While few people recognize the term Rhinophyma, many have likely seen what it does to the nose. Rhinophyma is a skin disorder in which the nose develops a bulbous, bumpy, red, or enlarged appearance. Most often found in older men, women suffer from this condition as well.

Defining Rhinophyma

Rhinophyma is a benign (non-cancerous) condition that affects the skin of the nose. The process causes abnormal skin growth, leading to a bumpy and red nose appearance, sometimes extending to the cheeks. Most experts agree that it is an advanced form of rosacea, associated with the presence of a mite known as demodex folliculorum that lives in the oil glands of the nasal skin.

Additional issues

Beyond the noticeable enlargement of the nose, Rhinophyma is also characterized by an increased number of sebaceous glands in the nose, inflammation, chronic swelling, and dilated blood vessels. These factors collectively give the nose a bulbous and reddened appearance. 

Functional issues

This condition is certainly troubling from a cosmetic standpoint, but it can also affect the ability to breathe through the nose. This can be a troublesome problem, as breathing through the nose becomes difficult. While Rhinophyma is not cancerous, the bulbous appearance that it causes can obscure existing signs of cancer, preventing a proper and timely diagnosis of cancer on the nose. 

How Rhinophyma is diagnosed

The diagnosis of Rhinophyma is relatively straightforward, as it is easily distinguishable from other skin conditions. The unique skin deformities and changes in the nose that are caused by this condition are sufficient for a clinical diagnosis of Rhinophyma to be made. In some cases, however, a biopsy may be needed if there is a lack of confidence in the external diagnosis. 

In the early phase of Rhinophyma, there is usually some sign of rosacea and a sizable enlargement of the sebaceous glands. The sebaceous glands are small glands in the skin that are usually attached to hair follicles and produce oil. In cases of Rhinophyma, the sebaceous ducts will be expanded and full of sebum.

How is Rhinophyma treated?

Different resurfacing procedures can be used to address the bulbous appearance of the nose. Most of them involve a resurfacing laser or electrosurgery. Dr. Vila uses a combination of an Erbium: YAG laser and electrocautery to treat rhinophyma. Usually, one treatment is sufficient for many years of improvement, but the condition can return years to decades later, at which point another laser treatment can be done.

What is the takeaway?

Rhinophyma is a rare, troubling condition associated with rosacea and Demodex folliculorum. Fortunately, modern technology allows for the treatment of this issue by way of lasers and surgery. As with any procedure, patients should consult an experienced, skilled practitioner for their treatment.