Nasal Vestibulitis

What is nasal vestibulitis?

Nasal vestibulitis is an infection in your nostrils, near the opening of your nose. It most often occurs with infections of the hair follicles inside your nostrils. This results in sores or pimples that develop just inside and around your nose.

How serious is nasal vestibulitis?

Most of the time, nasal vestibulitis is easily treatable and isn’t a cause for serious concern. But in severe cases, boils may develop inside your nostrils (nasal vestibular furunculosis). This can cause cellulitis (a spreading skin infection) at the tip of your nose.

At this point, the condition becomes more serious because veins in this part of your face (danger triangle of the face) lead to your brain. If bacteria spread to your brain through these veins, you may develop a life-threatening condition called cavernous sinus thrombosis or an infection in your brain.

If you have boils or painful swelling at the tip of your nose, call 911 or head to your nearest emergency room for treatment.

How common is nasal vestibulitis?

Mild nasal vestibulitis is quite common (and treatable). But the severe form is rare.

What does nasal vestibulitis look like?

Nasal vestibulitis symptoms may include:

• Pimples or sores inside your nostrils.
• Severe pain in your nose.
• Swelling and discoloration.
• Itching or bleeding just inside or around your nose.
• Yellow crusting or scabbing around your septum (the piece of tissue that separates your nostrils).

What causes nasal vestibulitis?

Staphylococcus bacteria are a common source of skin infections, including nasal vestibulitis. Possible nasal vestibulitis causes include:

• Excessive nose blowing.
• Picking your nose.
• Plucking nasal hairs.
• Nose piercings.
• Objects stuck in your nose (common among children).

Nasal vestibulitis may also develop as a complication of:

• Viral infections like shingles, herpes simplex or the common cold.
• A persistent runny nose (typically due to allergies).
• Other upper respiratory infections.

Is nasal vestibulitis contagious?

Nasal vestibulitis isn’t contagious, but germs that cause the condition are. Bacteria like Staphylococcus and viruses can spread to other people through physical contact or even through droplets in the air. To avoid contamination, wash your hands often and avoid sharing towels, eating utensils and other personal items with someone who has nasal vestibulitis.

What are the risk factors for nasal vestibulitis?

You’re more likely to develop nasal vestibulitis if you have:

• Autoimmune diseases.
• Diabetes.
• Cancer. (Research shows that nasal vestibulitis is common among people undergoing cancer treatment.)

What are the complications of nasal vestibulitis?

Possible nasal vestibulitis complications include:

• Cellulitis: Cellulitis is a bacterial infection of your skin and the tissue beneath it. It can develop when the infection inside your nostrils spreads to other areas. People with nasal vestibulitis may develop cellulitis in the tip of their nose. Left untreated, this infection can spread to your cheeks and other areas of your face — and ultimately, to your bloodstream or lymph nodes.
• Nasal abscess: Vestibulitis can form an abscess (pocket of pus) that, in some cases, may require intravenous (IV) antibiotics or surgical drainage.
• Cavernous sinus thrombosis: This condition occurs when bacteria from your face spreads to your cavernous sinus and causes a blood clot. Your cavernous sinus sits at the base of your brain, just behind your eyes. Cavernous sinus thrombosis is a serious, life-threatening complication and requires immediate treatment.
• Encephalitis: This condition is a serious and rare brain infection. It happens when bacteria or viruses from other parts of your body (like your face) travel to your brain.

How is nasal vestibulitis diagnosed?

A healthcare provider can diagnose nasal vestibulitis during a routine examination. They’ll ask about your symptoms and look inside your nostrils. You probably won’t need any special tests to confirm the diagnosis.

How is nasal vestibulitis treated?

Because bacterial infections usually cause nasal vestibulitis, healthcare providers treat the condition with antibiotics. Depending on the severity of your condition, your provider may prescribe:

• Topical antibiotics.
• Oral antibiotics.
• Intravenous antibiotics.

If the infection doesn’t respond to antibiotics, a provider may need to surgically drain any boils that’ve formed inside your nose.

Topical antibiotics

For mild cases of nasal vestibulitis, healthcare providers usually recommend topical antibiotic ointments. Two of the most common include bacitracin and mupirocin.

Oral antibiotics

For more moderate cases of nasal vestibulitis, healthcare providers may prescribe a round of oral antibiotics. Common medications include cephalexin, clindamycin and doxycycline.

Intravenous antibiotics

People with severe nasal vestibulitis (or nasal vestibulitis from antibiotic-resistant bacteria) may need intravenous antibiotics. A healthcare provider gives these medications through an IV in your arm. Common IV antibiotics include vancomycin, clindamycin and daptomycin.

How soon after treatment will I feel better?

Most people feel better in just a few days after starting treatment. Keep in mind, though — you’ll need to keep taking antibiotics exactly as directed until your healthcare provider tells you it’s OK to stop. Don’t stop taking them just because you feel better. The infection may come back. This can also lead to antibiotic-resistant bacteria, which need stronger, costlier antibiotics (many of which have higher risks of side effects).

Can I prevent nasal vestibulitis?

You can’t always prevent Staphylococcus infections and associated conditions like nasal vestibulitis.

But you can lower your risk for nasal vestibulitis by following these guidelines:

• Wash your hands frequently, especially before touching your face.
• Avoid excessive nose blowing if possible.
• Don’t pick your nose.
• Don’t pick at scabs or sores in or around your nose.
• Avoid plucking nose hairs (trim them instead).
• Don’t pop pimples or infected hair follicles in and around the entrance of your nostrils or on the outside of your nose.

What’s the outlook for someone with nasal vestibulitis?

With prompt treatment, the majority of people with nasal vestibulitis recover quickly and feel better in just a few days. It’s possible, however, for symptoms to worsen in rare instances.

If you develop a high fever, severe headaches, vision issues or skin that’s warm to the touch, call your healthcare provider right away. You may need stronger antibiotics to keep the infection from spreading further.

How long does nasal vestibulitis last?

With treatment, most cases of nasal vestibulitis last about three to four days.

When should I see my healthcare provider?

To reduce your risk of complications, you should see a healthcare provider at the first sign of trouble. Schedule an appointment if you develop:

• Sores or pimples inside your nostrils or around your nose.
• Nose itchiness.
• Crusting around your nostrils.

If you’re already receiving treatment for nasal vestibulitis, call your provider if:

• Your symptoms don’t improve after a few days on antibiotics.
• You develop a fever.
• You have redness, soreness or swelling that’s spreading to other areas of your face.

If nasal vestibulitis keeps coming back, let your healthcare provider know. They may need to run additional tests to rule out cancerous conditions, such as squamous cell carcinoma.

Can nasal vestibulitis go away on its own?

Though it’s possible for some bacterial infections to clear up without antibiotics, it’s not a good idea to play the waiting game with nasal vestibulitis. Prompt treatment helps reduce the risk of complications, such as cellulitis and cavernous sinus thrombosis.

A note from Cleveland Clinic

Nasal vestibulitis is a bacterial infection inside your nostrils. It causes sores, pimples and crusting around the opening of your nose. Nasal vestibulitis usually isn’t serious, especially when treated right away. Left untreated, however, the infection can spread to other areas of your face — and in severe cases, even to your brain. That’s why prompt treatment is essential.

If you think you might have nasal vestibulitis, schedule an appointment with a healthcare provider as soon as possible. Antibiotics can help get you back on track and help prevent further issues or dangerous complications.