Rhinophyma

Rhinophyma typically develops gradually over time, often starting with symptoms of rosacea such as facial flushing, redness, and acne-like papules and pustules. As rhinophyma progresses, the nose may become progressively larger, swollen, and irregular in shape, with prominent pores and sebaceous glands. Rhinophyma is typically skin-colored, but there may be prominent blood vessels with pitting and scarring. In severe cases, rhinophyma can cause functional and cosmetic concerns, including nasal obstruction, difficulty breathing, and significant disfigurement.

The exact cause of rhinophyma is not fully understood, but it is believed to be related to the underlying inflammation and vascular abnormalities associated with rosacea. Chronic inflammation and dilation of blood vessels in the skin of the nose contribute to the development of rhinophyma, along with other factors such as genetic predisposition, environmental triggers, and hormonal influences. Rhinophyma is much more common in male patients, possibly due to hormones.

Medical History

The team at Apex Skin Center will begin by asking about your medical history, including any symptoms you are experiencing, the duration and pattern of those symptoms, previous skin conditions or treatments, family history of rosacea, and any potential triggers or exacerbating factors.

Physical Examination

Board-certified dermatologist Dr. Knackstedt will conduct a thorough examination of the skin, looking for characteristic signs of rosacea or rhinophyma.

Skin Biopsy (if necessary)

In some cases, a skin biopsy may be performed to confirm the diagnosis of rosacea or rhinophyma and to rule out other skin conditions with similar features. During a skin biopsy, a small sample of skin tissue is removed and examined under a microscope by a pathologist to look for characteristic histopathological changes consistent with rhinophymatous rosacea. In most cases of rosacea or rhinophyma, this is not necessary.

Treatment options for rhinophyma may include:

• Medical Therapy: Topical and oral medications used to manage symptoms of rosacea, such as inflammation and acne-like lesions, may be prescribed to help control rhinophyma in its early stages.
• Loop electrosurgery: Loop cautery, also known as electrosurgical loop excision uses a small, heated wire loop to precisely remove excess tissue and reshape the nasal contour.
• Laser Therapy: Various laser treatments can be used to reshape and remodel the nasal tissue, reduce excess tissue, and improve the appearance of rhinophyma. Laser therapy can target blood vessels, sebaceous glands, and fibrous tissue, leading to tissue contraction and remodeling.
• Surgical Resection: In severe cases of rhinophyma that do not respond to medical treatment, electrosurgery or laser therapy, surgical resection may be necessary to remove excess tissue and reshape the nose.
• Combination Therapy: A combination of medical therapy and procedures may be used to achieve optimal outcomes in the treatment of rhinophyma, depending on the severity and characteristics of the condition. With appropriate treatment, many individuals with rhinophyma can achieve significant improvement in nasal appearance and function, as well as enhanced quality of life.