Breakouts around vermillion border - perioral dermatitis? Coldsores?

[nosroma]

I'm a 27 yo female who has perioral dermatitis, eczema, cystic acne and papular acne. A month ago, a small, single red dot appeared on my upper lip. I freaked out. I thought it was a cold sore (no history of them-looked like papule). I began picking at it constantly turning it into a big angry red dot (but still no blister or anything). I used abreva and even started taking lysine and stopped picking-no change. After two weeks, it turned into small whitehead-so I popped it. A couple weeks later it's now smaller red bump that's slowly flattening (looks like it will scar). Over past couple weeks-I've gotten 3 other small, single spots on the vermillion border of my lip, not near eachother. They were tiny (one pore large) whiteheads. I gently popped them-they were swollen for a day or so, but after a few days faded to a pink dot. I'm distressed. Afraid to go to a doctor because they'll tell me it's herpes or something and my anxiety is growing worse by the day. My questions are: 1. What are these tiny whiteheads on my lip line? POD has always spared lip line even though this looks similar. 2. The original red dot: If it's lasted this long (almost one month) and never blistered - it's likely not a cold sore, right? 3. The sebaceous glands around my lip are large. Always been like this. Could this be an infection of the sebaceous glands of some sort? 4. Am I completely over-reacting, need to calm down and hope this condition will resolve on it's own?

[Alan Rockoff, MD]

The answer to question # 4 is absolutely yes.  I'm not even sure why getting a cold sore would freak you out to start with, but what you have sounds nothing like herpes.  It sounds like a pimple that you've been attacking.  Please leave it alone and let it go away.  If there's still anything to see on 6 weeks, let a dermatologist have a look then.

Thanks.

Dr. Rockoff

[nosroma]

Thanks Dr. Rockoff - I appreciate your honest reply.

My main question though was what are these little whiteheads that keep popping up on my vermillion border? They go away in a couple days and are only about one pore large. I get one every 3-4 days, never near the previous one. I found a couple people online who also had this strange problem and one suggested it might be the heat?

[thetruth]

I think I'm having this happen to me.

I didn't notice it until this summer where it's hot.  And I work at a restaurant where I'm always hot, in the kitchen, etc,

Do I need to go to the doctor or just drink more water, use chapstick, etc?

[nosroma]

Additional information: I don't use lip stick/lip gloss (just plain unflavored chapstick). And I haven't changed my face wash, moisturizer, toothpaste - etc. Medications I'm on: Klaron (sodium sulfuctimide 10%) I use that to spot treat at night, doxycycline (only for the next 2 weeks to help clear up my skin for a wedding) and Yaz birth control (on my 4th month - previously on a generic for 12 years). I had an allergic reaction to Blistex of all things a couple weeks ago (I'm allergic to everything, latex, contact lenses, seasonal allergies, mold, etc.) - and my lips are actually still itchy from it even though the bumps are gone - could this be a delayed allergic response?

[nosroma]

Sorry to be a pest - just trying to be as informative as possible (plus I'm an anxious wreck). I wanted to note that none of these little spots has ever hurt at all - no pain, burning, itching, tingling - I don't feel them at all - I wouldn't even know they are there until I look in the mirror. (Of course, they are a little tender for a couple hours after I pop them - but not before or after).