Rhinophyma is a condition in which the nose gradually enlarges, becomes bulbous and red, and has prominent oil glands. It is commonly associated with rosecea (an inflammatory condition of the facial skin). It is a condition that can be very distressing for patients, on occasion causing them to become socially withdrawn, not least because of the false perception that it is due to excess alcohol intake. Some patients will have associated malarphyma, a related condition in which the skin over the upper cheeks takes on a similar appearance to the affected nose.

There are a number of surgical approaches to this condition. Typically, excess tissue iss cut away, and in some cases a skin graft placed on the resultant raw surface. 

If a surgical excision is performed, a dressing that adheres to the raw area will be applied at the end of the operation. This will gradually lift off in the following days to weeks, revealing new skin, similar to the situation after laser treatment. If a graft is performed, a dressing will be stitched in place, and removed a week later. Sun protection is also important following surgical treatment, in order to protect the new skin.

Unfortunately, no form of treatment can offer a permanent cure for this condition. It is likely that it will gradually recur over time, and further treatment may become necessary. It is a very slowly progressive condition, however, and most patients are very happy to undergo treatment in the knowledge that they may need further intervention a number of years later.

The treatment relies on your body’s ability to regenerate skin cells. For this reason, any condition that impacts on your healing ability (such as diabetes or some medications) may slow your healing response after surgery. Smoking will also negatively impact healing. The fact that we rely on the skin cells to regenerate may also limit the amount of tissue that can be removed.

Following treatment, the new skin that forms will be vulnerable to sunburn, and protection in the form of daily sunblock plus a wide-brimmed hat is advised. The colour of the new skin may never match that on the rest of the face, and hypopigmentation (skin that is permanently paler) may be an issue.