Rhinophyma, also known as phymatous rosacea, is the medical term for a large, red, bulbous nose. The condition occurs most commonly in men over the age of 30, although it can be found rarely in women. The late actor, W.C. Fields, is perhaps the most famous bearer of the condition.
Rhinophyma was once believed to be caused by excessive alcohol consumption. This is not the case, and it is now clear that rhinophyma occurs in people who drink alcohol with the same frequency as it occurs in non-drinkers. Alcohol may aggravate the problem by causing the skin to flush after consumption, but it is not the primary cause of the condition.
The characteristic redness and bulbous appearance of the nose is caused by thickening of the skin and hypertrophy of the sebaceous glands. Hypertrophy is an increase in tissue, and this enlargement leads to a deformed, pink mass covering the tip of the nose, which can leave the patient severely disfigured. The skin of the nose may appear oily, waxy and yellow when viewed closely. In severe cases, the adjacent cheek tissue may also be affected.
The underlying cause of rhinophyma is unclear. It is believed to be a severe form of rosacea, an inflammatory skin disease in which the blood vessels of the face enlarge and cause redness. When left untreated, rosacea may eventually lead to rhinophyma, although it has also been found in patients that have never been previously diagnosed with the condition. An overabundance of sebaceous glands in the nose is typically blamed for the development of rhinophyma in these individuals.
In most cases, a physical exam is the only requirement for diagnosing a patient with rhinophyma. A skin biopsy, however, may be used in rare situations. Rhinophyma treatment varies depending on the severity of the condition, but may include cosmetic surgery, prescription acne medications, low doses of antibiotics and topical creams used for treating rosacea.
Cosmetic surgery is used to reshape the nose and may be performed with a laser, scalpel, or rotating dermabrasion brush. The bulk of the excess tissue is cut away from the nose using one of these tools, and the area is grafted using fresh skin from another part of the body. In mild cases, the nose may be allowed to heal without the use of a skin graft. Many patients choose to manage the condition with medication, because the symptoms may recur after surgical intervention.
