Nasal vestibulitis is an infection in your nasal vestibule — the area just inside your nostril or nose opening. It’s where you have small, thick hairs to trap particles such as dust and dirt so they don’t get into your lungs.
Nasal vestibulitis usually isn’t serious. But you probably will need antibiotics so it doesn’t spread. While very rare, nasal vestibulitis can turn into a life-threatening infection.
What Causes Nasal Vestibulitis?
Nasal vestibulitis is caused by bacteria. “Staphylococcus aureus is the most common bacteria that we find in nasal vestibulitis,” says Devyani Lal, MD, professor of otolaryngology at Mayo College of Medicine and Science in Phoenix, Arizona. “About 30% of us may actually carry Staph aureus in our noses.”
Most of the time, bacteria inside your nose are harmless. But if the tissue gets damaged, germs can enter the opening and cause an infection.
This can happen if you do things such as:
- Pluck your nose hair
- Have a runny nose for a long time
- Pick your nose
- Pierce your nose
- Get an object stuck in your nose
- Use a steroid nose spray or oxygen tubes
- Get an ingrown nose hair
You may be more at risk of nasal vestibulitis if you have:
- An upper respiratory infection, such as a cold or sinus infection
- A virus, such as herpes simplex and herpes zoster
- Allergies
- Cancer or cancer treatments
- Autoimmune disease
- A chronic skin condition, such as eczema
- A job where you work around dust or polluted air
“One of the most common subsets of patients who may be at risk are diabetic patients, especially if your blood sugars are not well controlled,” Lal says. “You’re more susceptible to bacterial infections with staph. [so] you have to be very careful about not letting this get out of hand and seek care early.”
Is nasal vestibulitis contagious?
You can’t catch nasal vestibulitis from someone else. But the germs that cause it can spread from person to person. They can spread in the air when you talk, laugh, cough, or sneeze close to someone. For instance, if someone with nasal vestibulitis wipes their nose on a tissue and then you touch it, the germs could infect you, too.
What Are the Symptoms of Nasal Vestibulitis?
If you have nasal vestibulitis, here’s what you may notice inside your nose or at the opening of your nostrils:
- Pimples
- Soreness
- Pain
- Redness or other changes in how your skin looks
- Swelling
- Itching
- Crusting (which may look yellow)
- Bleeding
- Scabbing
When to see a doctor for nasal vestibulitis
“If you know that you nicked yourself pulling a nose hair out and it’s sore, using an over-the-counter [antibiotic ointment like] bacitracin…is helpful,” Lal says. “If it doesn't get better or it’s getting worse in one or two days, then you might contact your primary care physician and let them know your symptoms.”
They can do an exam and start treatment if you do have nasal vestibulitis.
In some cases, your doctor may do a biopsy (test a small sample of your skin) to rule out other conditions.
“Sometimes, skin cancers can mimic an infection,” Lal says. For instance, both basal cell and squamous cell carcinomas can look like infections that aren’t healing.
It’s rare to have these types of skin cancer inside your nose, but if you do, it needs to be treated right away. If not, it can spread to other parts of your body.
What Are the Treatment Options for Nasal Vestibulitis?
Most of the time, nasal vestibulitis can be treated with an antibiotic cream, such as bacitracin ointment or mupirocin. Your doctor will tell you how often to use it.
“Apply a dab on the outside of your nose and gently massage it in,” Lal says. “Don’t put your fingers or Q-tips inside your nose. That can inherently cause more trauma.”
In more severe cases, “oral antibiotics may be helpful,” Lal says. Typically, common kinds such as amoxicillin or cephalexin are prescribed, but your doctor has other options if you have an allergy to either of these medications.
If you have boils (painful red bumps that may contain pus), a moist, hot compress, applied three times a day for 15 to 20 minutes, could help the area heal faster. In some cases, your doctor may also need to surgically drain them, which can help prevent serious problems.
Don’t assume you’re in the clear just because you take your antibiotics as prescribed.
“Certain species of staph bacteria have become resistant to some antibiotics,” Lal says. “If things are not getting better, it’s important to keep in touch with your primary care physician.”
What Are the Complications of Nasal Vestibulitis?
Your nose is part of what doctors call the “danger triangle” of your face. This area covers the corners of your mouth to your nose bridge. It’s a dangerous area because many blood vessels in it are directly linked to your brain. This means that infections here may spread to your brain, although this is very rare.
Complications of nasal vestibulitis include:
Cellulitis. This is a serious bacterial infection of the skin. It’s usually caused by streptococci or staphylococci bacteria. Symptoms include:
- Redness
- Pain
- Skin that feels warm to the touch
- Blisters
- Swelling
- Puckered or dimpled skin
- Fever or chills
If left untreated, cellulitis can spread quickly to your bloodstream, lymph nodes, and other parts of your body. Seek emergency care right away if you have a fever and a tender, swollen rash, or if the rash changes quickly.
Cavernous sinus thrombosis. Your cavernous sinus is different from the sinuses in your nose. It’s one large vein at the bottom of your skull. All the blood in your face drains into it. Very rarely, bacteria from a facial infection can cause a blood clot in your cavernous sinus.
Symptoms of cavernous sinus thrombosis include:
- Severe headache
- Severe pain, especially in the eye area
- High fever
- Paralyzed or weak eye muscles (ophthalmoplegia)
- Double vision
- Uneven or dilated eye pupils (the dark part of your eye)
- Bulging eye
- Swollen eyelid
- Loss of feeling in your face
- Feeling very sleepy
- Confusion and seizures, which may mean that it’s spread to your brain
Cavernous sinus thrombosis is treated with high doses of antibiotics that you get through an IV. Sometimes corticosteroids or other hormones are given. You may also need surgery to drain the infection.
Can I Prevent Nasal Vestibulitis?
To lower your risk of getting this type of infection:
- Always wash your hands before touching your face.
- Keep your fingers out of your nose.
- Trim, don’t pluck, nose hairs.
- Don’t pop pimples that are in or near your nostrils.
- Avoid using towels or sharing personal items with someone who has nasal vestibulitis.
Takeaways
Nasal vestibulitis is an infection inside your nose. It happens when the skin inside your nostrils gets damaged and bacteria get into it. If you have symptoms such as redness, soreness, bumps, or swelling that don’t go away in a day or two, see your doctor. While rare, nasal vestibulitis can turn into a life-threatening infection.
Nasal Vestibulitis FAQs
Is nasal vestibulitis always a staph infection?
Nasal vestibulitis isn’t always due to staphylococcus bacteria. But this type of germ (which naturally lives on your skin and sometimes inside your nose) is believed to be the most common cause.
Is nasal vestibulitis harmless?
Most of the time, nasal vestibulitis is easily treated and doesn’t cause other problems. But rarely, it can spread into your brain or turn into a life-threatening infection. Because of that risk, see a doctor right away if you have symptoms.
What can be mistaken for nasal vestibulitis?
You might mistake nasal vestibulitis for a pimple, ingrown hair, cut, or bloody nose. That’s why it’s important to see a doctor. They can quickly spot the symptoms of nasal vestibulitis and start you on treatment right away.
How long will nasal vestibulitis last?
Once you start antibiotics, nasal vestibulitis usually starts to improve in about three to four days. Even so, finish taking your antibiotics exactly as prescribed. If your symptoms don’t improve or worsen, let your doctor know.