Some folks may be feeling pimples around their nose and mouth as they endure yet another exhausting and protracted allergy season. Perioral dermatitis, a skin disorder marked by an itchy, stinging rash, has been linked to the usage of steroid nasal spray allergy treatments.
But occasionally, steroid medicines can also have an impact on the skin around your nose, possibly leading to an exacerbation of perioral dermatitis, according to Dr. Teo Soleymani, a board-certified dermatologist in Pasadena, California. Rarely does the drug result in the onset of perioral dermatitis, but most persons who suffer the condition after taking steroids already have it.
According to Soleymani, perioral dermatitis is a fairly prevalent skin ailment that is frequently misdiagnosed.
Around the nose and mouth, the illness typically manifests as a rash of tiny red or flesh-colored pimples, according to him. According to the American Academy of Dermatology, the rash may also be itchy, burning, or sensitive, and it can result in dry, flaky skin in the affected area.
Soleymani explains that although it is frequently mistaken for an eczema-like rash or contact dermatitis, it actually belongs to the same family as acne and rosacea. Under a microscope, perioral dermatitis resembles rosacea and acne, despite not having the same outward appearance, he claims.
Dermatologists frequently witness patients with perioral dermatitis present with symptoms, and since they mistakenly believe they have another form of rash, they attempt to cure it at home with over-the-counter topical steroid creams.
These creams are “notorious for momentarily masking and controlling perioral contact dermatitis only to have it re-flare within minutes of stopping the topical steroid,” according to Soleymani. At that time, patients usually notice that their symptoms return as soon as they discontinue the creams, and they seek more medical advice from their doctor or dermatologist.
Although the connection between these drugs and perioral dermatitis is not fully understood, it is generally accepted that it is an inflammatory reaction linked to immune system dysfunction. According to Soleymani, using steroid medicine only temporarily reduces the inflammatory response; it does not address the immune system’s fundamental problem. As a result, people’s symptoms recur when they stop taking the drug.
Steroid sprays for nasal allergies and perioral dermatitis
Although oral and topical steroid medicines are the most frequently associated with perioral dermatitis flares, “we also see this in steroid that are a spray, such as Flonase,”
This is partially due to the fact that perioral dermatitis frequently flares up in the sprayed area of the nose, the opening around the nostril. The drug may also penetrate into the skin if any of it drips out of the nostril. This can result in a flare-up of perioral dermatitis in the future.
According to Soleymani, some persons first become aware of the connection between nasal steroid sprays and perioral dermatitis after taking them for a few weeks or after using them intermittently. “They say their perioral dermatitis appears OK or a little bit better initially, and then it comes right back,” he says. They might also observe that their rash gets worse after using those treatments for a few weeks.
However, this is much less frequent than a scenario in which someone first has perioral dermatitis, perhaps in a very mild form that they are unaware of, and then experiences a flare-up after taking steroid medication.
You don’t have to cease using your nasal allergy steroid sprays if you are prone to perioral dermatitis or other sensitive skin conditions. But before using them, it’s important to consult a doctor, allergist, or dermatologist. You should also watch out for any negative effects on your skin, the specialists advise.
Despite the fact that the drugs may be purchased over-the-counter, Bernstein advises that “they should be used under the guidance of a physician.” He advises seeking advice from your physician, allergist, or immunologist before taking a nasal allergy steroid spray for the first time. He adds that he routinely has these discussions with his own patients.
Make sure you’re taking the medication as prescribed and following the instructions on the packaging. more specifically
To ensure that the drug penetrates your nostrils sufficiently, spray it at the proper angle.
Avoid turning your head so that the drug drips onto your skin. If it does drip out, Soleymani advises quickly blotting it with a paper towel.
Avoid missing days. A flare-up may result from inconsistent medication use.
Despite being an unpleasant annoyance, perioral dermatitis is not harmful. However, allergy-related symptoms, particularly asthma symptoms, might affect your quality of life and breathing capacity. You may decide that perioral dermatitis pimples are worth it if you’re utilizing the nasal steroid spray to treat those symptoms.