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COLD SORE on my nose after shaving. HSV?

Resolved Question:

Hi,

I've been fighting a cold since last Saturday. Been feeling rundown and tired, coughing, and have a lot of mucus buildup - constantly blowing nose and hacking up phlegm. As result of constantly blowing my nose, the area directly below the nostrils were very dry and red by Tuesday. On Wednesday morning, as I was shaving, I felt a small sharp sensation around that same area under one of the nostrils. I thought it was a razor nick or burn, but by the end of the day it was really red and enflamed about the size of a dime. I put some aloe vera on it every couple of hours to try to relieve it. By Thursday morning, the area started showing a group of small blisters. I continued to put aloe vera on it and researched it online. Concerned that it could be a large cold sore, I put on some Lysine + (zinc oxide based) topical cream and ingested 2000mg L-Lysine tablets staring Thursday night. I continued the Lysine + and increased the L-Lysine tablets to 6000mg on Friday. Today, it's beginning to scab.

So my question is, "is this a cold sore (HSV)?" There is no evidence of any blisters on or around my lips, only my mustache area just under my left nostril where I shaved. I used to get cold sores around my lips as a kid, but haven't had any since - over 20 years. General info - 35 y.o. male, 6'-2", 185 lbs., in good health, workout regularly, no meds, and no known allergies except cats.


Category: Dermatologist

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Category: Cosmetic and Plastic Surgeon
Dr. Kruti Jobanputra Banodkar is online now

Expert:  Dr. Kruti Jobanputra Banodkar replied 4 Days.

Hello,

Thank you for choosing DoctorSpring.

The pattern of evolution is suggestive of HSV - Herpes Labials commonly called Cold sore. But cold sores does not scan this fast ! Can you send me a picture of the lesion ? You can take a couple of photos and attach as a followup query.

Thank you


Patient replied :

Hi Dr. Banodkar,

Thank you for getting back to me. Please see the attached photos.


Expert:  Dr. Kruti Jobanputra Banodkar replied 3 Days.

Hello

Thanks for posting your query.

I can understand your concern.

From the history and the pictures, this does seem to be a cold sore, that is herpes caused by hsv.

The treatment for it would be intake of valacyclovir, which would require a prescription from your doctor.

Usually the cold sore resolves within three to four days on its own, however intake of valacyclovir helps in quicker healing and prevents pain.

Whenever there is a slight lowering of immunity, cold sore can surface. That happened due to your cold.

Application of neosporin cream on the lesions twice a day will be helpful.

Please let me know if you have any queries.

Take care


Patient replied :

Hi Dr. Banodkar,
I guess I'm really confused by the location of the lesion. Is this common? Also, will I get future breakouts in the same area? Thank you.


Expert:  Dr. Kruti Jobanputra Banodkar replied 2 Days.

Hello

Thanks for your reply.

It is a common location for a cold sore. It can happen on any area of the skin on the body. There can be future breakouts too of the cold sore in the same area. Hope I have answered your queries.

Please let me know if you have any other concerns.

Take care


Patient replied :

One thing to note, aside from when I initially shaved over the area, I never felt any tingling or pain in the area. Is that common? Everything I read says before the outbreak occurs, there's a tingling and then once the outbreak occurs, there's pain. I didn't experience either. I do plan on getting tested for the virus by my primary care physician this week to confirm.

Also, is valacyclovir recommended for treatment once the outbreak occurs or before as a preventative measure?

Lastly, what do you recommend to avoid future breakouts (prescriptions or otherwise)? I've read that foods with high Arginine content should be avoided. Any other tips? I really don't want to experience another one of these..... Thanks.


Expert:  Dr. Kruti Jobanputra Banodkar replied 1 Day.

Hello

Thanks for your reply. I can understand how you feel about this.

However, sometimes patients may not feel tingling or pain before the lesions show up, it may even start a while later after the lesions show up. At times, patients don't experience the pain n tingling during the whole period of the presence of lesions.

Valacyclovir is a treatment measure and can also be used for preventing future attacks. It's a prescription medicine.

There are no food related tips that would really help in prevention.

Take care


Dr. Kruti Jobanputra Banodkar
Category: Cosmetic and Plastic Surgeon
Experience: 
Diploma in Dermatology - Royal College Of Physicians & Surgeons Of Glasgow, UK , 2010
Residency - DNB, Dermatology -  K.J Somaiya Hospital, Mumbai, 2009
Medical School & Internship - MBBS - Dr. D . Y . Patil Medical College, Mumbai, 2004
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