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    Sinus Scabs
    Jofu17 posted:
    For several years, I have been getting scab like formations in my lower sinus area. These scabs cause symptoms similar to strep throat - sore throat, fever, enlarged/painful lymphnodes, congestion and drainage, but no vomiting; when tested for strep by my pcp, the test is always negative. My tonsils were taken out 1 year after the scabs started forming in the hopes that this would end the problem. Unfortunately the scabs were not forming on top of the tonsil, but instead on the soft sinus area just above where the tonsils were. When I remove the scabs, the symptoms disappear within 12 hours.

    The scabs are usually twice the size of the first digit of my thumb. You can see ridges on the underside where it filled crevices in the skin of the sinus area. The top side of the scab is smooth. There is blood interwoven into the mucus visible usually from the underside only.

    I have been unable to determine what these are, unable to find anyone else who gets them, and unable to find a solution outside of manual removal of the scabs. Is there a name for this type of scab and is there something I can do to prevent them?
    Rod_Moser_PA_PhD responded:
    I am sorry, but unless I had the opportunity to examine you and see these "sinus scabs" I would not be able to identify the problem, let alone tell you how to prevent them. Based on your description, you are not really talking about the sinuses -- the paranasal sinuses are BONY areas on each side of your nose, below your eyes, and above your eyes, not where you are describing this problem.

    Have you seen an ENT? If not, this would be your logical next step. Sorry that I couldn't help.
    Jofu17 responded:
    Thank you for the quick response. At least now I have a direction to go it.
    dawnsway responded:
    I have I similar problem but I still have my tonsils. Almost every day I sneeze or cough up a rubber cement looking scab. It is a little smaller than a dime and is thick and hard, occasionally blood-streaked this has been going on for almost a year. I have not asked my doctor (I have no health insurance) because I'm dealing with more serious health problems and this seems minor in comparison. I'm still curious on what could be causing this and I'm wondering if it may be related to allergies? The only problem with that idea is that it is not clear drainage and there is a substantial amount of mucous that is the same consistency as rubber cement. One other point I can not produce anything when I blow my nose, only when I cough, sneeze or try to draw it to my throat and cough it out (gross I know). It happens during both the summer and winter months so I'm sure its not from dry air. Any Ideas?
    Rod_Moser_PA_PhD responded:
    You are facing the same situation.....a person cannot be adequately diagnosed over the Internet, based solely on a list of symptoms posted, and every person is different. Similar symptoms do not imply the same diagnosis....or treatment.

    Colds, allergies, environmental factors, smoking, chronic sinusitis causing postnasal drainage, etc. all are possibilities....and each one could require a different treatment approproach. This may not be a priority item in your life, but if it is annoying, it will need to be properly addressed at some point.
    ettesisters replied to Rod_Moser_PA_PhD's response:
    It is easy to say see a dr but as we state we have no insurance, I would like to add to the above situations that I also have. Mine started very fast. I have very bad sinus probs and use Clairitan D 12 hr twice a day. for a few years. The others did not mention what they take. OK, I have located the pain. We suffer when the scab is about to let go, it seems to take almost half a day. Then, we have a sore throat like strep but the difference is it is located where the nose meets the throat not lower and it does not affect tonsils. It feels like it does but it doesn't. some days the pain is as bad others or later in the day it is a burn. I am not sure if the pain is from the ripping of the scab. I as well as the other two posts would like to know why we have the scabs, what is causing the sore. I am going to try saline because salt is helpful to the sinus and salt is helpful for sore throat. I have had medication to cure flue and other illness but this does not clear up. Thank you for your information.
    Rod Moser, PA, PhD replied to ettesisters's response:
    I don't really believe there is a general answer that is appropriate for you. Every person is different, and the reasons for their symptoms will differ. Without the ability to examine YOU, I not be able to tell you why you are forming these "scabs" or the reason for the soreness. Insurance or not, the only way that you can be properly diagnosed is to be carefully examined by a good ENT -- using a rhinoscope (a fiberoptic device that can visually see the area of concern).

    In the meantime, it is a good idea to use the saline nasal spray and a good cool mist humidifier in your bedroom. Drink lots of fluids. And, finally, since antihistamines DRY mucous membranes, taking them may not be a good thing.
    RosieRiv replied to Rod Moser, PA, PhD's response:
    I also have the scabs. I have some other health issues and when seeing a new Dr would always ask about the throat scabs. Most Dr's would slightly tilt their head and look at me very strangely. I did go to a throat specialist recently and he diagnosed me with having chronic tonsillitis and tonsil stones. I looked up tonsil stones right away and undiagnosed myself! They look and are described nothing like what I described to the specialist and due to the fact that he did a very short examination I am clearly not suffering from tonsil stones. I will continue to research this and pray that I can find a Dr. that can help me. I have suffered for over a year from a sore throat. I cough the scab up a couple times a week and God forbid I am in public when it decides to come off. Dr. Moser, I respect your suggestion to seek an examination from a doctor but in my experience it is really hard, first of all to find a Dr to "listen" and to take me seriously and I have found it much more effective to seek out others who may have had the fortunate success of finding a Dr. that did. I am aware that Dr's are annoyed with the internet and patients trying to self diagnose but sometimes it is the only way we know that there are others with the same symptoms and that we are not as nutty as they think we may seem
    Rod Moser, PA, PhD replied to RosieRiv's response:
    Not all medical providers are created equal. Some do listen and take a patient's concerns seriously. Don't give up on the profession because your experience thus far has not been good.

