Coping with...RHINOPHYMA

Advice from our Woman’s Weekly doctor

- Dr Gill Jenkins

This progressive bumpy swelling of the nose is related to rosacea

Rhinophyma is mainly seen in people with the skin condition rosacea. Initially redness and a few small bumps occur, then as it progresses, the nose becomes redder and swollen at the tip, the bumpy surface changing its shape. Eventually the nose becomes bulbous, and the bulky skin has prominent pores and scarring, causing disfigurement. The swelling is a result of scar tissue and enlarged, oil-producing sebaceous glands.

Rhinophyma mostly develops in rosacea that has been active and untreated for years, but some people have it without ever having rosacea. Much more rarely, swelling affects other parts of the face, including the chin and ears. Although rosacea affects more women than men, rhinophyma is commoner in fair-skinned men aged between 50 and 70. The exact cause isn’t fully understood. Although previously believed to be due to alcohol, there’s no link between rhinophyma and excessive drinking, and no genetic link. The diagnosis is made from the nasal skin appearance with a history of rosacea. If the diagnosis is uncertain, a dermatologist may take a small skin biopsy under local anaesthetic.

Treatment

There’s no cure for rhinophyma, but treatments can be effective in improving the appearance and preventing deterioration.

Treating established rhinophyma can be challenging, needing a combination of different therapies, some of which are only available privately. Local gels and oral medications may help early on, but surgery is often necessary. This aims to remove excess tissue, restoring the natural nose shape. It takes several weeks after the procedures for skin to look smoother.

Non-surgical treatments include topical gels or oral isotretinoin, a retinoid medicine used for treating acne, which may reduce redness and sebaceous gland growth.