Allergic reaction? Cold sore? other?

[Crankin]

Well, I think you should go straight to the allergist. You have a history of allergies, if I recall, as do I, and these kinds of things can be scary, in addition to annoying. Sometimes, it's hard to figure out. And, you might have 2 things going on at the same time. The fact that you're having hives right now might be a hint that your body is just in an over-reactive state and hence, you are having allergic reactions to things that might not have caused an issue in the past. I've gone through several episodes of this, although not in a long time.
It's not fun to be worried about having an anaphylactic reaction to something you're not sure about. This is why I think you should go to the allergist first, and let him/her rule out something, before you see a derm.

[OakLeaf]

Personally I'd start with the dermatologist or maybe the PCP. It really sounds like you have some big-picture stuff going on.

But I'd also, at the same time, be investigating and eliminating household irritants and allergens. Just for example, a lot of brands of toothpaste will break my chin out if I even get a little bit on my face while rinsing, even though I don't get a reaction on my lips or mucous membranes. The little white pustules you're talking about, do sound similar to the eczema I get on my face from various triggers. Whatever laundry products you use on your pillowcases, might come in contact with your lips. If you wear wool - even wool socks - that will keep you sensitized to lanolin. Plus, as Crankin says, most people's allergic load is very high in weed season, so reducing your total allergic load from all sources and exposure routes, can't do anything but help.

[emily_in_nc]

That sounds miserable. I had something a little similar (but not exactly) when we were in Belize. I didn't have any cold sores or blisters, but seemingly overnight, my lips got very swollen and painful. Gradually, the swelling and pain abated but then they peeled and were chapped for a long time after. I never did figure out exactly what happened, but I ditched the Burts Bee's lip gloss I'd been using just fine in the US, thinking it was maybe the peppermint oil in it reacting with the increase in the amount of sun and closeness to the equator where I was now living. I can't even remember what I used on my lips until they healed up, maybe coconut oil? I also changed toothpastes and cut all citrus out of my diet for awhile in an attempt to remove all potential irritants. The problem did gradually go away and I had no further problems even getting the same amount of sun as I'd been getting when the issue initially occurred, but I didn't use any more Burts Bees products.

When I got back to the US, I bought a tube of the same lip gloss, since I really liked it. Tempting fate, I tried using it again and had absolutely NO problems. So I can only think it was a reaction to the intense sunlight and possibly the lip gloss interacted with that.

I have had no repeat of the problem in Mexico, which also has intense rays. I still have the Burts Bees lip gloss but only use it in the evenings if we go out to eat. During the day I wear only SPF chap stick.

You haven't suddenly been getting a lot more sun, have you? Hope you can get to the bottom of it! Lip problems suck. I remember feeling so unattractive while my lips were peeling like crazy. After my brief experience with Angelina Jolie lips, that is!

[WindingRoad]

I have had something similar to what you describe. The only thing helps me when this happens is Carmex in the little tiny round container. I've had Aquaphor irritate my lips like you mention when I had an 'impending' fever blister brewing. Have you tried taking lysine too? This helps considerably for me, I take about 1,000 mg during the time I have the blister then stop taking it when it goes away. However, if you eat a lot of green leafy veggies like spinach, kale or even avacado that can reactivate the virus responsible for cold sores. Lysine shuts off the other side of the replication pathyway. Be sure to use a lip balm with sunscreen in it b/c UV activates the virus too.

[marni]

I would go see a dermatologist as well. I recently had a similar patch of dry sluffing skin and occasional bleeding. Turned out to ba a patch of squamous cell cancer which was treated with a cream which did a chemical peel, left me with red swollen lipo injected looking lower lip for about 4 weeks but it has since healed up and is now no longer there. I should mention that this patch which I alwys thought was a cold sore or eczema had been with me for years. Better safe than sorry as my sister had to have part of her tongue removed because of cancer. Just the thought of some thing like that gives me the heebie jeebies.

[ny biker]

Thanks for all your replies, ladies. Since we're on a holiday weekend, I've got a couple more days until I can try to get in to see a doctor. It's almost time for my annual checkup with the allergist, but since this might have a viral component I will try to see the PCP or dermatologist first. I took some photos yesterday and this morning so I'd have evidence of what's been happening.

I'm starting to think the Vaseline is part of the problem, because I think it's causing the skin around my lips to break out. I used it last night without using any lip balm. The right corner of my mouth was a mess of small pimples/blisters when I woke up this morning, and a few more white spots had appeared on my lower lip. Since then I put the Vaseline away and have used just enough lip balm to keep things from feeling dry and chapped, with nothing at all in the corners of my mouth. Things have improved over the course of the day.

My usual treatment for the chronic hives is 10 mg of Zyrtec each day. My allergist has told me I can double that if things get worse, and that's what I did for most of the summer, and just recently went back to taking one tablet per day. I also was taking 150 mg of Zantac twice a day over the summer since that's helped me in the past when things have flared up. I recently reduced that dose to 150 mg per day (I had stopped taking it completely but started to have some symptoms of acid reflux, which I think may have been a rebound effect from the drug, so I've been taking the lower dose since then). I will double up on the Zyrtec again to see if that helps calm things down overall.

The really frustrating thing is not knowing what the cause of the lip problem is (yet). I want to treat it but I'm reluctant to try anything else for fear of making things worse.

BTW if I can't wear wool anymore then I will have to move farther south. I can no longer get through the winter without my Ugg boots and wool socks to keep my feet warm!! But fwiw I haven't worn anything made from wool in months, so if I do have a problem with lanolin it's not being made worse by my clothes.

[Blueberry]

Oh don't get me started on Zantac. I had occasional acid reflux for years, and my doctor finally told me to start taking Zantac continuously. My acid reflux got so much worse. My doctor wanted to put me on a proton pump inhibitor (I was opposed to that for a few reasons). I was absolutely miserable. As a last ditch effort, I did a ketogenic diet for 2 weeks and threw out the Zantac. I went back to my regular diet. At first, there were things I couldn't eat (but I was ok with that). Over time (6 months?), things improved. Now, no acid reflux unless I do something egregious (giant pizza I ate a big chunk of right before bed back in June, I'm looking at you). Seriously. Night and day difference. I eat a fairly clean diet (and did pre-getting off the medication). I am 100% convinced that the medication was causing the reflux.

I'm sorry I don't have good answers for you in the lip issue (which sounds miserable) - but I wanted to at least share the Zantac story.