Rhinophyma

Rhinophyma describes a persistent, firm, thickening of the tissue of the nose that is seen in some patients with rosacea

Skin condition:  Rhinophyma

What is this skin condition?

Rhinophyma describes a persistent, firm, thickening of the tissue of the nose that is seen in some patients with rosacea. The appearances arise due to an overgrowth of oil glands and to a lesser degree fibrous tissue. Phymatous swellings can occur at other sites in association with rosacea. These include the chin, ears, forehead and eyelids.

There are some other rare conditions that can cause swelling of the nose so if you have noticed a swollen nose it is important to get a formal diagnosis from a Doctor.

Why have I got it?

Rhinophyma is generally considered to part of the rosacea spectrum of diseases. Whilst some affected patients do have prominent and active rosacea, others have minimal disease. The precise cause of rhinophyma is not known.  Some authors refer to rhinophyma as a rosacea associated condition as the link between the two conditions is not yet understood.

Comparing the treatment options

Self-treatment

The same general measures that apply to rosacea treatment are thought to apply to rhinophyma. Any rosacea triggers need to minimised such as UV light, alcohol and extremes of temperature.

Help from your GP

There is no evidence that antibiotics help rhinophyma. If you are keen for treatment you will need to be referred to a Dermatologist

Help from a Dermatologist

There are both medical and surgical options for treating rhinophyma.

  1. In early stage disease there is some evidence that the medicine, isotretinoin, can be helpful. Isotretinoin has anti-inflammatory effects and also reduces the activity of the oil glands. Although there have not been formal clinical studies some authors have reported an improvement with isotretinoin treatment. This is an off-license use of isotretinoin.

 

  1. There are a number of surgical techniques that can be used to reduce the volume of the nasal tissue. These include excisional surgery, CO2 laser and electrosurgical re-modelling. The following images show before and after pictures of 2 patients with rhinophyma treated using electrosurgery. In this technique a heated loop of wire is used to carve the excess nasal tissue back to a normal shape. Any blood vessels are sealed as the cutting takes place. Thin layers of tissue are carved from the nose until it is slowly returned to a normal shape. During this process the top layer of skin, the epidermis, is completely removed. The epidermis re-grows out of the hair follicles to recreate the skin surface. These 2 patients were treated in Newcastle, UK by Dr James Langtry. Full patient consent has been obtained to display these pictures.

 

 

 

Patient A

pre-operative

IH 15.3.14 DSC_0091 A pre op 1

 

post- operative

IH 19.11.13 DSC_0073 (2) A post op 2

 

 

Pre-operative

IH 15.3.14 DSC_0091 (2) A preop 2

post-operative

IH 19.11.13 DSC_0073 (1) A post op

 

Patient A. Immediately post-operative

IH 15.3.14 DSC_0091 (1) A immed post op

 

 

Patient B

pre-operative

TD 30.9.13 DSC_0168 (1) B pre op

 

 

post-operative

TD 11.2.14 DSC_0083 (3) B post op


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