How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask dermdoc19 Your Own Question

dermdoc19
dermdoc19, Dermatologist
Category: Dermatology
Satisfied Customers: 4124
Experience:  30 years practice in general and cosmetic dermatology
50983945
Type Your Dermatology Question Here...
dermdoc19 is online now

i keep breaking out under my lower lip painful red raised bumps

Resolved Question:

i keep breaking out under my lower lip painful red raised bumps that sometimes becomes white head or stays angry red for a week
Submitted: 2 years ago.
Category: Dermatology
Expert:  dermdoc19 replied 2 years ago.

dermdoc19 :

These answers are for informational purposes and do not replace a physician head-to-head visit. A patient-physician relationship is not established.

dermdoc19 :

Hello

dermdoc19 :

I would be happy to look at a picture of the bumps if you would like.

Customer:

Full Size Image


 

Customer:

It's usually only one red blind pimple either side of my lower lip, I went to the doctor last week and he gave me eryacne gel. I used that for a week now and now it's broken me out with smaller red pimples as you can see and they all had white heads in them and painful

Customer:

I also take akamin tablets 2 x 50g daily

Customer:

I use to use duac gel once only gel at night, I think that use to work the best from all the stuff I have tried, but I think my body got use to it and rather than clearing the red spot up it started to make it look angrier red

dermdoc19 :

Hi again

dermdoc19 :

Thank you for the excellent picture.

dermdoc19 :

It appears to me that you may have a gram negative folliculitis. Sometimes, during acne treatment the "good" bacteria is killed off. This may allow bacteria that normally is not a problem to take hold. I would recommend seeing your physician and having a culture taken. Bacteria are divided into gram negative and gram positive depending on how they take up the gram stain. Gram negative bacteria like a moist environment such as found around the mouth. This is usually treated one of two ways. Sometimes, just taking a patient off their antibiotic and taking Probioitics such as Kefir and acidophilus milk will do the trick. Another method is to substitute an antibiotic that kills gram negative bacteria will do the trick.

dermdoc19 :

Hope that helps. I would be happy to elaborate or answer any further questions.

Customer:

I went back to the doctors today, the doctor who gave me eryacne gel originally said to stop using it because it's looking angry. I use to use duac gel and it worked good so he put me back onto that and also said to try bactroban for bacteria infection

Customer:

do you think I should continue using my regular facial cleanser and moisteriser? and do you think shaving makes any difference? ie, how I shave and what with

dermdoc19 :

I agree in that I do not use EryGel. Too much resistance toErythromycin. I nearly always use something that also contains a Benzoyl Peroxide. ( Bacteria cannot develop resistance to Benzoyl Peroxide). It seems to me that the infection is more in the area of the mouth and not the area you would be shaving so I think shaving would be OK. I would use a multi-blade such as Gillette Fusion.

Customer:

I am going to upload you 3 photos from today, I have a feeling I just had a reaction from the eryacne gel

Customer:

for some reason it isn't letting me upload the pic. Keeps telling me no file selected after I click on the one I want to send

Customer:

Should I continue to use my facial cleanser and moisteriser or do I let my skin naturally breathe?

What I normally do is have 1x akamin tablet after I eat food each day and if I have any blind pimples( red spot) I would put duac on over night and it usually cleared up by morning. I done this for about 2 years

I tend decided to have a break because my skin felt good and didn't think I needed it anymore so I was clear for about 6 months with maybe one or 2 pimples along the way but I didn't worry about taking any tablets for it

Just before xmas, I started getting really bad painful red spot on one side of my lower face, it would go, than it would appear on the opposite , than it would jump up on both sides with one painful red spot on each side. I tend started to take akamin again and I went to see the doctor 2 weeks ago and he said to try eryacne. It cleared up within the week but now it's just broken out with all the white heads and angry painful bumps. Today, one side is pretty much clear apart from red/pink spots that are soft not hard(under the skin) but on one side I still have 3 painful bumpy ones that leak out yellow/white puss because I popped them because it was too painful and felt like it was holding me back from smiling, it's relieved the pain but now it's oozing the clear liquid. What do you recommend for this?

Customer:

before I started akamin and duac.... I was using doxycline and differin about 2 weeks into that I broke out in nasty rash all over my body and had swelling in the face so I went to hospital and I am pretty sure they gave me phenergon? and my skin was amazing for ages after this, than I started to break out again, that's when I started my akamin and duac treatments

dermdoc19 :

The system does not work with Safari, Google Chrome or a hand held device. You might send the pictures [email protected]

dermdoc19 :

If there is clear liquid this is more of an indication of an allergic contact dermatitis, to an ingredient in the topical medication. The one thing I wonder about is if you had an drug allergy to Doxycyclline you might have one to Minocycline since they are related. However, I still think the best road to take would be to culture some of the pustules and let the results of the culture determine the course of therapy. If the culture grows out normal skin flora,that means all you have is a bad case of acne.

dermdoc19 :

I think the facial cleanser might be OK, but it does not look like you have dry skin so I would avoid the moisturizer until your skin is better. Just not sure whether that is creating some of the problem.

