Red, irritated skin on lip under nostrils

[wc708]

I have had red, irritated skin on my upper lip for the past six months. It all started when I got sick and was blowing my nose constantly, which irritated the area below my nose. It is not anything major but it looks unsightly and I want to get it cleared up. Now it gets irritated and flares a little after I shave my face (I usually shave every day for work). If I let my beard grow out for a few days it will usually diminish a little then reappear when I shave again.

I went to my dermatologist and she prescribed me Nutraderm to put on in the morning along with Ellidel (sp?) before bedtime. I did this dilligently for a couple of months but with no results. I saw my dermatologist again two months later and told her nothing was working. She told me to keep applying the Nutraderm and that it would eventually get better. After another month of the Nutraderm and Ellidel, nothing happened at all. My mother suggested using hydrocortizone which did nothing to help the redness. I remember my dermatologist mentioned that Retin-A was a possibility but resisted prescribing it because she would only use steroids as a last resort.

Feeling frustrated, I went through phases of using over-the-counter products like small amounts of hydrogen peroxide, rubbing alcohol or Neosporin, hoping that would help clear the area up. Nothing has worked. Lately I bought a over-the-counter product called Tend Skin which helped a little at first but now my skin gets red and burns when I use it. I've tried getting different types of shaving creams, changed razors, bought an electric razor and nothing has worked. I don't know what to do; it seems I've tried everything and nothing is working. I have dry, sensitive skin but it should not be this bad for this long. I do not have oily skin or rosacea, though I am fair skinned so this blemish shows up worse on my skin than most other people. Please help!!!

[Alan Rockoff, MD]

I suggest that you stay away from cortisone creams, even mild over-the-counter ones, since they might perpetuate the redness.  You certainly shouldn't use hydrogen peroxide or rubbing alcohol--no harm done, but those will certainly irritate you and delay healing.  I suggest you speak with your doctor about using an oral antibiotic like doxycycline for a few weeks, along with a non-steroid cream like Protopic (since Elidel didn't help.)  Most of all, you're going to need to be patient--even with treatment, it could take several more months for the redness to go away.  On the other hand, I don't recall ever seeing such a case where the color didn't go away eventually, if treated patiently and gently.

Best.

Dr. Rockoff

[wc708]

I also want to say that the red spots are about the size of a dime but not uniform. I originally suspected that it could be ingrown hairs but now I think the skin in these areas is the problem. thanks

[wc708]

Thanks for the reply,
One last question: Do you think a steroid cream (such as Retin-A) would help me? I probably sound impatient but like you said, I don't know why this hasn't gone away by now. I do live in a warm climate. I don't work or spend a lot of time in the sun but I find that my upper lip gets sweaty when it's hot out. I kind of feel that perpetuates my situation as anything topical I put on my face (such as a cream) would eventually get sweated out or rubbed off. Thanks again for your help.