Small bumps around the lips are common and can arise from various conditions. Understanding their causes and characteristics can provide clarity. This article offers an overview of why these bumps occur.
Common Conditions Causing Bumps
Several common conditions can lead to the appearance of small bumps around the lips, each with distinct underlying mechanisms.
Perioral dermatitis is an inflammatory rash characterized by red or skin-colored bumps, often appearing around the mouth and nose. It is frequently associated with topical steroid creams, certain cosmetics, or fluoridated toothpaste, suggesting an irritant or allergic component.
Cold sores, caused by the herpes simplex virus (HSV), are highly contagious fluid-filled blisters. The virus typically lies dormant and can reactivate, leading to painful outbreaks around the lips.
Acne around the mouth manifests as whiteheads, blackheads, or inflamed papules and pustules. This occurs when hair follicles become clogged with excess oil and dead skin cells, creating an environment where bacteria can thrive. Hormonal fluctuations, genetics, and lifestyle factors can contribute.
Milia are tiny, pearly-white cysts formed when keratin becomes trapped just beneath the skin’s surface. These benign bumps can occur spontaneously or secondary to skin damage from injury, sun exposure, or long-term steroid cream use.
Fordyce spots are small, harmless, and painless bumps that are enlarged sebaceous (oil) glands visible on hairless areas like the lips. They are a normal anatomical variation, often becoming more noticeable after puberty due to hormonal changes.
Allergic contact dermatitis, specifically allergic contact cheilitis when affecting the lips, is an inflammatory reaction when skin contacts an allergen or irritant. Common culprits include ingredients in lip balms, lipsticks, toothpaste, or certain foods.
Folliculitis involves the inflammation of hair follicles, manifesting as small, pimple-like bumps. This condition is often caused by bacterial or fungal infections. Factors such as shaving or friction can damage hair follicles, making them susceptible to infection.
How to Identify Different Bumps
Recognizing the specific characteristics of bumps around the lips is helpful for understanding their nature.
Perioral dermatitis typically presents as a red rash with small, inflamed bumps that may be scaly or flaky, often appearing around the mouth and nose while sparing a narrow border directly adjacent to the lips. Individuals might also experience itching or a burning sensation. These bumps can sometimes contain pus, resembling acne, but perioral dermatitis does not involve comedones.
Cold sores usually begin with a tingling, itching, or burning sensation around the lips before visible bumps appear. Within a day or two, clusters of small, fluid-filled blisters emerge, often on the lip border or surrounding skin. These blisters eventually break open, ooze, and then crust over, forming a scab that heals over one to two weeks.
Acne around the mouth can manifest in various forms, including non-inflamed whiteheads and blackheads, or inflamed papules (small, tender red bumps) and pustules (pus-filled pimples). More severe forms can include deeper, painful nodules and cysts.
Milia are tiny, pearly-white cysts that form when keratin becomes trapped under the skin, feeling somewhat firm to the touch. Fordyce spots, in contrast, are enlarged sebaceous glands that appear as painless, small (1-3 millimeters), pale white, yellowish, or skin-colored spots, often on the lip border or inside the cheeks. They are more noticeable when the skin is stretched.
Allergic contact dermatitis on the lips causes inflammation, redness, and possibly dry, scaly, or cracking skin. The affected area may feel itchy or burn. This reaction can be localized to where an allergen contacted the skin. On darker skin tones, the redness might appear as dark brown, purple, or reddish discoloration.
Folliculitis appears as small, red, or pus-filled bumps that resemble pimples, centered around hair follicles. These bumps can be itchy, tender, or painful. While they can occur anywhere hair grows, folliculitis around the mouth might be seen in areas like the upper lip or chin.
Approaches to Managing Bumps
Managing bumps around the lips often involves a combination of gentle self-care practices and targeted over-the-counter (OTC) treatments, depending on the underlying cause. A fundamental approach for any bump is to maintain good hygiene, which includes gently cleansing the affected area with mild soap and water. Avoiding irritation, such as picking or squeezing the bumps, is also beneficial as this can worsen inflammation or introduce infection.
For perioral dermatitis, discontinuing the use of topical steroid creams, certain cosmetics, and even fluoridated toothpaste is often the first step, as these can be triggers. Gentle, fragrance-free skin care products are recommended, and some OTC options like sulfur or azelaic acid preparations may help. Natural remedies such as aloe vera, coconut oil, or shea butter can soothe the skin and reduce dryness.
Cold sores can be managed with OTC antiviral ointments containing docosanol, which can shorten healing time if applied at the first sign of tingling. Other OTC products with numbing agents like phenol and menthol can alleviate pain. Applying ice or a cold compress can also help reduce swelling and discomfort.
Acne around the mouth can often be treated with OTC products containing ingredients like benzoyl peroxide or salicylic acid, which help to clear pores and reduce bacteria. Gentle cleansing, avoiding harsh scrubbing, and using non-comedogenic (non-pore-clogging) products are important. Warm compresses can also help to bring whiteheads to a head.
