Acne or Herpes?

[3M_Man]

Last month I had a pimple or blister under my nose, close to my lip. It started off as a welt, the next morning it looked like a pimple, then by the end of the day it was oozing or weeping fluid, which dried and formed a crust. If the crust was broken, it would continue to weep fluid until it dried to form a honeylike crust. It doesn’t hurt even if I poke at it. I think I have had this before, whatever it was lasted for two weeks, and didn’t go away until I applied hydrogen peroxide to it, which dried it up and then either by coincidence or result, a pimple formed which I popped. I didn’t see anything for a few months, then the same thing occurred in that general area (right where the lip meets the brow). I had been talking to my physician about herpes, because I had one night stand that had me paranoid, and I was requesting a blood test when it had happened again. I had the blister swabbed, and got a blood test. My physician didn’t think it was herpes, but did prescribe clindamycin phosphate. I applied the medication and it cleared up the blister within a couple of days, and the swab came back negative and so did the blood test. I had another blood test 3 months later to be sure, which also came back negative. A few weeks later I had an episode where I got a similar blister, I applied the medication and it went away a couple of days later only to return in the same general area a few days later. The medicine was applied again, and it was gone a few days later, then it came back again and gone a few days later. It has been two weeks and hasn’t come back.  However, I made an appointment with a dermatologist and described what happened and he seems to think its herpes based on my description, despite the negative tests.

I have researched herpes to no end, which is how I found you, and given what I have found on various websites, it doesn’t sound like herpes to me. There is no pain involved, and it is completely healed after 4 days. I have Googled the description of what is going on and Impetigo, Eczema, or Herpes always come up.  I don’t think Impetigo goes away on it’s own that quickly, and Eczema is such a broad term, and it just doesn’t look like herpes to me. It is a single blister with no pain and is completely gone after 4 days, and I think it responds well to the Clindamycin.

Also I do have skin allergies, which causes itchy rashes all over my body from time to time. Zyrtec was prescribed to me a while back and it clears up the itching, but I only take it as needed. Could this have anything to do with it? I think I have had the same thing on my face before, but I am not sure. I get bouts of acne around my lips, but usually they are obviously pimples. These look like pimples but ooze oil for a day before they go away, kind of like a popped pimple that weeps serum, but weeping for all day. Acne shouldn’t do that, right?

What do you think?

And thank you in advance.

-D-

[Alan Rockoff, MD]

I don't think it's herpes either.  But I can't be sure from your description.  So here's what I'd do: arrange to see the dermatologist within 24 hours of an outbreak.  That way cultures for viruses and bacteria can be done in a way which will give reliable information.  That's the only way you're going to be sure about this.

And by the way, even if it is herpes, there's no reason for you to sound so concerned.  Herpes of the lip is a cold sore, which affects millions and is no more than a mild annoyance, which medication can limit or even prevent.

Meantime, please take care to leave the lesion alone--no picking or squeezing, please.

Best.

Dr. Rockoff

[3M_Man]

Thank you for your response. I do have an arrangement with a dermatologist to get in to see him as soon as I notice something. And I think I am going to get another blood test in a couple of months to see. Maybe 3 months wasn't enough time to develop sufficient antibodies. I guess it's the not knowing one way or another that has me so concerned about this.

I don't know what to do in the mean time. Should I just tell girls that I date that I think I get cold sores, and hope for the best or just forget about it until I see something, which could be next month or next year. Guess I'll deal with that when it comes up.

Thanks again,

-D-