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This patient had a longstanding rhinophyma that gave his nasal bridge an uneven alligator back appearance. I shaved the excess skin down under local anesthesia and let the wound heal over the next 2 weeks giving this result. To prevent recurrence the patient has to take lifelong antibiotics alternating oral with topical gel antibiotics. The skin overgrowth is due to a condition called rosacea with bacteria in the sebaceous sweat glands of the nose stimulating this skin overgrowth.

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