The skin region above the upper lip, including the philtrum, is susceptible to a wide variety of lesions. These bumps range from very common and harmless skin irritations to less frequent infectious or structural issues. Understanding the underlying cause is the first step toward appropriate management. However, a definitive diagnosis always requires a medical professional.
Temporary and Inflammatory Skin Reactions
The most frequent causes of raised bumps above the lip relate to localized inflammation or irritation. Acne, or acne vulgaris, occurs when hair follicles become clogged with a buildup of oil (sebum) and dead skin cells. This blockage leads to the formation of whiteheads, blackheads, or small red, inflamed papules and pustules.
Hair removal, such as shaving or waxing, can result in ingrown hairs, a form of folliculitis. This develops when a hair curls back and grows into the skin, causing a small, red, and often painful bump. These bumps mimic pimples but are related to the hair follicle structure.
Contact dermatitis is a common inflammatory reaction, triggered by direct contact with an irritating substance or an allergen. Products like toothpaste, lip balm, cosmetics, or hair removal creams can cause the skin to react with redness, itching, and small bumps. Perioral dermatitis is a similar rash characterized by tiny red bumps and mild flaking around the mouth, often triggered by topical steroids or certain facial products.
Bumps Caused by Viruses and Bacteria
Bumps in the perioral area can result from an active infection caused by a virus or bacteria, often requiring specific treatment. Cold sores, caused by the Herpes Simplex Virus 1 (HSV-1), are a common viral cause. An outbreak begins with a tingling, itching, or burning sensation (the prodromal stage), before a cluster of small, fluid-filled blisters emerges.
These blisters eventually break open, weep fluid, and crust over with a characteristic honey-colored scab as they heal, a process that usually takes one to two weeks. Cold sores are highly contagious and tend to recur because the virus remains dormant in nerve cells.
Warts, caused by the Human Papillomavirus (HPV), may appear on the lips or surrounding skin. These growths are firm, flesh-colored, and have a rough, raised, or sometimes cauliflower-like texture. A specific type, the filiform wart, appears on the face characterized by long, thin, thread-like projections.
Impetigo, a bacterial infection, often causes bumps in children or after the skin barrier is broken. Lesions appear as small red sores that quickly rupture and develop a thick, amber or honey-colored crust. This superficial infection is highly contagious and is usually caused by Staphylococcus or Streptococcus bacteria.
Benign Cysts and Glandular Issues
Some bumps are structural abnormalities, not inflammatory or infectious, related to the specialized glands and tissues of the lip area. Fordyce spots are a variation of normal anatomy, appearing as tiny, painless, white, or yellowish bumps often clustered near the edge of the lips. These are visible, enlarged sebaceous glands that are not associated with a hair follicle.
A mucocele is a structural lesion that develops when a small salivary gland duct becomes blocked or severed, often due to physical trauma like biting the lip. This blockage causes mucous to leak into the surrounding tissue, forming a soft, dome-shaped swelling that can range from clear to a slightly bluish hue. Mucoceles are usually smooth, movable, and generally painless.
Tiny, firm, white bumps known as milia can also form above the lip. Milia are small cysts filled with trapped keratin, a protein naturally found in skin cells, which occurs when this material becomes lodged just beneath the skin’s surface. While common in infants, milia can affect adults and are harmless, often resolving without intervention.
Identifying When Medical Attention is Necessary
While many bumps above the lip are benign and resolve on their own, certain signs suggest the need for medical evaluation. Consult a healthcare provider if a bump persists for longer than two weeks without healing or improving. Rapid changes in size, shape, or color are warning signs that warrant attention.
A medical consultation is advisable if the bump begins to bleed spontaneously, develops an irregular border, or becomes painful, especially if the pain is severe or worsens over time. Signs of a spreading infection, such as fever, surrounding skin that is hot to the touch, or red streaks extending away from the bump, require prompt assessment. A doctor or dermatologist is the only person who can provide a definitive diagnosis, especially to rule out rare but serious conditions.