Common Bumps Around the Mouth: Identification and When to See a Doctor

1. Canker Sores (Aphthous Ulcers)

• Small, round, yellow-white center with red halo.
• Inside lips/cheeks, soft palate, tongue.
• Triggers: trauma, stress, certain foods, nutritional deficiencies.
• Self-limited (7–14 days); topical steroids, barrier pastes for pain.

2. Cold Sores (Herpes Labialis, HSV-1)

• Clustered vesicles on vermillion border → crust.
• Prodrome: tingling, burning.
• Recurrent; contagious via direct contact.
• Antivirals (acyclovir, valacyclovir) shorten duration if started early.

3. Fordyce Spots

• Ectopic sebaceous glands – tiny (1–3 mm) yellow-white papules on lips, buccal mucosa, genitalia.
• Harmless, asymptomatic, no treatment needed.

4. Milia

• Keratin-filled microcysts – 1–2 mm white domes.
• Periorbital, perioral; spontaneous resolution or extraction by dermatologist.

5. Skin Tags (Acrochordons)

• Soft, pedunculated, skin-colored/flesh-colored.
• Friction areas; benign; removal by snip, cryo, electrocautery if desired.

6. Warts (Verruca Vulgaris, HPV)

• Rough, hyperkeratotic papules; may have black dots (thrombosed capillaries).
• Contagious; treat with salicylic acid, cryotherapy, immunotherapy, laser.

When to See a Clinician

• Uncertain diagnosis.
• Rapid growth, bleeding, ulceration, color change.
• Immunosuppressed patient.
• Cosmetic concern.