Rhinophyma is a form of rosacea most commonly seen in men. Rhinophyma presents as excessive tissue growth on the nose. Rhinophyma can also be associated with enlarged pores, pimples and deformity or change in the shape of the nose.
This condition can be markedly improved with a combination of surgery and laser therapy. Mild to moderate cases of rhinophyma can be treated with CO2 laser surgery; more severe cases are treated with a combination of surgery and laser. Rhinophyma treatments are partially covered under Medicare. Patients who suffer from rosacea and rhinophyma are very sensitive to external factors such as sun exposure, hot and spicy foods and temperature changes. Contrary to popular belief, rhinophyma, also known as alcoholic’s nose, is not due to excess alcohol consumption.
Rhinophyma is a form of rosacea
Rhinophyma is secondary to inflammation and typically presents between 40 – 60 years of age
This form of rosacea is much more common in men
Treatments such as laser and surgery can make a significant difference
Treatments for rhinophyma are partially covered by Medicare
Laser and surgery for rhinophyma has a downtime of approximately 10-14 days
Once treated, rhinophyma rarely returns
A combination of anti-inflammatory antibiotics and creams can help reduce the small risk of recurrence
What Is Rhinophyma?
Rhinophyma is a form of severe rosacea that is relatively common in Australian males. Mild cases present as uneven lumps and bumps of tissue on the nose. In severe cases, the nose and other areas of the face is affected by a thick overgrowth of tissue.
Rhinophyma is also associated with enlarged pores, pimples and excess tissue. In most cases, rhinophyma develops in the late 40s and worsens with time.
Is It A Form Of Rosacea?
Rhinophyma is a severe form of rosacea that produces very visible lumps and growths, most commonly on the nose. It can cause pustules and sores, as well as facial redness, flushing and blushing.
Rosacea and rhinophyma is common in Australia, in part due to the genetic make up of this country and partly due to sun exposure. Most patients with rhinophyma as used to frequent pimples and sores around the nose area, often associated with intermittent bouts of redness.
This condition can be markedly debilitating for patients both emotionally and physically. Effective treatments are readily available.
Will Rhinophyma Recur After Treatment?
Laser treatments have a very high success rate in the treatment of rhinophyma. Laser and surgery remove excess tissue and enlarged pores, reshaping the nose back to its former contours. Once treated, rhinophyma rarely recurs.
Specialists often prescribe topical creams and medications to decrease the risk of rhinophyma recurrence. These drugs and creams reduce inflammation and in some cases decrease oil gland production on the nose.
How Can I Prevent Rhinophyma?
Early treatment of rhinophyma may stop the condition from ever becoming severe. Antibiotics and prescription creams can be used to treat outbreaks of pimples and sores. Dermatologists may also prescribe a vitamin A-based drug called Isotretinoin for early rhinophyma and a daily massage program. This is only of value in very early cases of rhinophyma. Rosacea treatment may decrease facial flushing and redness.
If I Have Rosacea, Will I Get Rhinophyma?
The majority of patients who have rosacea will not develop rhinophyma. Rhinophyma is most commonly seen in men between the ages of 40-60 and is not related to chronic alcoholism. It is exceedingly rare for women to develop rhinophyma. Rosacea is a skin disorder with multiple forms, including flushing, blushing, pimples and papules. Rhinophyma is just one form of this disease.
Apart From Surgery & Laser, Are There Any Other Treatment Options?
Unfortunately there are no great medical treatments for established rhinophyma. Early changes of rhinophyma can be partially halted with deep tissue massage and anti-inflammatory medications such as tetracycline antibiotics.
In some cases, early rhinophyma may begin as pimples and lumps on the nose in combination with broken blood vessels and redness. Over time, individual pimples join to produce thick tissue and lumps. Early inflammation can be treated with antibiotics such as minocycline or doxycycline. Firm massage for 10 minutes a day to the nose area can partially halt the progression of rhinophyma. Correct massage techniques break down congested tissue and stimulate lymphatic flow to reduce the accumulation of inflammatory products.
If medical treatment with topical creams and medications is ineffective in the treatment of early rhinophyma, the use of a vascular laser can reduce the number of blood vessels and pimples and calm any redness. Unlike erbium or CO2 Laser, vascular lasers can treat various forms of rosacea. Vascular laser treatment of rosacea is not associated with blistering of the skin and recovery is much quicker than other forms of laser therapy.
What Should I Consider Before Getting Laser Treatment For Rhinophyma?