Milia often resolve on their own, but gentle exfoliation with products containing salicylic or glycolic acid can aid in shedding trapped skin cells. Regular cleansing and steaming the face can also be helpful. It is important to avoid picking or trying to extract milia, as this can lead to scarring or infection.
Fordyce spots are benign and typically do not require treatment, but if their appearance is a cosmetic concern, some individuals may explore options like laser therapy or micro-punch surgery. For self-care, maintaining good hygiene, staying hydrated, and avoiding irritants like certain lip balms or toothpastes may help.
For allergic contact dermatitis, the primary management strategy is to identify and avoid the allergen or irritant. Once the trigger is removed, the rash usually resolves. OTC anti-itch creams, emollients, or oral antihistamines can help alleviate symptoms like itching and inflammation.
Folliculitis can often be treated at home by cleaning the affected area with antibacterial soap and applying warm compresses. Avoiding shaving or tight clothing in the affected area can also promote healing.
When to Seek Professional Help
While many bumps around the lips are harmless and may resolve with home care, certain signs indicate the need for professional medical evaluation. It is advisable to consult a doctor or dermatologist if a bump is very painful, does not heal within a couple of weeks, or bleeds. Any bump that worsens over time, seems to be enlarging, or is accompanied by jaw swelling or tongue numbness also warrants prompt medical attention.
Specifically for cold sores, professional help should be sought if it is a first outbreak, the sore has not started to heal after about 10 days, or if the sores are very large or painful. Individuals with a weakened immune system should also consult a healthcare provider if they develop a cold sore.
For perioral dermatitis, a doctor’s visit is recommended if the rash persists despite discontinuing topical steroids and irritants, or if it causes significant discomfort like burning or itching. The condition can sometimes require lengthy treatments, and a dermatologist can provide appropriate guidance.
Acne around the mouth that does not respond to over-the-counter treatments after several weeks, or if it presents as deep, painful nodules or cysts, should be evaluated by a dermatologist. These more severe forms of acne may require prescription medications to prevent scarring.
Milia typically do not require treatment, especially in newborns where they usually disappear on their own. However, if milia persist for several months in adults, are widespread, or cause cosmetic concern, a dermatologist can offer safe removal options. It is important not to attempt to extract milia at home.
Fordyce spots are benign, but if there are rapid changes in their size or color, or if they become painful, itchy, or show signs of infection like discharge, a doctor should be consulted. This is especially important for spots in the genital area to rule out other conditions.
For allergic contact dermatitis, medical attention is needed if the rash is severe, covers a large area, involves the eyes or mouth, or does not improve with home treatment. Signs of infection, such as pus, increased redness, or fever, also necessitate a doctor’s visit.
Folliculitis that spreads, is accompanied by fever, chills, or fatigue, or does not resolve after a week or two of self-care, should also be assessed by a healthcare professional.
Preventing Bumps Around the Lips
Preventing bumps around the lips often involves identifying and minimizing exposure to specific triggers, alongside maintaining consistent skin care practices.
For perioral dermatitis, a key preventive measure is to avoid strong topical steroid creams, as these are a common trigger. Using mild, fragrance-free cleansers and moisturizers can also help maintain a healthy skin barrier and reduce the likelihood of recurrence. It is also beneficial to avoid thick makeup or sunblock around the mouth area.
To reduce the frequency of cold sore outbreaks, individuals can identify and avoid personal triggers such as excessive sun exposure, stress, or a weakened immune system. Using lip balm with SPF 30 or higher, particularly when outdoors, and practicing stress management techniques are helpful strategies. Avoiding close contact with others who have active cold sores and not sharing personal items like lip balms or utensils can prevent transmission.
Preventing acne around the mouth focuses on good hygiene and product choices. Regularly cleansing the skin with a gentle cleanser, especially after sweating, helps remove oil and bacteria. Choosing non-comedogenic makeup and skincare products, and avoiding frequent touching of the face, can also minimize clogged pores and breakouts. Regularly changing pillowcases and cleaning cell phones can reduce bacterial transfer.
While milia cannot always be prevented, especially in infants, adults can minimize their formation by gently exfoliating the skin to prevent dead skin cell buildup. Using lighter moisturizers and protecting the skin from excessive sun exposure with sunscreen can also be beneficial. Avoiding harsh skincare products or excessive scrubbing helps maintain the skin’s natural barrier.
Fordyce spots are a natural variation and typically cannot be prevented. However, avoiding very oily or heavy skincare products and maintaining good oral hygiene may help keep them from becoming more prominent. It is important to avoid picking or squeezing them, as this will not remove them and can lead to irritation or infection.
For allergic contact dermatitis, strict avoidance of the identified allergen or irritant is the most effective prevention. Patch testing can help pinpoint the specific substance. Using hypoallergenic and fragrance-free products for lip care and oral hygiene can significantly reduce the risk of future reactions.
Preventing folliculitis involves careful hygiene and minimizing friction or damage to hair follicles. Shaving in the direction of hair growth with a clean, sharp razor can help, as can avoiding tight clothing that traps heat and sweat. Regularly cleaning the skin with antibacterial soap and showering after activities that cause heavy sweating can also reduce the risk of inflamed hair follicles.