Rhinophyma

Rhinophyma is manifested by a thickening and widening of the nose with the appearance of nodules which will give it an irregular surface. The tip of the nose has a red, bulging appearance with very large pores . The cutaneous hypertrophy at the level of the nose can be associated with papules and pustules . In severe cases, it may be a real disfigurement of the nose.

In addition, patients can consult for a nasal obstruction .

The evolution of rhinophyma is progressive and its diagnosis is clinical, carried out by a dermatologist.

Rhinophyma is considered to be the most advanced and severe form of rosacea . About 5% of patients followed for rosacea develop rhinophyma. They are mostly men over the age of 50.

Rosacea is a fairly common dermatosis in France and can manifest itself in different forms: vascular, ocular, papulo-pustular and hypertrophic .

Vascular rosacea is the most frequently found form. This skin condition is inflammatory and chronic and the skin lesions are mainly located on the face (wings of the nose, forehead and chin).

The rhinophyma corresponds to the hypertrophic form and can be primitive and thus appear in patients who do not have rosacea.

The red appearance of the nose along with the prominent protuberances have caused rhinophyma to have always been associated with chronic alcoholism. This is not the case.

The first consultation allows your dermatologist in Paris to fully understand your needs . A simple clinical examination can make the diagnosis of rhinophyma .

Depending on the stage of this skin condition, it will be possible to establish a treatment plan.

In the nodular and severe forms of rhinophyma, the treatment is often surgical. The procedure aims to remove excess skin, correct nasal deformities and recreate the harmonious contours of the nose. It may require general anesthesia. Surgical treatment must be carried out outside the phases of inflammatory flare-ups of the rhinophyma because these can alter postoperative healing.

Drug treatment of rhinophyma

Mild forms of rhinophyma can be treated with drugs that aim to control inflammatory flare-ups: oral antibiotic therapy (cyclins, metronidazole), or retinoids (isotretinoin).

As for rosacea, an adapted lifestyle and a limitation of exacerbation factors have an essential place in the management. If it is impossible to completely prevent the appearance of rosacea and rosacea, several measures can help reduce the intensity of symptoms:

• Put on suitable sunscreen before sun exposure
• Limit your alcohol consumption
• Avoid very hot and very spicy dishes
• Protect your face in very cold weather (protective cream, scarf, etc.)
• Moisturize your skin regularly
• Cleanse your face morning and evening with gentle products adapted to your skin type (your dermatologist can advise you on an appropriate skin routine ).
• Avoid medications (internal and external route) based on cortisone
• Learn to manage stress
• Avoid long hot baths and intense heat sources such as hot tubs and saunas

Laser rhinophyma treatment

The laser treatment of rhinophyma today represents an excellent therapeutic alternative, with satisfactory results and a low risk of scarring. Depending on the volume, the number of sessions required varies but it is often necessary to perform several sessions. The use of an ablative CO2 laser then combined with a fractional laser may be indicated.

A basic treatment of rosacea must be associated with laser treatment of rhinophyma.

Laser treatment of rhinophyma gives very good aesthetic results, with the satisfaction of the vast majority of patients.

Following a laser treatment, the recurrence of rhinophyma remains possible and it will then be necessary to resume the laser sessions.