Corrective surgery for rhinophyma is an out-patient procedure associated with a significant recovery period. This is a crucial step in nose reshaping through the removal of excess tissue. Consider the following if you are contemplating rhinophyma correction:
A recovery period of 10-14 days is mandatory
This means no exercise, and time off work
A post-operative laser check is carried out on the day following surgery
Mild to moderate rhinophyma (laser only) – please contact us for pricing information.
Moderate to severe rhinophyma (laser and surgery) – please contact us for further information.
*This treatment is partially covered under Medicare and covers assistant fees, laser theatre fees, anaesthetic fees, procedure and follow ups.
Will Medicare/Insurance Cover This?
A Medicare rebate may be applicable for the treatment of capillaries by VBeam or ClearScan lasers. Certain criteria must be met to qualify for a rebate. One of these is that facial or neck capillaries should be visible from a distance of 3 metres. In this case, a Medicare rebate applies to each treatment and for up to 6 treatments per year.
Treatments eligible for a Medicare rebate also count towards your Medicare Safety Net. Once the threshold on your Medicare Safety Net has been passed, 80% of the fee will be refunded. Your dermatologist will inform you of your rebate eligibility prior to the commencement of treatment.
What Are The Associated Risks?
Risks should always be considered prior to rhinophyma treatment. The risk of infection is rare; however, our laser specialists prescribe a combination of antibiotics and antiviral medication in preparation for the procedure. Scarring is extremely rare and occurs in less than 1% of cases.
Other considerations include:
Recovery period of 10-14 days, including the application of dressings and wound care. This requires time away from both social activities and work.
Post recovery redness of up to a few weeks to a few months.
Colour changes on treated areas that may last a few months.
What Are The Costs Involved?
The cost of rhinophyma treatment is dependent on the complexity of the case and the implemented technique.
Mild to moderate rhinophyma (laser only) – Please contact us for pricing.
Moderate to severe rhinophyma (laser and surgery) – Please contact us for further information.
*This treatment is partially covered by Medicare.
Quoted fees include laser theatre fees, assistant fees, procedure fees, anesthetic fees, as well as follow-up fees.
**All laser therapies are conducted in our specialist surgical and laser suites at Cutis Clinic. The procedure is conducted by a leading expert in the field of laser dermatology.
What Is The Cause Of Rhinophyma?
The cause of rhinophyma is often misinterpreted as this condition is actually form of rosacea. Although often considered the result of excess alcohol use, this is not the primary cause. Instead, prolonged inflammation prevents the lymphatic glands from draining around the surface of the nose, contributing to an increase in the number and size of oil glands. This leads to an overgrowth of tissue, a process referred as fibroplasia. Rhinophyma is characterized by excessive tissue, enlarged pores, and thickening or misshaping of the nose.
What Treatments Are Available For Rhinophyma?
Depending on the severity of rhinophyma, specialists use a variety of methods to correct the deformity. Moderate deformity rhinophyma is treated with a CO2 (carbon dioxide) laser. This laser, coupled with the skill of the dermatologist, reshapes the nose, removing excess tissue with each pass.
Severe rhinophyma is treated with a combination of surgery and laser resurfacing in a single session.
Our Board-Certified dermatologist Dr Davin Lim has performed this procedure many times over the past decade and is a leading expert in the field of rhinophyma treatment.
How Do We Perform Laser Rhinophyma Surgery?
All rhinophyma treatments are performed in our laser suite at Cutis Clinic. Patients are administered a mild sedative during the procedure and the treated areas are numbed with local anaesthetic. The procedure takes between 30-60 minutes depending on the complexity of each case. Treatment itself is virtually painless due to our expert anaesthetic protocols.
After the procedure, the treated area is covered with an antibiotic ointment and a dressing. Healing times typically range between 7 and 14 days.
How Much Improvement Can I Expect From This Treatment?
Rhinophyma treatment is very successful even when the underlying deformity is marked. The majority of cases only require one treatment. Touch-up treatments are occasionally performed for optimal results. This will be discussed during your initial consultation with one of our specialist dermatologists.
"Rhinophyma can be one of the most debilitating and deforming conditions for men. It can be a source of embarrassment for many, both physically and emotionally due to the incorrect assumption that this is the result of alcohol abuse. Fortunately, treatments are effective and provide all of our patients with significant improvement in both physical appearance and quality of life. I often combine surgery and CO2 laser in a single session. Recovery takes an average of 10-14 days, during which patients must limit work and social activities. This treatment is partially covered under Medicare and is eligible for a partial rebate.
Prevention of rhinophyma is important after surgery, although this condition very rarely recurs once treated. In some cases, I prescribe a cream called Metronidazole and combine this with intermittent courses of anti-inflammatories or vitamin A."
Dr Davin Lim