Customer:

I also have quite the active sex life, each time I have went to check my blood tests for stds and hiv they come back negative and to my knowledge I have never had anything, so could it be sex related? or possibly hormone imbalance considering I am 25 fairly white skin and I can grow patchy facial hair but no where near a healthy beard although my dad doesn't have any chest hair and neither do I but my brother and sister never had any acne problems growing up and they are both older than me. Although my sister breaks out in nasty red rashes all over her arms and legs and no one seems to know why but never on her face so she tends to cover her red rashes up with clothing and everyone kept saying hers is stress related because she's in a high demanding job

dermdoc19 :

Very high levels of testosterone can lead to acne, especially on the trunk. However, there is no known relationship between sex and acne.

dermdoc19 :

I mean sexual activity.

Customer:

In the mornings, I can get quite dry skin and can be flakey at times and that's when my skin isn't red and actually looks okay but it's flakey, so I use moisteriser however at times it seems like it's too oily but it says it's oil free and doesn't clog pores . I work in hospitality as a supervisor behind the bar so I too can be in stressful situations depending on how busy it is, plus with social activities I am keen sportsman and always playing sport 3 nights a week

Customer:

can no sunlight cause my skin to flare up including the weather?, I am usually indoors during the day and outdoors at night, so I don't get to see any sun really

Customer:

I live in QLD, Australia and it's quite hot at the moment, I went to ireland for 4 weeks back in 2010, and my skin was amazing and I didn't had to use anything

dermdoc19 :

The sun usually has a mildly beneficial effect. Lack of sun might mean low levels of Vitamin D, so I would add that orally Vitamin D 3 2000 I.U.

Customer:

should I be taking fish oil and zince supplements?

Customer:

as for diet, I don't eat much fruit so maybe I should be daily yes? and perhaps remove dairy products? I often drink milk and have cheese in my meals and I think that usually breaks me out same with eggs

dermdoc19 :

Yes, they both have been shown to help acne. Plus, if you doctor decides to put you on Accutane, the fish oil supplements will keep the cholesterol and triglycerides down.

dermdoc19 :

Excessive dairy products have been shown to worsen acne, but this is usually because ( at least in the US) the cows receive progesterone to increase milk production and Progesterone flares acne.

Customer:

do you recommend putting betadine on the ooozing pimple that is constantly leaking?, I usually put betadine on it and cover it with a band aid and it usually clears up

however if I have to go to work or out in public, I would dab the spot with cotton ball to prevent the leaking and leave some of the cotton ball on it so it doesn't look as red and the fluff from the ball is kinda blocking the ooze

dermdoc19 :

I like HIbiclens 4% Wash better since it is more effective and less likely to cause an allergy.

Customer:

can I get that in australia? qld?

dermdoc19 :

Pretty sure.

Customer:

I've never seen it, would I only get it from chemist over the counter or by dr script?

dermdoc19 :

In the United States it is over the counter and very easy to find.

Customer:

I keep hearing about all these awesome skin care range but it's never available in Australia

Customer:

ie, neosporin , now this product

dermdoc19 :

I am very sure it is found worldwide. It is not an acne product. It is used as an antiseptic....say before surgery or as a mouth wash ( in that case it is a prescription product).

Customer:

I will have to ask at the chemist

Customer:

so until then, should I continue using duac or bactraban on the oozing red spots?

Customer:

or betadine with a band aid or put nothing on them and let it naturally breathe/ooze

dermdoc19 :

Bactroban

Customer:

with or without band aid

Customer:

should I continue using akamin tablets or give it a rest

dermdoc19 :

My recommendation is to culture the lesions to see if they are a gram negative folliculitis. If so, sometimes, letting the natural bacterial flora grow back will crowd out the bad bacteria...in that case patients do better without an antibiotic.

dermdoc19 :

In this case without a bandaid.

Customer:

should I eat yakult?

Customer:

for the good/bad bacteria

dermdoc19 :

It would help.

dermdoc19 :

As would Kefir.

Customer:

I have noticed whenever I shave ( usually every 3 -4 days) my face looks quite clear the next day after I shower

Customer:

do you recommend on a daily basis putting on shaving cream and washing it off with the warm water and putting on aftershave without shaving to see if that keeps my skin clear?


 

dermdoc19 :

Yes, usually shaving creams have emollients which help the skin. So that is not a bad idea, especially if it works for you.

