body hair, especially over the face. Kindly avoid reverse shaving or reverse trimming. Forego any habit of nose-picking with fingers, as it would lead to further exacerbation of complaints. I suggest you try taking the following: Consult your specialist doctor, discuss with him or her, and start taking the medicines after their consent.

Capsule Doxy (Doxycycline) 100 mg, twice daily after food, for 10 days.
Tablet Pantop (Pantoprazole) 40 mg, once daily, before breakfast, for 10 days.
Tablet Levocetirizine 5 mg, once daily after dinner, for 10 days.
T Bact (Mupirocin) cream, twice daily over the affected area, for 10 days.

Thank you for consulting me.

You can always reach me at icliniq.com.

Answer 2

Hi,

Welcome back to icliniq.com.

I read and understand your concern.

Stress, reverse shaving, trimming, using the same razor multiple times, nose picking, eating foods with high glucose levels, etc., are well-known triggers for staphylococcal infection. You need not worry, just try to take the medicines that I suggested, after consulting your doctor. In case these episodes continue, I will suggest prophylactic therapy for staphylococcus eradication.

Looking forward to your response in order to help you.

Thank you.