Sunburned lip or first outbreak of cold sore virus?

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I have a rash over both of my lips, not outside them. The rash is small blisters. There are no "sores" to speak of - the entire lip skin area, top and bottom, is covered, although the blisters are more localized in the area where the lips meet when my mouth is closed. My lips are very painful and swollen today. I have had this condition for the last three days although it is much worse today. There is a little bit of pus when the blisters break. I have never had a cold sore and am quite sure I have not recently been exposed to the cold sore Herpes virus. However, I do have genital herpes which is largely under control (1 outbreak per year, no medication). The lymph glands in my neck, next to my throat, are swollen and sore. I do feel a little ill but I do not have a fever and do not think I have any other infection. I have been exposed to sun in the last three days, and I likely did not wear enough sun block. I don't think I have worn any new product (cream, lip gloss etc.) to which I might have developed a reaction. I know the sun can trigger a herpes outbreak if one already has the virus. I tried (probably wrongly) Polysporin, then Vaseline, and saline solution but these options do not help. Although I feel quite sure I have not been in contact with anyone with the oral herpes virus, can the first outbreak of the Herpes oral virus cover the complete lip, top and bottom, without going outside the lip line? Can the genital herpes virus turn into the oral version or are they completely separate? Is a sunburned lip likely to have small blisters? Can one get "heat rash" or "prickly heat" rash on the lips? What should I do for treatment?

[Alan Rockoff, MD]

Your genital herpes is irrelevant.  Also, none of the creams you're using are a problem, but also they aren't likely to do much.

I can't tell from your description whether you have eczema of the lip, or possibly a herpes (non-genital) infection triggered by the sun.  People who have latent (non-evident) cold sores sometimes flare up like this after a sunburn.  If so, you would benefit from oral anti-viral therapy.  If it's not that, you would benefit from a topical steroid cream.

Either way, I advise you to see a doctor ASAP, perhaps at a walk-in clinic.  You'll feel better a lot faster if you get seen and treated.

Best.

Dr. Rockoff

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Thanks Doctor. I have some 5% hydrocortisone cream which I can put on now, but would that hurt the condition if it does turn out to be the cold sore virus? Also, can it be the cold sore virus if the sore is entirely over the whole lip area as opposed to circumscribed sore(s). I am a nursing mother so I am reluctant to take the anti-viral if I don't have to. I do have eczema (on my ears exclusive to date) and wonder if you can tell me more about li eczema (no listings when I googled that condition). The bumps are much better today but the swelling is worse and so are the swollen painful throat lymph glands (more on the left than the right). I have taken an antihistamine and some ibuprofen which seem to be helping the symptoms, but not the apperance. I have a doctor's appt for tomorrow, but I did see a doctor yesterday who couldn't diagnose me.

[Alan Rockoff, MD]

Lip eczema is like eczema anywhere else, only on the lip--dry, scaly, itchy, etc.  I suggest you use only non-medicated moisturizers until you see the dermatologist.

Dr. Rockoff