What is the treatment for a red patch on the bottom of the left nostril?

Treatment for Red Patch on Bottom of Left Nostril

The most effective treatment for a red patch on the bottom of the left nostril is application of a topical intranasal corticosteroid spray, which should be used as first-line therapy due to its anti-inflammatory properties and safety profile. 1

Diagnostic Considerations

Before initiating treatment, it's important to consider the likely causes of a red patch in this location:

1. Allergic or non-allergic rhinitis - Common cause of nasal inflammation
2. Localized irritation or dermatitis - From environmental irritants or trauma
3. Vestibulitis - Inflammation of the nasal vestibule
4. Early sinusitis - May present with localized inflammation

Treatment Algorithm

First-Line Treatment:

• Intranasal corticosteroid spray (e.g., fluticasone, mometasone)
  • Apply 1-2 sprays in the affected nostril once daily
  • Proper technique: tilt head forward slightly, direct spray away from septum
  • Continue for 2-4 weeks for optimal effect 1

Adjunctive Measures:

• Saline nasal irrigation

  • Use twice daily to cleanse the area and reduce inflammation
  • Helps remove allergens and irritants 1

• Cold compresses

  • Apply for 5-10 minutes several times daily
  • Reduces inflammation and provides symptomatic relief 1

For Persistent Cases:

If no improvement after 7-10 days with first-line therapy:

• Consider topical antibiotic ointment (bacitracin)

  • Apply a small amount to the affected area 1-3 times daily 2
  • Use only if bacterial infection is suspected
  • Limit use to 7-10 days to avoid developing resistance or contact dermatitis 3

• Avoid nasal decongestant sprays

  • While they provide temporary relief, prolonged use beyond 3-5 days can cause rebound congestion and rhinitis medicamentosa 1

Special Considerations

When to Seek Further Evaluation:

• If symptoms persist beyond 2-3 weeks despite treatment
• If accompanied by fever, severe pain, or spreading redness
• If the patch is unilateral, growing, or changing in appearance
• If there is bleeding or crusting that doesn't resolve

Cautions:

• Avoid prolonged use of topical antibiotics - Can lead to bacterial resistance and contact dermatitis 3
• Avoid petroleum-based products deep in the nose - Risk of lipoid pneumonia if aspirated
• Avoid excessive nose-blowing or picking - Can worsen irritation and delay healing

Prevention Strategies:

• Maintain adequate humidity in living spaces
• Avoid known irritants and allergens
• Practice good hand hygiene to prevent introducing bacteria
• Apply a thin layer of petroleum jelly to the outer rim of nostrils (not deep inside) during dry seasons

The evidence strongly supports intranasal corticosteroids as the most effective treatment for nasal inflammation, with the best safety profile for long-term use 1. While topical antibiotics may be considered for suspected bacterial infection, they should be used judiciously due to increasing concerns about antibiotic resistance and contact sensitization 3.