What is Rhinophyma? Q&A with Dr. Lisa Ishii

Rhinophyma is a skin disorder that causes the nose to enlarge and become red, bumpy, and bulbous. When left untreated, Rhinophyma can severely alter the shape of the nose and even cause changes in breathing. A somewhat uncommon subtype of rosacea, Rhinophyma affects a low percentage of total rosacea patients. Rhinophyma occurs when chronic inflammation and increased oil glands (sebaceous hyperplasia) on the skin of the nose causes a swollen, “cobble-stoned” appearance of the skin that is permanent. This skin disorder is most common in Caucasian men between ages 50-70. Dr. Ishii, who regularly treats Rhinophyma, recently answered a few of our most commonly asked questions.

Q: What is Rhinophyma?

Rhinophyma is a subtype of rosacea. Chronic inflammation and increased oil glands (sebaceous hyperplasia) of the skin of the nose causes a swollen, “cobble-stoned” appearance of the skin that is permanent.

Q: How fast does Rhinophyma grow?

Most rhinophyma is progressive over the course of years, but in rare cases it will grow quickly over the course of months. For those who have a rapidly growing form of rhinophyma, it is imperative to see a dermatologist as soon as possible to rule out other types of growths.

Q: When should you consider Rhinophyma treatment? What signs can you look for?

Rosacea is best treated as early as possible, starting at the first signs of redness and telangiectasias (small, dilated blood vessels). The more progressive the disease, the more aggressive the treatment has to be, often requiring a series of treatments. Because more advanced stages of Rhinophyma call for more aggressive treatment, it is best to get an evaluation at the first signs of nasal deformation. Some patients begin to develop side effects from their rhinophyma, including collapse of the nostrils or even trouble breathing—this is certainly an indication for treatment.

Q: What Rhinophyma treatment options are out there?

A pulsed dye laser, like the Vbeam, is an excellent option for treating redness and bumps. The Vbeam is appropriate for treatment in the very early stages of this skin condition. Fully ablative Erbium or CO2 lasers are often used to help reshape the nose. In more severe instances, shave removal or electrosurgical cautery loop is employed to help debulk the tissue in combination with the laser treatment.

Q: How Does Laser Resurfacing for Rhinophyma Work?

At Aesthetic Solutions, Dr. Ishii use fully ablative Erbium or CO2 laser to help resurface and reshape the nose. These lasers vaporize skin layer by layer so that we essentially “carve” down the rhinophyma into a more cosmetically pleasing contour of the nose. On the day of procedure, injectable lidocaine is used to help numb the nose for a more comfortable treatment experience. There are 14 days of downtime where the nose is swollen, bloody, and crusty. Regular visits to the office in the days following treatment ensure a smooth recovery process.

Dr. Ishii provides Rhinophyma treatment for Chapel Hill, Durham, Raleigh and surrounding areas in The Triangle. To learn more about your treatment options, request a consultation with Aesthetic Solutions.