This condition typically affects men more often than women and usually develops in more severe, untreated or not well controlled cases of severe rosacea. Rhinophyma can cause the nose to appear bulbous and irregular, sometimes called a potato nose, leading to both cosmetic concerns and, in some cases, functional issues such as nasal obstruction.
Rhinophyma can vary in presentation and severity including any or all of the following:
- Glandular Rhinophyma: Marked by enlarged prominent oil glands or skin pores resultsing in an uneven, bumpy surface.
- Fibroangiomatous Rhinophyma: Characterised by redness, thickening of the skin, with prominent visible blood vessels.
- Fibrous Rhinophyma: Involves firm, thickened skin with thickened and excessive growth of the skin’s collagen layer.
The exact cause of rhinophyma is not fully understood, but it is often linked to untreated or poorly managed rosacea.
Key contributing factors include
Chronic Inflammation
Long-term inflammation in rosacea (which results in redness, skin sensitivity along with pimple like lesions) leads to skin thickening and tissue growth.
Hormonal Factors
More common in men, particularly those over 50 years old.
Genetic Predisposition
A family history of rosacea or rhinophyma may increase the likelihood of developing the condition.
Environmental Triggers
Factors such as excessive sun exposure, alcohol consumption, and spicy foods can exacerbate rosacea and contribute to rhinophyma and its progression.
Effective Rhinophyma Treatments:
Treating rhinophyma often involves a combination of medical and procedural interventions including laser. Early management of rosacea is critical to prevent progression to rhinophyma. For early or established cases, the following treatments are recommended:
For Moderate to Severe Rhinophyma: Laser therapy for Rhinophyma Ablative Laser Treatments
- Acclaro Ultraclear
- Offers a controlled, layer by layer removal approach with faster healing times compared to traditional electrosurgical methods.
- Use of its microcoring and deep fractionated modes also help repair and remodel deeply to target the skin changes that drive rosacea and rhinophyma.
- This laser has multiple options to provide a tailored, individualised approach to treating a bulbous nose.
a cutting-edge ablative laser that precisely targets and remove excess tissue, to sculpt and smooth the skin, reducing the bulbous appearance of the nose.
- Alma Hybrid
- Particularly useful for achieving both functional and cosmetic improvements.
combines ablative and non-ablative laser technologies to effectively reduce thickened skin, improve texture, and promote collagen & elastin remodelling.
Early (mild to moderate severity) Rhinophyma:
Candela Matrix: radiofrequency (RF) microneedling device that provides effective treatment for early rhinophyma by targeting enlarged oil glands, and increased amount of blood vessels, improving skin texture and reducing redness and inflammation and swelling.
- RF microneedling stimulates normal collagen production to prevent further skin thickening.
- Targets early-stage tissue changes to delay progression.
- Minimally invasive with only limited downtime.
Surgical Intervention/Electrosurgery for Rhinophyma: in severe cases, surgical sculpting or electrosurgical removal of abnormal or involved nose skin may be necessary to remove excess tissue and restore nasal contours. This is often combined with ablative laser treatment for optimal results. Dermabrasion treatment for rhinophyma has largely been superseded by the combined use of electrosurgery and new generation lasers.
Vascular laser (Candela V Beam Prima, Candela Nordlys) may be used or recommended in follow up after Alma hybrid and Ultraclear laser treatments to address redness if needed and/or as a maintenance treated every year or two.
Topical and Oral Medications
- Topical Treatments: may include antibiotics or anti-inflammatory agents to manage rosacea-related inflammation and help prevent recurrence of rhinophyma after effective treatment.
- Oral Medications: such as isotretinoin, can help reduce sebaceous gland activity, inflammation and prevent rhinophyma recurrence.
Maintenance Skincare
- Use gentle, rosacea-friendly products to manage inflammation and protect the skin’s barrier.
- Daily application of broad-spectrum SPF 50+ sunscreen to prevent exacerbation by UV exposure.
Rhinophyma is a challenging condition that can significantly impact both a person’s appearance and confidence. Effective treatment options however are available. Early intervention with rosacea management is key to preventing progression, while advanced technologies such as the Acclaro Ultraclear, Alma Hybrid, and Candela Matrix offer excellent results from early disease to severe rhinophyma. Schedule a consultation at KDAA to create a personalised treatment plan and restore your skin’s health and appearance.
