Persistent Bumps on Nose: Causes, Treatments, and Expert Advice - Dermatology

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Persistent bumps on the nose can be a source of frustration and concern, especially when they have been present for an extended period, as in your case. Based on your description, it seems you have been dealing with these bumps for about ten years, and despite consulting multiple doctors and trying various treatments, you have not found a satisfactory resolution. Let's explore the potential causes of these bumps, possible treatments, and some expert advice.


Possible Causes
1. Sebaceous Hyperplasia: These are small, soft, yellowish bumps that can appear on the nose and are caused by enlarged sebaceous glands. They are benign and often mistaken for acne or warts.

2. Viral Warts (Verrucae): Caused by the human papillomavirus (HPV), warts can appear anywhere on the body, including the nose. They can be flesh-colored and may feel raised. If they are indeed warts, they can be persistent and may require specific treatments like cryotherapy or topical treatments.

3. Acne Vulgaris: While acne typically resolves over time, some individuals may experience persistent acne lesions, especially if they have a history of hormonal imbalances or skin type predispositions.
4. Milia: These are small, white cysts that can appear on the skin, often mistaken for whiteheads. They are caused by keratin trapped beneath the skin's surface and are common on the face.

5. Folliculitis: This is an inflammation of hair follicles that can lead to small, red bumps. It can be caused by bacterial infections, irritation, or even fungal infections.

6. Keratosis Pilaris: This condition results in small, rough bumps on the skin, often on the arms, thighs, and face. It is caused by the buildup of keratin and is generally harmless.


Treatment Options
1. Topical Treatments: If the bumps are due to acne or folliculitis, topical retinoids or benzoyl peroxide may help. However, since you mentioned using A-acid without success, it may be worth exploring other options or combinations.

2. Cryotherapy: This treatment involves freezing the bumps with liquid nitrogen. While you mentioned that this did not work for you, it is often effective for warts and sebaceous hyperplasia.

3. Laser Treatments: Certain laser therapies can target specific skin lesions, reducing their appearance or eliminating them altogether.

4. Chemical Peels: These can help improve the texture of the skin and reduce the appearance of bumps, especially if they are related to acne or keratosis pilaris.

5. Surgical Excision: For persistent lesions that do not respond to other treatments, a dermatologist may recommend surgical removal.


Expert Advice
- Seek a Dermatologist: If you have not already, consider consulting a board-certified dermatologist who specializes in skin lesions. They can provide a thorough examination and possibly a biopsy to determine the exact nature of the bumps.

- Document Changes: Keep a record of any changes in the bumps, including size, color, and any associated symptoms. This information can be valuable for your healthcare provider.

- Avoid Self-Treatment: While it may be tempting to try over-the-counter treatments or home remedies, these can sometimes exacerbate the condition. It’s best to follow a treatment plan prescribed by a healthcare professional.

- Consider a Second Opinion: If you feel that your concerns are not being addressed adequately, don’t hesitate to seek a second opinion from another dermatologist. Different specialists may have varying approaches and insights.

In conclusion, persistent bumps on the nose can arise from various causes, and finding the right treatment may require some persistence and professional guidance. By working closely with a dermatologist and exploring the appropriate treatment options, you can hopefully find a solution that alleviates your concerns.