Nasal Vestibulitis - Causes, Risk Factors, Symptoms, Diagnosis, and Management

Introduction:

Nasal vestibulitis is a bacterial infection of the nasal vestibule. The nasal vestibule is located inside the nostril, near the nasal openings, or between the nostrils. Nasal vestibulitis is also known as nasal folliculitis. A nasal vestibule area is present with skin and thick hairs. The hairs act as self-defense and prevent foreign dust particles from damaging the nose and lungs. It is a rare type of bacterial infection caused by Staphylococcus aureus. Nasal vestibulitis is an inflammation of the nasal vestibule caused when the hair follicles become infected due to either a person pricking the nose, pricking the hairs from the nose, or excessive blowing of the nose. Nasal vestibulitis can also occur in healthy people. Some cancer treatments can also lead to an infection. Nasal vestibulitis is easy to treat but may lead to serious complications. The inflammation may cause pain and swelling and may heal by itself. Chronic rhinorrhea is the secondary cause of nasal vestibulitis. Other infections like folliculitis can also lead to pimples at the hair follicle root and result in the crust in the nostrils. Sometimes nasal vestibulitis can be treated and resolved on its own and sometimes may lead to serious complications.

What Are the Causes of Nasal Vestibulitis?

• Nasal vestibulitis is caused by a bacteria known as Staphylococcus aureus. Several types of bacteria live in the nose but are usually harmless. An injury to tissue inside the nose can cause bacteria to enter the nose and cause infection.

• The infection can be due to minor injury in the nasal vestibule due to pricking the nose, nose piercing, excessive blowing of the nose, plucking of nose hair, using nasal sprays, and in children, the objects stuck inside the nose.

• Some infections that cause nasal vestibulitis include herpes simplex (viral infection) and herpes zoster (viral infection). Allergies or respiratory infections can also cause chronic runny nose and upper respiratory tract infections. Cancer patients taking anticancer drugs frequently develop nasal vestibulitis.

What Are the Risk Factors for Developing Nasal Vestibulitis?

Nasal vestibulitis affects all ages, races, and sex, but the infection is most common among older adults. Mild nasal vestibulitis is very common among all people. The common risk factors are diabetes, weakened immune system, smoking, skin lesions in the nasal area, and patient taking anticancer and immunosuppressive drugs. Oxygen therapy through the nose can dry, irritate, and increase the risk of nasal vestibulitis.

What Are the Signs and Symptoms of Nasal Vestibulitis?

The symptoms of nasal vestibulitis vary according to the underlying cause and severity of the infection. Symptoms of nasal vestibulitis include.

• Severe pain and tenderness in the nostril area.

• Swelling in and out of the nose.

• Redness and discoloration in the nostril area.

• Yellow crusting in and around the nostril.

• A pimple-like growth inside the nose.

• Popping and picking growths can worsen the infection.

• Small bumps around or inside the nostril.

• Abscess in the nasal cavity.

• Fever.

• Pus discharge from the affected area.

• Boils in the nose.

• Bleeding from the nose.

• Chronic nasal vestibulitis or chronic recurring infection of nasal vestibulitis includes induration or thickening of the dermal layer of the nasal membrane and formation of crust.

How Can Nasal Vestibulitis Infection Be Diagnosed?

Nasal vestibulitis can be diagnosed by following the investigations include.

• Physical Examination - The healthcare provider can ask the patient for the symptoms and perform a physical examination of a wound to diagnose nasal vestibulitis.

• Laboratory Examination - The laboratory personnel can take a cotton swab from the nostril and examine it under a microscope to look for bacterial and viral infections.

How Can Nasal Vestibulitis Infection Be Managed?

The treatment of nasal vestibulitis depends upon the severity and cause of the infection. The treatment includes.

• The first line of treatment for nasal vestibulitis is the application of warm compression to the infected area a few times a day for 15 to 20 minutes.

• Most cases of nasal vestibulitis can be treated with topical antibiotic creams such as Bacitracin and Mupirocin ointment, preventing the infection from spreading and reducing the risk of recurrence. The doctor can prescribe the ointment twice a day for 14 days.

• The doctor may recommend saline drops and nasal emollients. In case of severe infections like boils, the doctor may prescribe an oral antibiotic such as Dicloxacillin for seven to ten days.

• Some people develop a painful, infected boil called furuncle. A doctor may recommend surgical removal and draining of the furuncle to prevent the spread of infection. The doctor may recommend rose geranium oil to people who have undergone chemotherapy to reduce the risk of infection, as the oil may clear the infection completely.

How Can Nasal Vestibulitis Infection Be Prevented?

A person can follow several strategies to reduce the risk of spreading or preventing the infection. The preventive measures include.

• Avoid plucking nose hairs.

• Avoid pricking the nose.

• Wash your hands before touching or blowing your nose.

• Minimize nose dryness.

• Seek medical treatment in case of medical conditions like diabetes.

What Are the Possible Complications Related to Nasal Vestibulitis Infection?

Many serious cases of nasal vestibulitis can lead to serious complications because the vein in the nose leads directly into the brain's dangerous area. The complication includes.

• Facial Cellulitis: It is a bacterial infection of the skin. The bacteria causing the infection is Staphylococcus. It occurs when the infection spreads behind the skin or other areas. The symptoms include pain, swelling at the tip of the nose, eventually spreading to cheeks, redness, fever, blisters, warm skin, and enlarged lymph nodes. If left untreated, the infection can spread quickly to the blood and lymph nodes.

• Cavernous Sinus Thrombosis: A cavernous sinus is a space present at the base of the brain and behind the eyes. The blood from the veins of the face drains into the sinuses. Bacteria from the face infection can spread and cause a blood clot in the cavernous sinus. Symptoms include severe headache, high fever, severe pain in the eye area, bulging eyes, swollen eyelid, severe facial pain, blurred vision, confusion, and seizures.

Conclusion:

Nasal vestibulitis is a common, bacterial, and treatable infection. Treatment involves topical or oral antibiotics. With treatment, the risk of the spread of infection can be decreased. Nasal vestibulitis is not a serious infection, but in rare cases, if left untreated, it can lead to serious complications. The healthcare team, including doctors, nurses, and pharmacists, can educate people about disease and prevention. The team can work together to reach better outcomes.