Would you say this was a coldsore? Or impetigo?

[Nomorewineever]

I am consulting a HCP but appreciate this is very trivial in the current scheme of things. My GP is (rightly) triaging and the receptionist has said a nurse will call me tomorrow morning and likely give a prescription over the phone. But I just wondered if the opinion of what this probably is sounds the same as mine and therefore I’m asking for the right thing!!

It starts with a tingle, but is not on my lip it’s about .5 of an inch under my lip on my chin. It’s red and no lump, no whitehead and nothing in it so so speak. Then it blisters and leaks clear fluid. It doesn’t really go scabby but it does dry look and as if it’s going, then just as I think it’s gone I get another tingle day and the fluid is then back and the redness is back.

I get it at the same time of year - spring - usually when the sun first starts appearing and I’ve been out. And also if I’ve had stress. I didn’t have it last spring but I didn’t have the stress. The year before we were moving house and this year of course is kind of unusual. I’m very worried about an elderly relative and very stressed with work.

I’ve been treating it with Zovirax Cream but it’s doing nothing. I thought I’d beaten it but today woken up with it blistering again. This is now day 15 of this cycle.

I think I’d like to try a course of aciclovir tablets but I’m concerned I’m asking for the right thing as effectively self diagnosing!

Anyone think it’s NOT a cold sore? Could it be something else like impetigo?

My daughter had impetigo. It looked like normal skin with little pimples, no redness.
This looks like cold sore.

Thank you lunar the nurse has called me already and said I can try a 7 day course of aciclovir so fingers crossed!

Coldsore. I only get them in my nostrils the last 10 years or so, but I had impetigo really badly and took months to shake it during sixth form, and that was many many coldsore like spots all over my face and chest. Never heard of impetigo with just one patch as it spreads so easily?

The triggering in the spring with uv increasing screams classic hsv1 infection - cold sores. I get them in my nose too, main triggers are uv, stress, and any skin damage.

Thank you. I was just concerned as the normal immune response doesn’t seem to be working - lil cold sores (which I had as a teen so I know I have the herpes virus) healed in a week. This git (as per its predecessors) has been over 2 weeks and is now weeping again. And unlike lip cold sores it doesn’t go into a big scab which then falls off to reveal almost healed skin, it just stays red and then fades and fades then within hours can be up and blistering again. Like I almost get rid, then it’s back.

I have been very distracted though; and the sun is back, so it does all sound like it ties up. The Zovirax cream has done nothing though so I hope these tablets work

Looks like impetigo to me.
i've gotten both in the past.

It could be perioral dermatitis. I had terrible cold sores as a child and when I started getting tingly itchy patches around my mouth and on my chin I assumed they were cold sores but it turned out to be perioral dermatitis. It eventually cleared up with antibiotics.

Wouldn’t it be spread all over by now @crazycrazady ? It’s not moved and very isolated. I though impetigo ran rampant? It doesn’t crust either. But then with cream on it maybe it wouldn’t?

It looks like a cold sore to me. A course of aciclovir will definitely clear it up in a matter of days. Keep some in your medicine cabinet and next time you feel the tingle take one. You may be lucky and not have a breakout at all, but if you do it should only last a few days. Aciclovir has been a game changer for me.

Cold sore. Ask for oral aciclovir if the topical cream isn't having any affect.

Look up perioral dermatitis. It sounds exactly like what I had, and I too thought it was cold sores and used acyclovir to no effect whatsoever for ages!! Very possible the nurse didn't recognise it - seems not to be that widely known about even though it is relatively common especially in women.

That's Impetigo. 38 YRS of Paeds Nursing behind me .

Acyclovir will just inflame that even more

You need some Fusidic Acid cream on it

Well randomly I do have some fucidic acid cream! DS had a toenail which was sore down the side and the GP gave us the cream and I still have it, well within date. So using the fusidic acid alongside taking the acyclovir would cover all bases?

@emsyj37 I’ve looked that up. Possibly but did you get the weeping of clear fluid? And blistering? The nurse only went on how I described it as she (of course) doesn’t want me coming to see her for this right now. I described to her exactly as I did in my OP.

