As a subtype of rosacea, rhinophyma is characterized by the progressive enlargement and deformity of the nose, resulting in a bulbous, swollen appearance. It is a chronic inflammatory skin condition that affects the face primarily. The causes, symptoms, diagnosis, treatment, and prevention of rhinophyma are discussed here.
Causes
Rosacea, a chronic inflammatory condition affecting the blood vessels and sebaceous glands in the skin, may be associated with rhinophyma. Factors that may contribute to rhinophyma development are as follows:
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The risk of developing rosacea or rhinophyma may be increased by having a family history of the condition.
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Symptoms of rosacea may be exacerbated by exposure to certain environmental factors, such as sunlight, hot or cold weather, wind, spicy foods, alcohol, and emotional stress.
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Research suggests that Demodex mites, microscopic parasites that inhabit hair follicles, may be involved in the pathogenesis of both rosacea and rhinophyma.
Symptoms
Rhinophyma may cause the following symptoms:
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Swollen, bulbous, and disfigured noses are often referred to as "bulbous" or "potato noses" due to their characteristic appearance.
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Skin thickening: The skin on the nose may thicken and develop a rough, irregular texture with prominent pores and oil glands.
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Inflammation or exacerbation of rosacea can cause persistent redness and flushing of the nose and surrounding areas.
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Some individuals with rhinophyma may experience ocular symptoms such as dryness, irritation, and sensitivity to light.
Diagnosis
Typically, rhinophyma is diagnosed by clinical evaluation and visual inspection of the nose. Diagnostic procedures may include:
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A healthcare provider may ask about symptoms, medical history, and any predisposing factors or triggers that may contribute to rhinophyma development.
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An examination of the nose and surrounding facial features will be performed to look for signs of enlargement, swelling, redness, and thickening of the skin.
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Rhinophyma can be differentiated from nasal polyps, granulomatous disorders, or malignancies causing swelling or deformity.
Treatment
In order to address the underlying rosacea and reshape the nose, rhinophyma is typically treated with a combination of medical therapies and surgical interventions.
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Inflammation, redness, and thickening of the skin associated with rosacea and rhinophyma can be reduced with topical medications, such as metronidazole, azelaic acid, or ivermectin.
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Antibiotics or isotretinoin may be prescribed to control inflammation and reduce the size of sebaceous glands.
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In order to remove excess tissue, reshape the nose, and improve the appearance of rhinophyma, laser resurfacing or ablative laser procedures may be used.
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In order to restore a more natural contour to the nose, surgical excision or shave removal of excess tissue may be performed.
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The use of cryotherapy or freezing of the affected tissue may be used to reduce the size of enlarged blood vessels and oil glands.
Prevention
There are a number of prevention strategies that can be used to prevent rhinophyma, including managing the underlying rosacea and avoiding triggers that may exacerbate symptoms.
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Skincare that is gentle and non-abrasive, and that avoids harsh chemicals or irritants that can aggravate sensitive skin.
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Protecting the skin from harmful UV rays by applying sunscreen with a high sun protection factor (SPF) and wearing protective clothing, hats, and sunglasses.
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Identifying and avoiding triggers such as sunlight, hot or cold weather, wind, spicy foods, alcohol, and emotional stress that may exacerbate rosacea and rhinophyma symptoms.
