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Bump face
Bump face  
Hi Dr. Craig.
I must say you have been so nice and kind to answer my questions

I have this small patch on my chin that is red and it doesn't seem to clear up with things I've done. I've used tea tree oil, vitamin E oil, apricot scrub among a few other creams and it doesn't seem to be healing. I don't know what it could be. Pic attached  

Ps. You are hot. :-)

Answer
Hi Nanc and thanks for your question.  You are more than welcome, it is a pleasure being of assistance to you and thank you so much for your very kind words and compliment.

I feel your question would be best answered by a dermatologist, given its location, but if I had to offer an educated opinion, I would say it looks rather like a herpes infection - i.e. a cold sore, given its location, persistent and recurring nature and its clinical image.  Now please don't freak out and get into a panic over the name herpes - its a very common viral infection that kids usually contract from adults while growing up and although related to the herpes which causes ano-genital warts by structure only, has no significance other than causing facial lesions as recurrent blisters, especially on and around the lips.  For the most part, the worst symptoms involve these blisters making a return whenever your immunity becomes a bit over-taxed, such as during exam time, emotional stress such as divorce,marriage, moving house, with excessive direct sunlight or UV exposure, immune disorders or other viral infections which precede their appearance on the face.  I myself, am a victim of this virus and have found only 1 thing to help clear it up quite effectively.

The problem with the commercial anti-viral creams, is that they are usually only applied once the virus has travelled along the neuron or nerve cell from where its hiding to its final destination on the lip. The virus remains protected within the neuron, with a few particles being secreted in the liquid which forms as the blister develops, and after a few days the virus once again travels back to lie dormant in the terminal nerve ganglia.  From my experience, the most effective way of blocking the virus from forming a visible blister, is to apply 90% alcohol or higher to the area as soon as you feel any symptoms in the area.  You will find that the same area of the lip is usually affected and most often you will feel a tingle in that area - take that as a warning sign and start applying alcohol as often as you can, but at least 5 times during the day.  You might find that the skin gets a drier as a result, but that is what you want because the dessication effect that the alcohol has, will literally dry up any developing or established blister.  Once the lesion has cleared up, apply moisturiser regularly to return the skin tone and complexion to normal.  You will find that, over time, by using this treatment, the viral attack will get less and less and the interval between attacks will lengthen.

The other condition which appears similar to your lesion to me, is psoriasis.  This is a chronic, non-contagious skin condition, suspected to have a genetic link in development.  Normal skin cells flake off about every 4 weeks, whereas in psoriasis, the new skin has a faster turn-over rate and starts to accumulate in the area, resulting in the formation of red, dry and scaly patched called plaques. For the most part, treatments have limited effect but can reduce the redness and irritation of the area, making the lesion less visible.  To reduce the severity of this condition, avoid exposure to direct sunlight, reduce alcohol and smoking, reduce stress where ever possible.  There are some OTC preparations available and in my experience, those containing tar are the most beneficial. But as I said, these are only possibilities and no means a definitive diagnosis.  Make an appointment to see a dermatologist and get the peace the mind you deserve over this - I really don't think its anything serious for you to worry about.  

I hope this helps and wish you al the best in resolving this issue speedily and as uneventfully as possible, take care.

Kind regards
Dr Craig Peck  

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Dr Craig W Peck ( B.Med.Sc., B.Ch.D., Clin. Botox, Cosmet. Derm.)

Expertise

I am a General Dental Practitioner, with special interests in Cosmetic Dentistry & facial aesthetics and Periodontology, placing a strong emphasis on the establishment and maintenance of a healthy periodontium (the support structure of the tooth) before cosmetic options are considered. I uphold all principles of prevention above interventional treatment and try as far as possible, to remain conservative in my approach. I believe in detailed, open and honest patient discussion, establishing what the patients expectations are and what the reality is of achieving this and involving the patient at every level of the treatment. I have strong principles on ethical treatment and appropriate patient management. I have chosen to treat and rehabilitate many nervous and phobic patients, who, for whatever reason, find it impossible to take part in the very important task of even a routine check-up. I will accept questions relating to general and cosmetic dentistry (in conjunction with the use of facial cosmetic procedures) and dental fears/phobias. I will be more than willing to answer any academic questions in dentistry, biology, physiology, psychology and health sciences in general. As most dentists will tell you, there is often not only one way of dealing with a dental issue - so very often, there is no precise right and wrong way of approaching the problem. All clinicians vary when it comes to treatments and what works best in their hands is often the treatment that is advised. Be understanding of this and bear in mind that nothing lasts forever! Patients are happy to accept only a one-years warrantee when buying a new car, but seem to expect that dental work is going to last them their lifetime.

Experience

I have worked for many years in the UK and RSA as a general dental practitioner - within the NHS, private practice and the government dental health services. I am certificated for the administration of Botox and Dermal Fillers for facial lines and wrinkles as I have attended further courses in minimally invasive facial cosmetic procedures. I started seeing an increasing number of patients who presented with severe to moderate dental fears, even with full-blown phobias, so I started with the slow and patient task of tackling this problem and have successfully rehabilitated many patients. The key is good, effective, concise and understandable communication, shifting control from the dentist to the patient in order to slowly, but confidently, regain their trust back in dentistry, thereby giving them the feeling of achievement and this self-empowerment which drives them to the next level of treatment.

Organizations
Academy of General Dentistry. American Dental Education Association. IAPAM (International Association for Physicians in Aesthetic Medicine). Professional Speakers, Writers and Managements Consultants in Dentistry. The British Dental Association. UK Aesthetics Group. ARC - Aesthetic Professionals. Botox. Aesthetics & Beauty. American Association for Dental Research. FDI - World Dental Federation. SOURCE1uk. World Dental Hygiene Forum. ProDentalCPD. Public Health Dentistry. Dentist Network. LinkedIn. Who's Who of South Africa.

Education/Credentials
B.Med.Sc. Degree (Medical Physiology and Medical Virology; Physiology Cum Laude; Stell 1994). B.Ch.D. Degree (Bachelor of Dental Surgery; Clinical Dentistry Cum Laude; Stell 1997). CPR and CPR-Advanced Courses (2000/2001; UK). Clinical Botox (UK, 2001). Cosmetic Dermatology (Botox and Dermal Fillers; RSA 2011).

Awards and Honors
Placed on the Dean's List at University for academic achievement (1994). Highest achievement in the subject Dental Materials. Medal from 3M and the Radiology Association of South Africa for highest achievement in the subject Dental Radiology and Imaging. Medal from The Periodontal Association of South Africa for highest achievement in the subject Periodontology. Highest achievement for Oral Medicine. Highest achievement in Oral Pathology. Received the DASA (Dental Ass. of South Africa) Gold Medal for highest achieving dental student across the 5 1/2 years of the Degree. Passed the subject, Clinical Dentistry with distinction in final year.

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