Fine scattered spots in nasolabial folds

[ReadyForSeason]

Seems to have appeared out of nowhere, subside for a few days, then breakout again. Skincare, food, nothing has changed. They start in the corners near nose and travel down in a loose cluster. Red like rash but they are separate scatters tiny spots.

Is there some antiseptic I can try, can this be fungal, hormonal? Aged 45, no history of acne or eczema, taking pill back to back, so no other symptoms of hormonal fluctuations.

I occasionally have peri-oral dermatitis, which sounds like what you're describing. The only thing that clears it up is doxycycline which is a type of antibiotic.

Skin can change in peri. I started getting small painful red spots on my nose if I put moisturiser on it, I found the clean and clear blackhead cleanser keeps them at bay.

Sounds like it could be perioral dermatitis or possible seborrheic dermatitis both fit the physical description and pattern on the face. I would see the GP to confirm as treatments differ depending on what it is.