Redness Around the Philtrum: Causes and Treatments

The skin in the philtrum may appear reddened?

Hello, doctor.
About three weeks ago, I woke up in the morning to find a small area on my philtrum that was reddened, and this was the only area on my face showing this sign.
I informed the doctor during my visit, as I was undergoing treatment for acne at the time, and I wondered if it could be caused by the application of tretinoin.
The doctor suggested it might be inflammation and prescribed "Allergan Cream" for me, advising me to stop applying tretinoin to that area and to use the cream instead.
During this period, the area did not appear red after washing my face, but after a while, mild redness would return.
I applied the cream, but there was no improvement; in fact, not applying it seemed to help a bit more.
When I returned for a follow-up, I informed the doctor about this situation, and he mentioned it could also be eczema.
The doctor then prescribed "Dexamethasone Cream." It was effective for the first two days, and the redness became very mild, almost invisible.
However, on the third morning, the redness returned and was even more severe, and applying the cream seemed to make it redder.
I'm unsure whether I should stop using the cream.
In the meantime, I have tried to avoid using any skincare products on that area, refrained from using fluoride toothpaste and mouthwash, maintained a light diet, and drank plenty of water, but the redness persists.
I would like to inquire if there could be any other reasons causing the redness in that small area on my philtrum.
I sincerely appreciate your assistance.
Thank you.

ALLAN, 30~39 year old female. Ask Date: 2023/10/29

Dr. Wu Yuxin reply Dermatology

Your concerns should be discussed with the doctor who has examined your skin.
I haven't seen it, so I cannot provide you with the best advice.

Reply Date: 2023/10/29

More Info

Redness around the philtrum, or the area between the nose and upper lip, can be a concerning and frustrating issue, especially when it persists despite treatment. Based on your description, there are several potential causes for the redness you are experiencing, and understanding these can help guide your treatment options.

Possible Causes of Redness
1. Irritation from Topical Treatments: You mentioned using AHA (alpha hydroxy acid) for acne treatment. While AHAs can be effective for exfoliation and acne management, they can also cause skin irritation, especially if used excessively or on sensitive skin. This irritation can manifest as redness, particularly in localized areas.

2. Contact Dermatitis: This condition occurs when the skin reacts to a substance it has come into contact with, which could include skincare products, dental hygiene products (like fluoride toothpaste), or even certain foods. If you have recently changed any products or introduced new ones, this could be a contributing factor.

3. Eczema or Dermatitis: Your physician suggested that the redness might be related to eczema. Eczema can cause localized redness, dryness, and irritation. It often flares up due to environmental factors, stress, or irritants.

4. Rosacea: Although typically affecting the cheeks and nose, rosacea can sometimes present as localized redness in other areas of the face. It is characterized by flushing, visible blood vessels, and sometimes acne-like bumps.

5. Infection: In some cases, a localized infection or inflammation can cause redness. This could be due to bacteria or even a fungal infection, particularly if there is a history of skin issues in that area.

Treatment Options
1. Discontinue Irritating Products: If you suspect that the AHA or any other topical treatment is causing irritation, it may be wise to stop using these products temporarily. Allow your skin to recover and observe if the redness subsides.

2. Use Gentle Skincare: Switch to a gentle, fragrance-free cleanser and moisturizer. Products containing ceramides or hyaluronic acid can help restore the skin barrier without causing further irritation.

3. Topical Treatments: Since your doctor prescribed topical creams, it's essential to follow their advice. However, if you notice that the creams exacerbate the redness, you should communicate this to your physician. They may consider alternative treatments, such as a mild corticosteroid or a non-steroidal anti-inflammatory cream.

4. Avoid Triggers: Identify and avoid any known triggers that worsen the redness. This includes spicy foods, alcohol, extreme temperatures, and stress.

5. Consult a Dermatologist: If the redness persists despite trying these measures, it may be beneficial to consult a dermatologist. They can provide a more thorough examination and may suggest treatments such as prescription medications or specialized therapies.

Conclusion
Redness around the philtrum can arise from various causes, including irritation from topical treatments, contact dermatitis, eczema, rosacea, or even infections. It's crucial to monitor your skin's response to any treatments and to communicate openly with your healthcare provider about what works and what doesn't. By taking a gentle approach and avoiding known irritants, you can help your skin heal and reduce redness over time. If symptoms persist, seeking further evaluation from a dermatologist is advisable for a tailored treatment plan.

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