Rhinophyma

Rhinophyma describes the growth of the nose in some patients with Rosacea. It is an uncommon complication and if it occurs it is almost always a man. The distal part of the nose thickens up. In time it develops a knobby appearance and the pores may be significantly enlarged. Large superficial blood vessels sometimes develop.

Treatment:

Treatment requires physical destruction of the excessive growth of sebaceous and fibrous tissue. Topical and oral medications do not help other than reducing inflammation. The vascular laser used for flushing and blood vessels may reduce the redness but not the size of the nose.

A variety of techniques have been used including dermabrasion, hot knife surgery, electrosurgery as well as laser removal of tissue.

Laser treatment is best achieved by using a CO2 laser. It can be used in a cutting mode (CW –continuous mode) to reduce the bulk of the nose. The Silktouch laser is ideal. The tissue is vaporized so that the shape of the nose can be remodeled. Care need to be taken not to over treat but scarring is uncommon. A danger in over correcting is contracture pulling up the tip of the nose.

Local anesthesia using nerve blocks and local infiltration is used or general anesthesia is the other alternative.

Healing usually takes 2-3 weeks. There is a yellow colour to the skin because the sebaceous glands are exposed. There is oozing from the pared tissue and crusting will develop.

Most patients are delighted with the response to treatment.

1) Rhinophyma	2) Post Laser Treated	3) Nose Healed After Treatment