Rhinophyma (“rhino” – nose , “phyma” – swelling) is a chronic skin disorder characterised by a large, bulbous, red nose with bumpy skin. It is more common in males and with increasing age.
It is commonly associated with Rosacea, a very common inflammatory skin conditions that causes redness and flushing of the face, and rhinophyma may be a long-term consequence of Rosacea. Unfortunately, the common presentation of a ruddy coloured face and swollen red nose gave rise to the stigma that these men are boozers. This is not so and it is not related to alcohol intake however, if they do drink alcohol their face and nose will brighten because alcohol makes their rosacea flare.
There is a strong association with skin cancers, in particular BCC which can occur in 5% of sufferers.
The exact cause is not clear but we do know that it is associated with a number of factors:
- Rosacea sufferers, particularly in males, if poorly or not treated over many years
- Family history of Rosacea and/or Rhinophyma
- Fair skin (English, Scottish, Scandinavian, Eastern European)
- Increasing age, as noses and ears normally continue to grow with age
The skin, pores and oil glands on the nose will increase and become more prominent with age with the following changes seen:
- Gradual development of a swollen bulbous shape
- numerous enlarged oil glands, a waxy rough surface appearance
- enlarged pores which ooze sebum (skin oil) and may contain scaly plugs
- ruddy coloured skin tone with prominent blood vessels
- thickening of the skin layers
Rhinophyma can be treated with medicines or surgery.
Medical – Topical or oral antibiotics to reduce inflammation and redness (e.g. doxycycline and erythromycin orally, Rozex cream topically)
-Topical medications to minimise inflammation (e.g. Retin-A, azelaic acid)
-Oral medication to reduce oil glands and production (Roaccutane, as used for acne)
Surgical – This is the preferred treatment in most cases and offers definitive treatment of rhinophyma by reducing the thickened overgrown skin and oil glands, reducing the size and re-shaping the disfigured nose. This is generally done with scalpel and laser combined.
Treatment benefits include psychological well-being, improved professional and social interactions through improved confidence, and importantly, it will nearly abolish the risk of skin cancer on the nose.
The nose has a resurfaced raw appearance but does not require any dressings. There may be some soreness or stinging for a couple of days but no significant pain. Healing is quite rapid and total downtime is around 10-12 days
Results are generally very good to excellent with an extremely high satisfaction rate.
Most concerns have more than one course of treatment. Feel free to contact us so one of our team can discuss options for your unique concern.