I can’t believe it would come back in exactly the same spot (or thereabout) if it was anything other than a coldsore. Would impetigo do that? I also thought impetigo was spread easily - and obviously for the past weeks I’ve been studiously not touching my face and washing my hands, so why would it appear now?

Confused and I don’t want to start the aciclovir if it’s not the right thing to do.

Sorry, I meant Acyclovir cream would inflame it. Oral Acyclovir will at best make no difference

That looks like either what was originally either a cold sore or patch of impetigo that has now got a staph infection

Slather Fusidic Acid on it tonight. If it is going to work it will look a lot better in the morning

Will do! I will report back

I get bad multiple cold sores. Just had a look at the NHS site and your pic looks very similar.

Have also used fucidin on a cold sore (told by HCP years ago, years ago pre aclivor) Good luck they are the most miserable things.

I've never had impetigo but the pics and symptoms are very similar by the looks of it, save that impetigo is contagious and perioral dermatitis isn't as far as I know.

Yes I did get the little tiny tiny itchy blisters that weep clear fluid but never crust over, and I did used to think quite often that it was about to clear up but then it would come back up again. It would start a new patch by a very distinctive tingly itchy that would come up red and bumpy quite quickly (within hours).
I would contact the GP and ask if there is a doctor at the practice who has a special interest in skin. I struggled to get mine cleared up and I really suffered for over a year until I worked out what it was and asked specifically for treatment for perioral dermatitis. It's really common in women my age (I'm 40) but seems quite hard to get diagnosed. You may have to wait til post lockdown to see someone but do ask for a doctor who has a particular interest in skin issues. Whatever you do dont put any type of hydrocortisone on it, it might initially seem to improve it but medium term it will make it much worse.

Thank you. I will let you know what happens.

I had an impetigenous cold sore once, that was a hoot. It was much bigger than that though, it covered most of one side of my top lip right up to my nostril. I had oral acyclovir and antibiotics to shift it

OP have you used any harsh new products on your face recently? I only ask because I believe perioral dermatitis can be triggered by damaging your skin's moisture barrier. I think I I triggered mine using too many acids. If you look up Nadine Baggott perioral dermatitis on youtube she has a fairly detailed account on there of her experience with it and how she thinks it was triggered.
No wisdom on impetigo sorry but it was one of the things that came up when I was googling to try to work out what my skin issue was. I decided that it couldn't be that for me as it's highly contagious and mine hadn't spread to any family members etc. NHS advice is that you stay off work with impetigo it's that catching but nobody caught anything from me that I'm aware of despite having the blisters in some form on my face for the majority of 12/18 months (and I am a terrible picker so I was touching them constantly and for a long time was smearing zovirax on them multiple times a day too).

If it's a cold sore, the oral aciclovir will clear it very quickly.
If it's impetigo or a staph infection the fucidin will clear it quickly.
Start using both to cover all bases.

No nothing new on my skin. I’ve always used Clinique clarifying lotion but the gentlest one, and a la Roche posay moisturiser. I stick to light products as very very occasionally I get one big cystic spot but that’s hormonal and they throb and have a middle and clear up within a week. So I tend not to use heavy moisturisers in case it triggers a spot. But even then I’d only get one of those once or twice a year. As I say there is nothing ‘in’ this it’s a patch. I’m in my mid 40s.

And the same - no spread further on my face and no spread to DC or DH. But what I do know is I had it before, at least once, at the same time of year. Before I used Zovirax cream and something like freederm spot gel as I didn’t know what it was. I’m fairly sure last time it ended up lingering for about 8 weeks and then whatever I was doing either worked or it healed itself. So when I felt this tingling this time (like a patch of strange sensation) I was so pissed off!!! Sure enough the next day it was there.

I will @ofwarren - be nice to know what it actually is though so if the bastarding thing keeps reappearing I know what to hit it with!! Nurse wasn’t overly keen on giving the tablets she said they prefer people to use the Zovirax cream but as I was persistent that I’d tried it she said we’ll give it a go.