Rhinophyma
Bulbous nose; Nose - bulbous; Phymatous rosacea
Rhinophyma is a large, red-colored (ruddy) nose. The nose has a bulb shape.
Rosacea has multiple phases, beginning with flushing of the skin, followed by redness, followed by the development of small blood vessels visible in the skin. The later stage and is exhibited by the red blisters on this person's cheeks, nose, forehead, and chin. Underlying redness and small blood vessels are also seen.
Causes
Rhinophyma was once thought to be caused by heavy alcohol use. This is not correct. Rhinophyma occurs equally in people who do not use alcohol and in those who drink heavily. The problem is much more common in men than in women.
The cause of rhinophyma is unknown. It may be a severe form of a skin disease called rosacea. It is an uncommon disorder.
Symptoms
Symptoms include changes in the nose, such as:
- Bulb-like (bulbous) shape
- Many oil glands
- Reddish color (possible)
- Thickening of the skin
- Waxy, yellow surface
Exams and Tests
Most of the time, a health care provider can diagnose rhinophyma without any tests. Sometimes a skin biopsy may be needed.
Treatment
The most common treatment is surgery to reshape the nose. Surgery may be done with a laser, scalpel, or rotating brush (dermabrasion). Certain acne medicines may also be helpful in treating the condition.
Outlook (Prognosis)
Rhinophyma can be corrected with surgery. The condition may return.
Possible Complications
Rhinophyma can cause emotional distress. This is because of the way it looks.
When to Contact a Medical Professional
Call your provider if you have symptoms of rhinophyma and would like to talk about treatment.
References
Habif TP. Acne, rosacea, and related disorders. In: Habif TP, ed. Clinical Dermatology. 6th ed. Philadelphia, PA: Elsevier; 2016:chap 7.
Qazaz S, Berth-Jones. Rhinophyma. In: Lebwohl MG, Heymann WR, Berth-Jones J, Coulson I, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 5th ed. Philadelphia, PA: Elsevier; 2018:chap 219.
Version Info
Last reviewed on: 10/14/2018
Reviewed by: Michael Lehrer, MD, Clinical Associate Professor, Department of Dermatology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
