What should you know about perinasal rash?

Dry, itchy patches may fit atopic dermatitis, while a rash appearing after a new cleanser, cosmetic, mask or topical medicine may reflect contact dermatitis. Moisture and friction in the creases can contribute to intertrigo. Ringworm may form a scaly edge, while psoriasis can produce more defined, persistent scaling. Heat, sweating, medicines and mites are other possibilities.

The location alone cannot identify the cause. A clinician considers whether the rash is one-sided, spreading, crusted, blistered or associated with symptoms elsewhere. A new drug rash can affect more than the skin around the nose, so timing of every medicine matters.

Pause newly introduced fragranced products and wash gently with lukewarm water. Pat dry rather than rubbing, avoid picking flakes, and use a simple fragrance-free moisturiser if the skin is dry and not infected. Do not apply steroid, antifungal or antibiotic creams inside or around the nose without advice, because the wrong product can worsen some rashes or hide useful signs.

Keep a short record of products, medicines, heat exposure and flare timing. A clinician may need to examine the rash or test a scale sample before choosing treatment.

Arrange review if the rash persists, repeatedly returns, spreads, forms a painful crust or affects the eyes. Seek urgent help for facial swelling, trouble breathing, rapidly spreading blistering, skin peeling, eye pain or a severe illness after starting a medicine.

Ask what features point toward irritation, allergy, infection or inflammation; whether a swab or skin scraping is useful; which products to stop; and how long to try the recommended treatment. Tell the clinician about nasal sprays, cosmetics, shaving, medicines and allergies.