Red spots on my nose for over 10 years. How can I remove these? (Photos)

Question

Red bumps on nose for 10 years or more. They look like pimples. I have to use steroid medications like Mometasone because of seborrheic dermatitis.

Anna Chacon, MD, FAAD · Answer

Thank you for your question and for sharing your long-term concern.

Based on your description — red spots on the nose persisting for over 10 years and a background of seborrheic dermatitis treated with Mometasone — these bumps could be one of the following:

Rosacea (Subtype: Papulopustular or Erythematotelangiectatic) – This is a chronic condition that often presents with red bumps, especially on the nose and central face, and can persist for years if untreated.

Sebaceous hyperplasia – Enlarged oil glands often appear as flesh-colored or slightly red papules, particularly on the nose.

Steroid-induced rosacea or perioral dermatitis – Long-term use of topical steroids like Mometasone on the face can cause or worsen these conditions, leading to persistent red bumps.

Acneiform eruptions – Less likely if this has been stable for over a decade, but still a consideration.

Management Recommendations:
Stop using topical steroids on the face (unless explicitly prescribed short-term by a dermatologist) — they can worsen or cause persistent facial eruptions over time.

Switch to non-steroidal anti-inflammatory creams such as pimecrolimus or tacrolimus if anti-inflammatory action is still needed.

Topical treatments like metronidazole, azelaic acid, or ivermectin cream can be helpful for rosacea or steroid-induced dermatitis.

Oral medications such as doxycycline (low-dose) may be needed for persistent inflammation or redness.

Laser therapy or IPL (intense pulsed light) could reduce visible redness and vascular components if present.

If the red spots resemble dilated capillaries or have not changed in many years, they may also be benign vascular growths like telangiectasias or angiomas, which can be treated with lasers.

Consistent and gentle skincare, sun protection, and discontinuing facial steroids are essential in helping manage and improve this condition.

Anil R. Shah, MD · Answer

Hello, my name is Ranen and I am an aesthetic nurse at Aesthetic skin in Chicago.  It makes sense that you’re confused and frustrated — red bumps on the nose for 10+ years, combined with seborrheic dermatitis and long-term steroid use (mometasone), fits a very recognizable pattern. I’ll explain what the pattern likely is, why it happens, and what general steps help — without giving medical instructions.  This happens very often when topical steroids are used long-term on the face, especially on the nose and around the mouth.  Common options used for both seb derm and steroid rosacea include: Pimecrolimus (Elidel), Tacrolimus (Protopic). These reduce inflammation without causing the steroid damage cycle.

Raffy Karamanoukian, MD, FACS · Answer

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser.  Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.  
Best,
Dr. Karamanoukian 
Realself100 Surgeon

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