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What Is Nasal Vestibulitis?

Reviewed by Dan Brennan, MD on April 24, 2021

Nasal vestibulitis is when there is an infection in your nasal vestibule. Your nasal vestibule is located just inside your nostril or nose opening. It’s lined with skin that has thick hairs. The hairs help to stop dust, dirt, and other particles from entering your lungs.

It’s a common infection but can lead to some rare and life-threatening complications. 

Symptoms of Nasal Vestibulitis

The symptoms of nasal vestibulitis include:

  • Fever
  • Painful swelling of your nose
  • Boils (furuncles) in your nasal vestibule 
  • Dryness
  • Crusting in your nostrils
  • Nosebleeds
  • Bumps filled with pus

If your nasal vestibulitis persists or keeps coming back, see your doctor. They may need to carry out some tests to rule out basal or squamous cell carcinoma.

Squamous cell carcinoma is a common form of skin cancer and it can be found in many parts of your body. If left untreated, it can spread to other parts of your body.

Squamous cell carcinoma of the nasal vestibule tends to be rare. It can sometimes be misdiagnosed as nasal vestibulitis.

Causes of Nasal Vestibulitis

Nasal vestibulitis is an infection caused by the Staphylococcus bacteria.

There are many types of bacteria that live in our noses and they’re usually harmless. But once there’s an injury to the tissues inside the nose, the bacteria can enter the wound and cause infection.

Injuries to your nasal vestibule can be caused by: 

  • Plucking your nose hair
  • Blowing your nose excessively  
  • Picking your nose
  • Nose piercing 
  • Objects stuck in the nose (most common in young children)

There could also be underlying reasons for this infection. One possible reason is viral infections such as herpes simplex and herpes zoster.

People with weakened immune systems, such as those with diabetes and autoimmune diseases, may be more prone to nasal vestibulitis.

In a study of 118 people with nasal vestibulitis, 10% of them also had diabetes:

Researchers also found that cancer patients taking targeted anticancer drugs frequently develop nasal vestibulitis. Of 115 cancer patients who developed nasal vestibulitis when on anticancer treatment, 13% of them had repeated occurrences.

Continued

Researchers studying cancer patients found that nasal vestibulitis symptoms are common among those seeking cancer treatment. Yet doctors don’t always record or treat them. Some doctors list these symptoms as allergies or nosebleeds instead.

There have been few research studies on nasal vestibulitis. Experts say it’s a common condition, especially among older adults.

Complications of Nasal Vestibulitis

Your nose is part of the “danger triangle” of your face. This area of your face covers the corners of your mouth to your nose bridge. It’s a dangerous area because many of the blood vessels in this area are directly linked to your brain. This means that infections here may spread to your brain, although this is very rare. 

Some possible complications of nasal vestibulitis include the following.

Facial cellulitis.Cellulitis is a serious bacterial infection of the skin. It’s usually caused by streptococci or staphylococci bacteria. Among its symptoms are: 

  • Pain
  • Warmth
  • Redness of the skin that spreads rapidly
  • Swelling 
  • Fever and enlarged lymph nodes in more serious infections

Continued

If left untreated, cellulitis can spread quickly throughout your body. The infection can spread to your bloodstream and lymph nodes. Seek emergency care immediately if you have a fever and a red, tender, and swollen rash, or if the rash is changing quickly. 

Cavernous sinus thrombosis. Your cavernous sinuses are located at the base of your brain. The blood from the veins on your face drains into these sinuses. Cavernous sinus thrombosis is a very rare complication when bacteria from facial infections cause a blood clot in your cavernous sinuses. Its symptoms include: 

  • Severe headache
  • Severe pain, especially in the eye area
  • High fever
  • Paralysis or weakness of the eye muscles (ophthalmoplegia)
  • Bulging eye 
  • Swollen eyelid 
  • You may begin to lose feeling in your face
  • Confusion and seizures, which may mean that it has spread to the central nervous system 

Cavernous sinus thrombosis is treated with high doses of intravenous (IV) antibiotics and sometimes corticosteroids.

The underlying infection will also need to be treated. Starting anticoagulant therapy within 7 days of hospitalization may help reduce the risk of death. Anticoagulant drugs will help stop your blood from thickening.

Treatment for Nasal Vestibulitis

Talk to your doctor to work out a suitable treatment for your nasal vestibulitis.

Most cases of nasal vestibulitis can be treated with topical antibiotic creams, such as bacitracin ointment or mupirocin. You may have to use these ointments twice a day for 14 days.

Your doctor may also recommend saline drops or nasal emollients.

If you have boils in your nose, you’ll be prescribed oral antibiotics as well as topical ointments. Your doctor may also recommend that you apply a hot compress three times a day for about 15 to 20 minutes. If the boils don’t go away after taking antibiotics, your doctor may need to surgically drain them. It’s important to treat these boils to prevent further complications.

WebMD Medical Reference

Sources

SOURCES: 

Archives of Internal Medicine: “Septic Thrombosis of the Cavernous Sinuses.”

Diagnosis in Otorhinolaryngology: “Nasal Vestibulitis and Nasal Furunculosis and Mucormycosis.”

Diagnostic Microbiology and Infectious Disease: “Nasal vestibulitis: etiology, risk factors, and clinical characteristics: A retrospective study of 118 cases.”

Drug Invention Today: “A case report on nasal vestibulitis associated with preseptal cellulitis.”

Indian Journal of Otolaryngology and Head & Neck Surgery: “Cavernous Sinus Thrombosis of Nasal Origin in Children."

Journal of Clinical Oncology: “Nasal vestibulitis as an under-recognized and undertreated side effect of cancer treatment.”

MAYO CLINIC: “Cellulitis,” “Squamous cell carcinoma of the skin.”

MSD MANUAL: “Bacterial Nasal Infections," “Cavernous Sinus Thrombosis,” “Cellulitis.”

NATIONAL CANCER INSTITUTE: “nasal vestibule.”

Otolaryngology Case Reports: “A rare case of squamous cell carcinoma arising from nasal vestibule.”

Supportive Care in Cancer: “Nasal vestibulitis due to targeted therapies in cancer patients.”

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