Summary about Disease
Nasal vestibulitis is an infection of the nasal vestibule, the area just inside the nostrils. It is usually a bacterial infection, most commonly caused by Staphylococcus aureus (staph). It can manifest as small pimples, boils, or more diffuse inflammation within the nasal vestibule. It can range from a mild annoyance to a more painful and potentially serious condition, particularly if it spreads.
Symptoms
Redness inside the nostril(s)
Pain and tenderness in the nasal vestibule
Small pimples, boils, or crusts inside the nostril(s)
Swelling of the nasal vestibule
Itching or burning sensation
Nasal discharge (sometimes)
Fever (rarely, in severe cases)
Causes
Bacterial infection: Staphylococcus aureus* is the most common culprit.
Nose picking or excessive nose blowing: These actions can irritate the nasal lining and introduce bacteria.
Nasal hair removal: Plucking or waxing nasal hairs can create micro-trauma and allow bacteria to enter.
Nasal piercings: These can increase the risk of infection.
Upper respiratory infections (colds, flu): Increased nasal secretions and irritation can predispose to vestibulitis.
Weakened immune system: Individuals with compromised immune systems are more susceptible.
Dry nasal passages: Can lead to cracking and fissuring, creating entry points for bacteria.
Use of nasal steroids: Can sometimes increase the risk of infections.
Medicine Used
Topical antibiotics: Mupirocin (Bactroban) and bacitracin are commonly prescribed. These are applied directly to the affected area inside the nostril.
Oral antibiotics: May be necessary for more severe infections or if topical treatments are ineffective. Common choices include dicloxacillin, cephalexin, or clindamycin. Antibiotic choice will depend on local resistance patterns of Staph Aureus.
Pain relievers: Over-the-counter pain relievers like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help manage pain and discomfort.
Is Communicable
While nasal vestibulitis itself isn't directly "communicable" like a cold, the Staphylococcus aureus bacteria that often causes it *is* contagious. It can spread through direct contact with the infected area or contaminated surfaces. However, exposure to the bacteria doesn't guarantee that someone will develop nasal vestibulitis; it depends on individual susceptibility and hygiene practices.
Precautions
Avoid nose picking: This is a major cause of the condition.
Gentle nose blowing: Avoid excessive force.
Proper hygiene: Wash hands frequently, especially after touching the face.
Avoid nasal hair removal (plucking or waxing): If necessary, use blunt-nosed scissors to trim hairs carefully.
Moisturize nasal passages: Use saline nasal sprays or a humidifier, especially in dry environments.
Avoid sharing personal items: Towels, washcloths, and razors should not be shared.
Clean nasal piercings regularly: Follow aftercare instructions provided by the piercer.
Treat underlying conditions: Manage conditions that weaken the immune system or cause dry nasal passages.
How long does an outbreak last?
With proper treatment (typically topical antibiotics), a mild case of nasal vestibulitis usually resolves within 1-2 weeks. More severe infections, especially those requiring oral antibiotics, may take longer to clear up, potentially 2-4 weeks. Recurrences are possible if the underlying cause (e.g., nose picking) isn't addressed.
How is it diagnosed?
Nasal vestibulitis is usually diagnosed based on a physical examination of the nasal vestibule. A doctor will look for signs of redness, swelling, pimples, boils, or crusting. In some cases, a culture of the affected area may be taken to identify the specific bacteria causing the infection and determine the best antibiotic to use. This is more likely to be done with recurrent or severe infections.
Timeline of Symptoms
The timeline can vary, but generally:
Initial Stage (1-2 days): Mild itching or burning sensation inside the nostril.
Early Stage (2-4 days): Redness and tenderness develop. Small pimples or bumps may appear.
Established Stage (4-7 days): Pain intensifies. Boils or crusts may form. Swelling may become more noticeable.
Resolution Stage (7-14 days, with treatment): Symptoms gradually improve with antibiotic therapy. Redness and swelling decrease. Lesions start to heal.
Important Considerations
Potential Complications: In rare cases, nasal vestibulitis can lead to more serious complications, such as cellulitis (spread of infection to the skin), furunculosis (deep boil), or cavernous sinus thrombosis (a blood clot in a large vein at the base of the brain). Seek medical attention immediately if you develop fever, severe headache, vision changes, or facial swelling.
Recurrent Infections: If you experience frequent episodes of nasal vestibulitis, it's important to identify and address the underlying cause. This may involve improving hygiene practices, managing underlying medical conditions, or avoiding irritants. A nasal swab to determine if you are a staph carrier may be useful to discuss with your healthcare provider.
Self-Treatment: While mild cases may improve with careful hygiene and over-the-counter pain relievers, it's crucial to consult a doctor if symptoms worsen, don't improve within a few days, or if you develop signs of a more serious infection. Avoid squeezing or picking at boils, as this can spread the infection.
MRSA: Methicillin-resistant Staphylococcus aureus (MRSA) is a type of staph bacteria that is resistant to many antibiotics. If you are diagnosed with nasal vestibulitis and the infection doesn't respond to initial antibiotic treatment, your doctor may test for MRSA and prescribe a different antibiotic.