Rhinophyma

What is Rhinophyma?

Rhinophyma is a soft tissue disease of the nose where there is tuberous enlargement of the skin of the lower half of the nose. It typically affects Caucasian men in the fifth to seventh decades of life. The only confirmed cause is an association with rosacea, with rhinophyma being a late and uncommon component of this disease.

The skin in rhinophyma becomes irregularly thickened. Sebaceous glands enlarge and make more sebum than usual. Early on, sebaceous glands increase in size and number. In later stages, ducts dilate, cysts form and there is more fibrous tissue which leads to visible nodules. Hidden basal cell cancers can form in the thickened tissues.

What techniques are available to treat rhinophyma?

Some medical treatments can be helpful (antibiotics, topical solutions, reducing alcohol and stress, steroids) but generally surgery is the only treatment to offer significant benefits and a chance of cure.

Many surgical techniques have been tried and described. They all involve shaving or in the case of a C02 laser burning off the thickened tissue with or without immediate resurfacing (skin grafts and flaps). If some of the sebaceous glands are preserved new skin will grow without the need for skin grafts and flaps.

What is the razor blade excision technique for rhinophyma?

A scalpel blade or disposable razor blade can be used to remove the outer, tuberous layers of the rhinophyma skin while preserving deeper tissues. A much smoother appearance can be achieved and significant scarring can be avoided. A disposable razor allows incremental removal of the outer layers of skin preventing inadvertent damage of deeper tissues such as nasal cartilage. Skin grafts are not needed after the procedure as new skin can regenerate from islands of sebaceous glands left behind.

How do I learn more about rhinophyma treatment?

Please make an appointment to see Dr Roth if you would like to discuss the surgical management of options of rhinophyma. Dr Roth treats rhinophyma using the razor blade technique. Some patients also subsequently undergo a rhinoplasty using standard rhinoplasty techniques if they desire further changes once the skin has been recontoured.

Approx 6 weeks following rhinophyma shaving. The skin is still a little red. This will settle in the coming weeks.