Sores or blisters inside the nose, often near the nostril opening, are common lesions on the delicate lining of the nasal vestibule. These can manifest as small pimples, painful scabs, or fluid-filled blisters. While usually minor, they can cause significant discomfort, tenderness, and swelling. The inner skin of the nose is sensitive and easily damaged, making it susceptible to various infectious and non-infectious causes.
Identifying Viral and Bacterial Causes
Infectious agents are responsible for many cases of nasal blistering and soreness. One common bacterial condition is Nasal Vestibulitis, an infection of the nasal vestibule often initiated by Staphylococcus aureus. This infection frequently presents as painful, red, and swollen bumps or pimples at the base of the nasal hairs (folliculitis), sometimes accompanied by pus or yellow crusting. The bacteria typically enter through a break in the skin barrier caused by excessive nose picking, plucking nasal hairs, or vigorous nose blowing.
A related bacterial infection, Impetigo, can affect the skin around the nose and mouth, sometimes extending inside the nostrils. Impetigo sores typically start as reddish spots that quickly rupture, ooze fluid, and then form a distinctive honey-colored crust. This condition is highly contagious and is more common in children, though it can affect adults.
Viral causes are most often attributed to the Herpes Simplex Virus type 1 (HSV-1). A nasal HSV-1 outbreak usually begins with a tingling or burning sensation before clusters of small, painful, fluid-filled blisters appear in or under the nose. These vesicles eventually burst, leading to painful sores that dry out and form a scab as they heal. Since HSV-1 remains dormant in the nerve cells, these viral blisters can recur, often triggered by stress, illness, or sun exposure.
Irritation, Trauma, and Environmental Triggers
Many nasal sores are caused by physical injury or irritation to the delicate internal nasal lining rather than an active infection. Physical trauma, such as chronic nose picking, aggressive rubbing, or overly forceful nose blowing, can easily damage the skin, leading to small cuts, bleeding, and scabs. Once the skin is broken, the resulting wound becomes sore and vulnerable.
Environmental conditions, particularly low humidity or extreme dryness, are frequent contributors to nasal soreness and cracking. Dry air can dehydrate the nasal lining, causing it to become brittle and prone to cracking, which then manifests as painful sores or scabs. Frequent or prolonged use of certain medicated nasal sprays can also dry out the nasal airways, increasing irritation.
Allergies or chronic nasal conditions can further compound this irritation, as inflammation and excessive mucus production lead to constant wiping. Certain chemical irritants, such as harsh cleaning products or cigarette smoke, can also inflame the nasal lining, making it more susceptible to developing sores.
Over-the-Counter Relief and Home Management
For minor nasal blisters and sores, home management focuses on soothing the area. Applying a thin layer of a soothing product, such as petroleum jelly or specialized nasal moisturizers, can help combat dryness and cracking, promoting a moist environment conducive to healing. This also creates a protective barrier over the sore, which reduces friction and further irritation.
Maintaining gentle nasal hygiene involves avoiding any further manipulation of the area, including picking or aggressive rubbing. If the sore is painful or swollen, applying a warm compress to the external area for short intervals can help reduce inflammation and discomfort. Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can be taken orally to manage pain and tenderness.
For a suspected viral cold sore outbreak, topical over-the-counter antiviral creams containing ingredients like docosanol may help reduce the recovery time if applied at the first sign of tingling. If home care does not yield improvement, further steps may be necessary.
When to Seek Professional Medical Diagnosis
While most minor nasal sores resolve on their own within one to two weeks, certain symptoms signal the need for a professional medical evaluation. You should seek diagnosis if symptoms persist beyond 7 to 10 days, or if the pain, redness, or swelling begins to worsen rapidly or spread. The presence of systemic symptoms, such as a fever, or the occurrence of deep, large, or frequently recurring blisters warrant consulting a doctor.
A medical professional is necessary to accurately distinguish between viral, bacterial, or non-infectious causes. For a bacterial infection like Nasal Vestibulitis, a doctor may prescribe a targeted treatment, such as a topical or oral antibiotic, to prevent the infection from spreading. For severe or recurring viral outbreaks, prescription-strength antiviral medications may be necessary to shorten the duration of the episode. Consulting a physician ensures the underlying cause is addressed with appropriate treatment.