Understanding Nose Sores
Types of Nasal Sores
- Scabs and crusts:
- Dried blood or mucus
- Often from picking or dryness
- May reform repeatedly
- Can be painful when disturbed
- Ulcers:
- Open sores
- May have white or yellow base
- Painful, especially when touched
- Can bleed easily
- Blisters:
- Fluid-filled bumps
- Often from viral infections
- May burst and crust over
- Can be very painful
- Bumps or nodules:
- Raised lesions
- May be hard or soft
- Can be single or multiple
- Various causes
Location Matters
- Nasal vestibule: Just inside nostril opening
- Septum: Wall between nostrils
- Nasal floor: Bottom of nasal cavity
- Lateral walls: Sides of nose
- Deep nasal cavity: Further back in nose
Common Causes
Minor/Benign Causes
- Nose picking (Digital trauma):
- Most common cause
- Creates small tears
- Can lead to infection
- Often habitual
- Worse with long/sharp nails
- Dry nasal passages:
- Low humidity environments
- Winter heating
- Air conditioning
- Dehydration
- Mouth breathing
- Certain medications
- Environmental irritants:
- Dust and pollutants
- Chemical fumes
- Cigarette smoke
- Strong perfumes
- Cleaning products
- Allergic rhinitis:
- Seasonal allergies
- Pet dander
- Dust mites
- Causes inflammation
- Frequent nose blowing
Infections
- Nasal vestibulitis:
- Bacterial infection of nasal vestibule
- Often Staphylococcus aureus
- Red, swollen, painful
- May have pus
- Can spread if untreated
- Impetigo:
- Superficial skin infection
- Honey-crusted lesions
- Highly contagious
- Common in children
- Spreads easily
- Herpes simplex:
- Cold sores in nose
- Painful blisters
- Tingling before outbreak
- Recurrent episodes
- Triggered by stress/illness
- Folliculitis:
- Infected hair follicles
- Small red bumps
- May have white heads
- From plucking nose hairs
Systemic Conditions
- Autoimmune disorders:
- Lupus
- Pemphigus
- Behçet's disease
- Cause recurring ulcers
- Often affect other areas too
- Vasculitis:
- Granulomatosis with polyangiitis
- Causes nasal crusting
- Saddle nose deformity
- Bloody discharge
- Systemic symptoms
- Sarcoidosis:
- Granulomatous disease
- Nasal lesions
- Crusting and bleeding
- Often with lung involvement
Medications and Treatments
- Nasal sprays:
- Overuse of decongestants
- Steroid sprays
- Saline sprays (if preservatives)
- Improper technique
- Oxygen therapy:
- Nasal cannula irritation
- Drying effect
- Pressure sores
- Chemotherapy:
- Mucositis
- Increased infection risk
- Poor healing
Serious Conditions
- Nasal cancer:
- Squamous cell carcinoma
- Basal cell carcinoma
- Melanoma (rare)
- Non-healing sores
- Bleeding
- Mass effect
- Nasal lymphoma:
- Progressive swelling
- Destructive lesions
- Systemic symptoms
- Invasive fungal infections:
- In immunocompromised
- Diabetics at risk
- Black eschars
- Rapid progression
- Life-threatening
Other Causes
- Foreign bodies: Objects stuck in nose
- Nasal polyps: Benign growths
- Septal perforation: Hole in septum
- Cocaine use: Damages nasal tissue
- Piercings: Infection or rejection
- Trauma: Injury to nose
Associated Symptoms
Local Symptoms
- Pain or tenderness
- Bleeding or bloody discharge
- Crusting or scabbing
- Swelling inside nose
- Difficulty breathing through nose
- Foul odor from nose
- Burning or stinging sensation
- Itching
Signs of Infection
- Increased pain and swelling
- Pus or yellow discharge
- Red streaks from nose
- Fever
- Swollen lymph nodes
- Facial swelling
- Warmth around area
Systemic Symptoms
- Fever and chills
- Fatigue
- Weight loss
- Night sweats
- Joint pain
- Skin rashes elsewhere
- Eye problems
Warning Signs
- Sore not healing after 3 weeks
- Rapidly growing lesion
- Irregular borders
- Multiple colors in lesion
- Numbness around nose
- Vision changes
- Severe headache
Diagnosis and Evaluation
Medical History
- Duration of sore
- Previous episodes
- Triggering factors
- Associated symptoms
- Medical conditions
- Medications
- Substance use
- Environmental exposures
Physical Examination
- Nasal examination:
- Direct visualization
- Nasal speculum
- Otoscope examination
- Palpation of nose
- Additional assessment:
- Lymph node check
- Facial examination
- Oral cavity inspection
- Skin examination
Diagnostic Tests
- Nasal endoscopy: Detailed visualization
- Culture and sensitivity: Identify infections
- Biopsy: For suspicious lesions
- Blood tests: Autoimmune markers, CBC
- Imaging: CT or MRI for deep lesions
- Allergy testing: If allergic cause suspected
Treatment Options
General Care
- Keep area clean:
- Gentle cleaning with saline
- Avoid picking or touching
- Don't remove scabs forcefully
- Pat dry gently
- Moisturize nasal passages:
- Saline nasal spray
- Petroleum jelly (small amounts)
- Nasal gel or ointment
- Humidifier use
Medical Treatments
- Topical antibiotics:
- Mupirocin ointment
- Bacitracin
- For bacterial infections
- Oral antibiotics:
- For spreading infection
- Systemic involvement
- MRSA coverage if needed
- Antiviral medications:
- For herpes simplex
- Topical or oral
- Early treatment best
- Corticosteroids:
- For autoimmune causes
- Reduce inflammation
- Topical or systemic
Procedural Treatments
- Cauterization: For recurrent bleeding
- Debridement: Remove dead tissue
- Excision: For tumors or suspicious lesions
- Cryotherapy: Freeze abnormal tissue
Home Remedies
- Warm saline rinses
- Steam inhalation
- Avoid irritants
- Stay hydrated
- Use humidifier
- Trim fingernails short
- Manage allergies
Prevention
- Avoid nose picking
- Keep nasal passages moist
- Use humidifier in dry environments
- Manage allergies properly
- Gentle nose blowing
- Avoid irritants and allergens
- Proper nasal spray technique
- Good hand hygiene
- Treat infections promptly
- Regular saline rinses if prone to dryness
- Protect nose from trauma
- Avoid cocaine and other nasal irritants
When to See a Doctor
See Doctor Immediately
- Severe facial pain or swelling
- High fever with nasal sore
- Vision changes
- Confusion or severe headache
- Spreading redness
- Black or dark tissue in nose
- Heavy bleeding
Schedule Appointment
- Sore lasting >2-3 weeks
- Recurring sores
- Unusual appearance
- Not responding to treatment
- Associated with other symptoms
- Interfering with breathing
- History of skin cancer