CO2 Laser for Sebaceous Nose?

Question

Thank you for your reply about my sebaceous bulbous nose. Possibly Rhinophyma?However, my nose is not distorted (yet); it only seems to have a growing bulb, which is extremely oily (within minutes of washing). Can this still be  considered Rhinophyma? Could it be sebaceous hyperplasia or something else? Incidently, last year a plastic surgeon took approximately 2 minutes touching my nose and said the problem was not in my cartilage, but in the flesh. So, in lieu of the fact that the oil bothers be more than the size, is there anything that can solve both? Still wire loop cautery and CO2 laser?

Ross A. Clevens, MD, FACS · Answer

To better understand rhinophyma, it is important to first become familiar with rosacea. Rosacea is a chronic disease that affects the skin. Rosacea is characterized by redness, pimples, and, in advanced stages, thickened skin. When rosacea reaches this advanced stage, rhinophyma may develop. Rhinophyma is characterized by an enlarged, bulbous, and red nose resulting from the enlargement of the sebaceous (oil-producing) glands beneath the surface of the skin on the nose. Rhinophyma occurs more often in men than women. Treatment options for this advanced stage of rosacea include medications and surgery.
	
	Rhinophyma that does not respond to medications may be treated with:

	
		Electrosurgery
	
		Laser treatment
	
		Dermabrasion
	
		Resculpturing


	Lasers are used to remove the excess tissue that accumulates on the nose in patients with rhinophyma. The tissue can also be removed with a scalpel or a rapidly rotating wire brush known as dermabrasion. Although the nose will look red for a year or so following tissue removal, the nose will assume a normal skin color after about a year.  In my practice I often combine dermabrasion, excision AND Co2 Laser for the effective treatment of rhinophyma.

Raffy Karamanoukian, MD, FACS · Answer

Fractional CO2 laser is an excellent tool for skin rejuvenation in our center in Santa Monica. We use the fractional multi-depth ablative approach to help resurface the skin, recontour acne scars, improve incisional plastic surgery scars, and reduce surface irregularities from skin tone to dark pigmentation. Our approach utilizes a multi-depth approach that targets melanocytes in the epidermis and collagen fibroblasts in the dermis. This approach can be combined with a TCA Peel in a process known as a sapphire peel. Fractional laser is excellent for acne scars and contour scars in the skin. Patients are advised to undergo skin protocols with Melarase creams before and after treatment to help reduce pigmentation. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. After the laser, we expect redness for a few weeks as the skin improves. PRP and Hydrafacial enzyme facials can further improve skin quality after fractional co2.

Best,
Dr. Karamanoukian
Realself100 Surgeon

Best,
Dr. Karamanoukian 
Realself100 Surgeon

Brooke R. Seckel, MD, FACS (retired) · Answer

Sebaceoius hyperplasia can be treated with the medication Accutane which inhibits the production of oil and the growth of sebaceous glands. If the problem is far advanced CO2 laser alone might also help. 
Loop cautery is only required for Rhinophyma.
I recommend that you consult a board certified dermatologist who is very experienced treating acne, as he/she will be familiar with Accutane use.

CO2 Laser for Sebaceous Nose?

Answers (3)