in Calgary, AB
Rhinophyma is a skin condition affecting the nose in which sebaceous (oil) glands become overactive and the skin becomes thickened, bumpy, and enlarged. The nose usually appears red and may have prominent blue or red blood vessels along the surface of the skin.
Rhinophyma is often secondary to rosacea and is seen as an advanced state of that condition. However, because nasal redness and enlargement are often associated with alcoholism, people with rhinophyma are often subjected to intense self-consciousness related to that social stigma.
What Causes Rhinophyma?
Although research has identified a link between rosacea and rhinophyma, there is very little else that is known about the onset of this condition. Patients whose rosacea worsens to this state may have a genetic predisposition that becomes triggered later in life. Research has confirmed that rhinophyma is not related to alcohol consumption.
Is rhinophyma hereditary?
There is no clear genetic link to this condition. People with a family history of rosacea are more likely to develop rhinophyma, but it’s not genetic.
What Are The Symptoms of Rhinophyma?
The early symptoms of rhinophyma include constant redness of the nose and thickened skin. Each of these signs worsens over time, and additional symptoms such as yellowing of the skin and a waxy appearance occur. Thickened tissue eventually changes the shape of the tip of the nose, which can appear enlarged, bulbous, or irregular in shape. Pores also enlarge as the condition worsens.
How is rhinophyma diagnosed?
Rhinophyma occurs in a subgroup of rosacea known as phymatous rosacea. Rhinophyma has classified as part of subtype 3 rosacea. It forms gradually over several years and is believed to be the result of poorly treated or untreated rosacea.
Rhinophyma occurs after initial lower subtypes of rosacea have been identified. It is a pretty straightforward diagnosis for our three Remington Laser Dermatology dermatologists. We can typically diagnose the condition after talking with the patient about his medical history and performing a physical inspection of the affected area. In rare cases, we may need a skin biopsy to verify our diagnosis, but this is unusual.
Who is a good candidate for rhinophyma treatment?
Rhinophyma occurs more frequently in men by ratios of up to 30 to 1. It develops gradually after the onset of the initial stages of rosacea. To be a candidate for laser surgery, the patient would need to be a subtype or grade 3 rhinophyma.
- Grade 1 — Prominent follicular openings with no skin thickening
- Grade 2 — Prominent follicular openings with mild skin thickening
- Grade 3 — Prominent follicular openings, skin thickening, and overactive sebaceous glands, and nodular nasal contour
At Remington Laser, we’ve found these CO2 treatments to be the best option for treating grade 3 rhinophyma. There are few limitations, as long as the patient is in good overall health and doesn’t have any active skin infections.
Rhinophyma Nose Treatment
Previous attempts to treat rhinophyma include plastic surgery or electrocautery. Unfortunately, these methods frequently resulted in scarring and/or inadequate improvement. As the primary underlying condition is excessive and enlarged oil glands, the CO2 Laser has revolutionized the treatment of this condition.
Can Rhinophyma Re-Occur?
Once rhinophyma has been treated, recurrence is rare.
Is there any preparation for rhinophyma treatment?
The only preparation prior to these treatments is to avoid unprotected sun exposure for four weeks prior to your session (although it’s always a good idea anyway) and to not have any medium chemical peels over the same period.
CO2 Laser for Rhinophyma Treatment
The laser vaporizes the skin in a bloodless fashion thereby shrinking excess oil glands while allowing the physician to systematically reshape the nose. Dr. Remington may recommend vascular laser treatments prior to or in conjunction with the CO2 laser to collapse the blood vessels.
How long does treating rhinophyma take?
These CO2 laser treatments usually take about one hour. Most patients only need a single treatment.
Is the CO2 Laser Treatment for Rhinophyma Painful?
Before commencing with laser treatment, we may apply topical numbing medication to the skin to diminish sensation and make the procedure as comfortable as possible. Injections of local anesthetic may also be administered.
How is a CO2 Laser Treatment Performed?
We perform this procedure in a single session at our non-hospital surgical site. Markings may be made along the nose to distinguish the boundaries between normal and abnormal tissue. Resurfacing is conducted to debulk nasal tissue and contour the nose to a proportionate shape.
Rhinophyma Before & After Photos
What are the risks of CO2 laser treatments for rhinophyma?
These are low-risk treatments at Remington. Afterward, patients will typically have some redness, swelling, and itching across the treated skin. This is not severe. There is a slight risk of infection, but this is easily avoided with simple home care.
The CO2 laser is an ablative rhinophyma treatment that removes layers of superficial tissue from the nose. To protect newly forming skin cells, surgical staff may apply gauze over the nose at the conclusion of the procedure. After the first 24 hours, the dressing will need to be changed up to three times per day. This schedule will continue until tissue healing has progressed. During the initial healing period, tissue drainage may be noticed. While the nose can be cleaned with soap and water, it should not be submerged. A healing balm may be prescribed to patients to use for wound healing. Our office provides detailed recovery instructions and our staff is available to answer questions that may arise after rhinophyma treatment.
Tissue healing can take up to two weeks after CO2 treatment. Discomfort is usually manageable with over-the-counter medication. Aside from the need for gauze, patients are often able to resume normal activities within a day or two after treatment.
Can you prevent rhinophyma?
There is no known way to prevent rhinophyma. But rhinophyma occurs after rosacea has been present, often untreated. So, treating rosacea as soon as it develops could play a part in not developing rhinophyma.
Rosacea is aggravated by increased blood flow to the surface of the skin. These triggers can cause that, so it is wise to avoid them if you have rosacea:
- Spicy foods
- Overly hot foods and beverages
- Very hot or very cold temperatures
- Exposure to sunlight
- Enduing stress and anxiety
Patients with rosacea need to be very cognizant of protecting their skin from sun exposure with regular sunscreen of at least SPF 15. Also, the use of hypoallergenic skin moisturizer is recommended.
What Our Patients are Saying
“This clinic is absolutely amazing! When you come in and you feel like they are all family, and each and every single person there treats you like you are a part of their family, it’s an awesome feeling, which I will never let go of! They truly care about helping, and it’s not just a “business” to them, and that’s valuable beyond comparison with respect to other clinics here in Calgary….which I’ve had my fair share of visits to other clinics where they just did not care about you as a human and it was all about the business! I recommend this clinic over all other clinics for all your dermatology needs and wants, and you can go there with full confidence that they will do what they can to help you! Thank you Team Remington for everything you’ve helped me with so far……finally I have found the right place!” -Adonis K.
How Should I Protect My Nose After a Rhinophyma Treatment?
After healthy new tissue is revealed, patients are encouraged to keep protective sun habits that include daily sunscreen and wearing a hat when outdoors. This prevents unnecessary tissue damage to a sun-sensitive nose.