Skin Bumps on Chin/Lip – w/pics

Hello Everyone,

I posted awhile back on this topic (copied below for more background information), but the information I received did not do the trick. This probably occurred because I had to describe everything, but now I have pictures to aid the diagnosis.

http://i778.photobucket.com/albums/yy61/Joe_from_Washington/0103110101.jpg

http://i778.photobucket.com/albums/yy61/Joe_from_Washington/0103110100.jpg


For years now I have had what seems to be hundreds of flesh colored bumps on my chin (sometimes they have a red tint to them). They are nearly invisible, the only way I can see them is if I look in a mirror up close and stretch my skin. There is a similar phenomenon on my upper lip (however these are more noticeable, as the picture demonstrates). The problem is that I shave all of my facial hair, but because of the bumps, I never get a clean shaven look. Physically, the skin in these areas feels like fine sandpaper (even after a shave). Visually, it always looks like I have a mustache shadow because the razor can only get the hair above the bump. Even after a shave, if you look closely, you can see a very small piece of hair in each bump. It’s as if the hair penetrated the skin, entered the bump, and then needs to leave the bump to be out. Sometimes this causes the hairs on my chin and upper lip to become ingrown or develop a small puss filled like pimple. In summary, my chin has flesh/white/redish colored bumps that lead to some nasty breakouts/infections from hairs failing to properly penetrate the skin (this mainly occurs on the area of the chin where the vertical part of a goatee would be). The upper lip area appears darker because my black mustache hair grows horizontal to the skin, you can even see the hairs under the skin, hence the permanent shadow. This has nothing to do with shaving techniques because I have gone months without shaving and the condition persists.

I have tried all sorts of exfoliating techniques and topical treatments (AHA, salicylic acid, benzoyl peroxide, lactic acids, etc…) and nothing ever gets rid of the bumps. What do you think is causing these bumps? What are these bumps? How do I get rid of them?

Thanks for your help,

Joe

Here are some possible issues related to this problem:

My upper lip tends to sweat
The hair on my upper lip and chin is very coarse/inflexible
I Have Keratosis Pilaris on my upper arms & legs and I have mild Keratosis Pilaris Rubra Faceii
More than likely I have Trichostasis Spinulosa on my nose

[Bhupinder Kaur, MD]

Hello,
As I had replied earlier, since you are having keratosis pilaris faceii, so your symptoms may be due to that. The other possibilities are of clogged pores, milia or whiteheads. The best way is to avoid treating your skin with excessively harsh chemicals and to limit sun exposure. Also use good quality cosmetics and exfoliate your skin regularly. If still the symptoms persist then chemical peeling or laser removal can be done. Also then cysts have to be ruled out.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[Milkman95th]

Hi all,

Since I last posted about this topic, I have seen an experienced dermatologist on three separate occasions. His response to what I have, “no idea.” He wants me to come with him to a dermatology conference in the fall so that hundred of derms can look me over. As much as I would love to be put on display and wait months to possibly get a correct diagnosis with a treatment, I was hoping someone could shed some new light on what I have. The pictures I posted are not the greatest quality, but if need be I could probably get the high quality copies my dermatologist took.

He had me try Promiseb for a while, that did nothing. For the last few months I have been on a daily Desonide .05% cream (morning) and Tretinoin .025% (night). Which has also had no effect, other then making my skin softer, with the bumps still ever present. He believes that it is all related to my Keratosis Pilaris, including the weird outbreaks on the back of my neck (which he has me treating with moderate success, with Clindamycin). Any ideas on what I have and more importantly how to get rid of it?

Thanks for your help,

Joe

P.S. The Tretinoin has greatly cleared up my Trichostasis Spinulosa.

[maatson]

It is best to get a dematoscopy done here to see what these lesions are. This procedure would help to view the hair as it comes out of the follicle.While I am not sure, this could well represent a form of psedofolliculitis barbae.Procedure is noninvasive.

11.Chuh A, Zawar V. Epiluminescence dermatoscopy enhanced patient compliance and achieved treatment success in pseudofolliculitis barbae. Australas J Dermatol. Feb 2006;47(1):60-2. [Medline].

[Milkman95th]

My derm did that and he had nothing to say other than he did not know. If anybody can shed some light on what I have I would be forever grateful.

[maatson]

Ofcourse in the absence of a plausible clinical diagnosis a biopsy may be advised.