Rhinophyma

Rhinophyma is a skin condition that causes your nose to gradually become large, bumpy and bulb-like at the tip (bulbous). It usually affects the tip of your nose, but may also be on the sides and the skin on top.

It can take several years for rhinophyma to develop. If rhinophyma isn’t treated, the changes may be permanent.

Rhinophyma is also called phymatous rosacea. Rhinophyma is an advanced stage of rosacea. That’s a chronic skin condition that causes skin discoloration, flushing and visible blood vessels.

Types of rhinophyma

There are four types of rhinophyma that vary based on the cause of the overgrowth, including:

• Actinic: Masses of elastic fibers
• Fibrous: An overproduction of connective tissue cells (hyperplasia)
• Fibroangiomatous: A buildup of fibrous connective tissue, wide blood vessels (telangiectasias) and inflamed tissue
• Glandular: Sebaceous gland expansion

Symptoms of rhinophyma

If you have rhinophyma, the shape, appearance and color of your nose changes gradually.

Signs and symptoms of rhinophyma on your nose include:

• Bulbous features (the tip of your nose grows in different directions)
• Enlarged pores or visible oil glands (sebaceous glands)
• Lumps
• Skin discoloration (red to purple or darker than your natural skin tone)
• Swelling
• Thickened skin
• Waxy or rough surface texture

Rhinophyma can also affect your mental health. It can affect the way you look and how you feel about your body.

Rhinophyma early stages

In the early stages, you might have the following on your nose:

• Some skin discoloration
• Noticeable skin thickening
• Small lumps forming
• Visibly widened blood vessels under your skin

Rhinophyma causes

An overgrowth of sebaceous glands and/or the underlying connective tissue causes rhinophyma. The reason why this happens isn’t clear.

Rosacea may cause this condition. But you can also have rhinophyma without having rosacea.

Does alcohol cause rhinophyma?

People once thought that rhinophyma was the result of drinking a lot of alcohol. But this isn’t true. Rhinophyma occurs in an equal number of people who drink alcohol as in people who don’t drink.

Risk factors of rhinophyma

You may be more at risk of developing rhinophyma if you:

• Are male
• Have a biological family history of rosacea or rhinophyma
• Have a fair skin tone

What is the age of onset for rhinophyma

A rhinophyma diagnosis usually happens after age 50.

Complications of rhinophyma

Having a larger nose tip may block your nasal passageway. This may make breathing out of your nose more difficult.

In some cases, a skin cancer known as basal cell carcinoma may develop on your nose. Scientists are still figuring out if rhinophyma plays a role in skin cancer development.

How doctors diagnose rhinophyma

To diagnose rhinophyma, a healthcare provider or skin care specialist (dermatologist) will perform an exam and review your symptoms. They’ll look at your nose and ask you about your personal and family medical history. They’ll ask if you or other known biological family members have a history of rosacea. No other testing is usually needed.

If your symptoms don’t get better after treatment, your provider may order tests, like a skin tissue biopsy, to check for cancer or other conditions.

Rhinophyma treatment

Your dermatologist may recommend the following treatment options for rhinophyma:

• Dermabrasion: A rotating device “sands” away skin to unveil the smooth new skin underneath.
• Laser skin resurfacing: Concentrated beams of light remove the outer layers of skin.
• Cryotherapy: Extremely cold temperatures freeze and destroy abnormal skin tissue.

Rhinophyma surgery

Surgery is another treatment for rhinophyma. The goals of surgery are to:

• Reshape your nose to change the look or appearance.
• Remove excess tissue and sebaceous glands.
• Reduce enlarged blood vessels.
• Improve your ability to breathe.

Surgery is a big decision, so you’ll want to understand the risks and benefits before you decide if it’s right for you. Your provider will make sure surgery is a safe option and that you have realistic expectations about the outcome of the procedure.

When should I see my healthcare provider?

You should let your healthcare provider know about any changes in your skin. Take note of areas that are raised, discolored, thickening or swelling.

As rhinophyma is a severe form of rosacea, it’s important to manage rosacea early if you have it. This may prevent rhinophyma. Talk to your healthcare provider about rosacea treatment options.

Is there a cure for rhinophyma?

There isn’t a cure for rhinophyma. Treatment may remove symptoms of the condition. But, while rare, there’s a risk that symptoms may return. Your provider will take all steps necessary to reduce the risk of symptoms coming back in the future.