    A sore throat for a year is not normal. Although I have no way of diagnosing you over the Internet without an exam, I encourage you to continue your search for a compassionate and thorough ENT. You may want to try a large, university-based medical center ENT department. The collaborative resoruces of MANy ENTs in these large teaching and research institutions are often better for these more ununusal...and, apparently, more-difficult-to-diagnose condtions.

    Seeking information via the the Internet is certainly not treatening to me, as long as those sites are MEDICAL. As you may have discovered: Not everything on the Internet is accurate (or scientifically-based).

    I wish you the best....
    wickedgirl65 replied to Rod Moser, PA, PhD's response:
    I have seen an ENT doctor no less than 3 times for the same type of problem and all they have been able to tell me is that my throat looks like hamburger with rubber cement all stuck to it and they have never seen anything like it - however, even though they can never tell me whats wrong they try to write me a prescription for medication to help with the problem. Unfortunately, I am hesitant to take the medication since I am concerned they are writing prescriptions without knowing whats wrong. It gets bad enough 3 to 4 times a year that it causes me to lose my voice - sometimes for weeks at a time.
    Rod Moser, PA, PhD replied to wickedgirl65's response:
    Then you need to see another ENT for a second opinion. If you never accept, nor embrace a treatment....not even trying it, you may never know if it would work. Not all conditions in medicine can be properly diagnosed (giving it a "name"), but that does not mean it cannot be treated.

    You need to see another ENT.
    girlfriday13 replied to dawnsway's response:
    Sigh. I have had the EXACT same thing off and on for the last 12-15 years. I have been to 4 ENTs and have had a biopsy. The doctors don't know what it is and don't know why it won't heal.

    I am a healthy, athletic, 42 year old female. Have never smoked. I did have surgery to repair a deviated septum in my early 20s and have always thought that it was somehow related, but the doctors don't think so.

    I do notice that it is worse in the winter (dry heat) or after a head cold, when a scab is produced and coughed up nearly every day. In the summer, when the air is moist, it seems to be better or I may go a week before a scab is "ejected" through coughing.

    However, for the past year or so I haven't coughed up a scab. This may have been due to a trip to Costa Rica where I spent a week in a really humid climate and it was able to heal over. Then I got a head cold and now the scab is back and I'm coughing one up every day. I am now using nasal gel and a humidifyer at night to try to heal the scab. This has been going on now for 2 weeks. I will try to remember to follow up in another 4 weeks to let you know if this moisture therapy has worked. If I could go another 2 years without a scab, that would be great.

    What is odd about it, is that a scab on the outside of your body will heal over more quickly with dry air. The problem with having a scab in your nose/throat is that if it dries out, it causes pain and you want to then get rid of the scab because getting rid of it brings immediate relief. I've always wondered what might happen if I could ignore the pain and leave the scab in there until it just fell off without any coughing to prompt its removal. However, since this really isn't an option (I couldn't tolerate a tight, sore throat for an indefinate length of time), I've found that if you can get new skin to form where the scab would be without the scab forming then you might be able to heal - at least temporariliy. Its tricking though, because if you don't keep it moist enough and a scab forms, and you cough this "rubber cement" thing up, you are basically starting from scratch with the healing process.
    Rod Moser, PA, PhD replied to girlfriday13's response:
    Thank you for those helpful comments....
    Lmcdaniel1970 replied to dawnsway's response:
    Hi there! I am hoping this post reaches you. I just came across this post and I am suffering with the same thing! You described exactly what I'm going through. I am SO frustrated and feel hopeless. I have a lot of fullness in my ears, especially the left one. The scabs you described started about a year ago. I have mucous that is so thick and sticky. I always have to try and get it's embarrassing. Allergy testing and sinus scans, etc. are showing nothing. Did you ever get a diagnosis? Thanks for your help!
    Rod Moser, PA, PhD replied to Lmcdaniel1970's response:
    Have you had a rhinoscopy -- An ENT will look directly up your nose with a fiberoptic scope? People with similar symptoms, may not have identical diagnoses. While I am sorry that no one has been able to diagnose YOU yet, or find an effective treatment, another person's diagnosis may be different, and certainly the treatment would need to be individualized.

    See a different ENT, my friend.....

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