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, your 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 help treat 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
Contact your provider if you have symptoms of rhinophyma and would like to talk about treatment.
References
Dinulos JGH. Acne, rosacea, and related disorders. In: Dinulos JGH, ed. Habif's Clinical Dermatology. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 7.
Grande DJ. Rhinophyma. In: Lebwohl MG, Heymann WR, Coulson IH, Murrell DF, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 6th ed. Philadelphia, PA: Elsevier; 2022:chap 218.
Raghallaigh SN. Rosacea and related disorders. In: Bolognia JL, Schaffer JV, Cerroni L, eds. Dermatology. 5th ed. Philadelphia, PA: Elsevier; 2025:chap 37.
Version Info
Last reviewed on: 10/13/2024
Reviewed by: Ramin Fathi, MD, FAAD, Director, Phoenix Surgical Dermatology Group, Phoenix, AZ. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