Customer:

Full Size Image


 

Customer:

that's a picture taken today, I still have the red spots but they are not as angry and seem to have faded, however I still feel bumpy ones under a couple of the spots looking like they are forming into a big white head

Customer:

Full Size Image

Customer:

that was a picture yesterday, it seemed angrier yesterday that's after I had a shave. Usually after I had a shave the next day after I use facial cleanser and moistieriser it clears up like the pic above

Customer:

Full Size Image

Customer:

that was my original picture after I broke out from the eryacne gel on Tuesday

dermdoc19 :

Yes, I am still thinking of gram negative folliculitis, but as I said, a culture would be needed to prove this.

Customer:

I will ask for a culture on my next day off until then do you think toothpaste could be an issue?

I notice I dribble in my sleep and where I dribble tends to break out on the sides of the lower mouth, also I have notice whenever I drink water my lips seem dry and leave like broXXXXX XXXXXp skin on my lips and gets into the corner of my mouth where I sometimes break out in corner mouth red whiteheads

dermdoc19 :

One of my colleagues blames toothpaste for peri-oral dermatitis, which causes a number of small little papules in the area around the mouth. However, this looks more like gram negative follikculitis or acne to my eye. By the way, Accutane is a medication would clear up both conditions. It does have some risks though and must be used cautiously.

Customer:

Full Size Image

Customer:

I took that photo today, it's cleared up heaps. How quick does gram negative clear up if it was that or do you think it could have been something else?

I have been using mud soap by secret which I think has helped, because my skin feels when I massage it in the shower, before I could feel deep bumps under the skin

Customer:

Ingredients in the soap are- ELAEIS GUINEENSIS KERNEL OIL, MARIS LIMUS EXTRACT (DEAD SEA BLACK MUD), AQUA, SODIUM CHLORIDE, HAMAMELIS VIRGINIANA EXTRACT, MARIS SAL (DEAD SEA SALTS).

dermdoc19, Dermatologist
Category: Dermatology
Satisfied Customers: 4124
Experience: 30 years practice in general and cosmetic dermatology
dermdoc19 and other Dermatology Specialists are ready to help you

What Customers are Saying:

 
 
 
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me FROM a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O.
< Previous | Next >
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me FROM a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O.
  • Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help. Mary C.
  • This expert is wonderful. They truly know what they are talking about, and they actually care about you. They really helped put my nerves at ease. Thank you so much!!!! Alex
  • Thank you for all your help. It is nice to know that this service is here for people like myself, who need answers fast and are not sure who to consult. GP
  • I couldn't be more satisfied! This is the site I will always come to when I need a second opinion. Justin
  • Just let me say that this encounter has been entirely professional and most helpful. I liked that I could ask additional questions and get answered in a very short turn around. Esther
  • Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help. Mary C.
 
 
 

Meet The Experts:

 
 
 
  • dermdoc19

    dermdoc19

    Dermatologist

    Satisfied Customers:

    2779
    30 years practice in general and cosmetic dermatology
< Previous | Next >
  • http://ww2.justanswer.com/uploads/dermdoc19/2010-09-30_160749_Photo_122807_015.JPG dermdoc19's Avatar

    dermdoc19

    Dermatologist

    Satisfied Customers:

    2779
    30 years practice in general and cosmetic dermatology
  • http://ww2.justanswer.com/uploads/tcsatish/2009-4-14_221547_satish_pp.jpg Dr. Skinner's Avatar

    Dr. Skinner

    Dermatologist

    Satisfied Customers:

    1548
    MD , DNB ( D &V), FAAD
  • http://ww2.justanswer.com/uploads/FA/FamilyPhysician/2013-8-31_191624_JA550x500Photo.64x64.jpg Family Physician's Avatar

    Family Physician

    Doctor

    Satisfied Customers:

    2418
    GP with over 27 years experience including emergency medicine
  • http://ww2.justanswer.com/uploads/DR/DrK99/newpic2.64x64.jpg Dr. K.'s Avatar

    Dr. K.

    Board Certified MD

    Satisfied Customers:

    276
    Board certified with experience in primary care.
  • http://ww2.justanswer.com/uploads/agketch/2008-7-14_184046_drketchresized.jpg Dr. Ketch's Avatar

    Dr. Ketch

    Board Certified Physician

    Satisfied Customers:

    76
    Medical Degree, Former Assistant Professor at School of Medicine at Yale University
  • http://ww2.justanswer.com/uploads/JA/JACUSTOMERjtu60wne/2011-2-14_183449_passportphoto2.64x64.jpg docwithheart's Avatar

    docwithheart

    Board Certified Physician

    Satisfied Customers:

    0
    Board certified pediatrician, with special experience in general pediatrics, hospital pediatrics, and pediatric cardiology