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Rhinophyma / Rosacea of the Nose

Rhinophyma is a condition of very marked overgrowth of the sebaceous glands of the nose. This condition is a variant of the common skin condition rosacea. It manifests as enlargement of the nose and bulbosity of the nasal tip with enlargement of pores. This problem can be quite disfiguring as seen in pictures below. There are various treatments, both medical and surgical, which can improve rosacea and its associated effects on the nose, rhinophyma. Women tend to suffer more rosacea symptoms and men tend to manifest rhinophyma more commonly. The effects of rosacea on the nose and cheeks present symptoms of flushing and finally dilated small red veins visible at the surface of the skin.

Who does rosacea typically affect?
Rosacea usually afflicts people of Celtic and Southern Italian background, both with fair skin. People with brown or black skin are affected much less commonly. Patients are typically between 30-50 years old when this condition is present.

Are there any triggering or aggravating factors for rosacea or rhinophyma?
Extreme temperature, hot liquids, alcohol, spicy foods or sun exposure are aggravating factors for the rosacea component of this condition which occurs more in females. There is a stigma that all patients with a large red nose are alcoholics but this is in fact not true, although alcohol is one of the triggering factors.

How does rhinophyma occur?
The sebaceous glands that are typically overgrown in rhinophyma are regular skin glands that occur in all areas of our skin with the exception of the soles and palms. These glands produce an oily substance called sebum, a composition of fat and debris from dead fat-producing cells. The product is designed to lubricate skin in non-hair bearing skin and hair shaft itself in hair bearing skin. The sebum is brought to the surface of the skin through ducts. Excess sebum production can occur in response to poor hygiene, diet rich in fat, in conditions of accelerated glandular activity (like rosacea/rhinophyma) and naturally during adolescence.

How is rhinophyma treated?
Treatment of rhinophyma includes both laser treatment and medical treatment. Surgery can sometimes be used as well as dermabrasion in severe cases. The fractionated co2 laser (miix2) or the regular co2 laser is an excellent way of shrinking the skin and pores of the nose as well as nasal reshaping. The laser has a healing period of 1-2 weeks and there could be some scabbing or redness in the healing process. The dermabrasion and surgical treatment can also reshape deformed noses from rhinophyma. Surgery is usually performed under local anesthesia as an outpatient and involves dermaplaning the skin to go down to the deeper pores of the sebaceous glands that grow in this condition. The speed of healing depends on many factors, including how deep the surgeon needs to go with the laser or dermabrador.

Non-surgical treatment of rosacea is similar to acne and includes avoiding the many triggers of rosacea, meticulous cleaning, good skin hygiene, avoidance of foods that seem to worsen the condition, and antibiotics may be useful when small infections are present. It is important to check with your dermatologist for skin lotions that they may recommend as well.