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Redness Under Nose
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Redness Under Nose

About six weeks ago I seemed to develop a cold sore under my right nostril.  I am 50 years old and I never had one before in my life.  I went to my PCP and he thought it was a cold sore, too, although he wasn't positive.  He prescribed Acyclovir tablets and ointment.  Blood tests were taken and I seemed to be fine.  The Acyclovir never really seemed to help though - I think it just got better on its own.  It seemed like a cold sore because it went through all the stages that I've read about.  But it never completely went away and I had a little bit of a recurrence also.  Now I have this good-sized red spot in its place.  Some days I wake up and I can peel tiny bits of skin off of it.  Sometimes it is shiny and sometimes it is dull and dry.  And the rash seems to be spreading just a little bit to other areas above my lips.  Sometimes you can't see it that much and sometimes it is terrible.  It looks like I have been rubbing the daylights out of myself or I used a chemical hair remover and left it on too long.  I never touch it and I always keep it very clean.  People are starting to comment on it, too, and that hurts me because I have always had very nice skin.  What do you think it sounds like I have?  And is there something I can buy or use to make it go away?  Thank you.      

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It certainly doesn't sound like a cold sore.  A cold sore (herpes, fever blister) produces a cluster of blisters which scab, last 7-10 days, and go away.  They may recur later in more or less the same place and do the same thing.

What they don't do is 1) "never completely [go] away", or 2) get "a little bit of a recurrence," or 3) "spread just a little bit to other areas above my lips."

I think you may have just had some mild irritation, which you are concerned about and therefore keep rubbing at.  Although you say, "I never touch it," you also say, "Some days I wake up and I can peel tiny bits of skin off."

Please stop peeling tiny bits of skin off.  Instead, apply over-the-counter 1% hydrocortisone twice a day and leave the area alone.

If that doesn't make the redness disappear in 3 weeks, I suggest you see another doctor, who is perhaps more familiar with herpes and cold sores.  I say that because your PCP wasn't sure, as you say, and ordered blood tests, which are not very relevant.  Finding herpes antibodies in the blood doesn't mean anything more than that you were exposed sometime in your life to the virus.  Finding no antibodies means that it couldn't be herpes.  So if "Blood tests were taken and I seemed to be fine," that should have ruled the condition out, not in.

Best.

Dr. Rockoff
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