Can Fraxel Repair Effectively Treat Rhinophyma?

Hi,
Theoretically Fraxel re:pair should be effective at improving rhinophyma as we have used traditional carbon dioxide lasers for rhinophyma in the past. I have not personally treated, or heard of any other physicians treating the condition at this time. I would think that the treatment would involve high settings, and most likely a series of treatments. I have treated a patient with rhinophyma with a series of Fraxel re:store laser treatments with moderate improvement. I may have that patient return for Fraxel re:pair. So, I should have a better answer to your question in a few months. Be well.
Dr. P

Fraxel repair is a fractional laser treatment that is used to correct deeper wrinkles and tighter skin. Since rhynophyma require excisional ablation, treating it with fractional lasers is best approached by increasing the treatment level (IE fraction of area treated per session) to the maximum. With this said, the result of a traditional CO2 non fractionated laser can be achieved with the fractionated CO2 (Fraxel Repair) in 1-2 sessions. Non fractionated CO2 laser is an effective treatment for Rhyniphyma, however, it should not be used in patients of color and it is fraught with a more severe healing phase. If these factors are of consideration, fractionated CO2 laser at higher treatment levels can be considered a better alternative to traditional non fractionated CO2 laser or even dermabrasion.

Rhinophyma is a proliferative condition characterized by hypertrophy of the glandular and porous elements of the nose. Some clinical studies have shown occult basal cell carcinoma in as many as 10% of longterm rhinophyma specimens.
Since this is a proliferative and chronic condition, there is no single treatment that will cure the condition. Rather, treatments will ameliorate the symptoms associated with rhinophyma and provide suitable reduction in size of the nose.
To date, the gold standard for treatment has been the following three modalities:

Ablative laser
Chemical peels
Surgical curettage and dermaplaning

Since Fraxel is relatively expensive and unproven in light of other treatment protocols, the decision should be made to proceed with Fraxel after a thorough discussion of all available options with your surgeon.

Fraxel's greatest benefit is that it treats small areas, not large areas.  On the other hand, rhinophyma requires that large areas be treated, so I don't believe that Fraxel will be helpful at all for this concern. 

There have been several presentations at conferences where the re:pair is used to treat rhinophyma.  You treat at the highest desity levels and then go over the same area more time than the set passes.  It gets you close to 100% coverage.  Healing takes slightly longer than at a lower density but results are pretty good.  You might need a few treatments for optimal results.

Fraxel Repair works to fine tune after a surgical procedure.

Rhinophyma reduction thins the thicken skin of acne rosacea using a radio freguency procedure first to debulk the thickened skin.   Irregularities are then corrected by the Fraxel CO2 repair or other ablative proceures. 

As the other reviewers have indicated one of the treatments for rhinophyma is ablative laser. Since Fraxel is a fractional laser treatment, it will be less tissue destructive making down time less but meaning that it will likely take several treatments to get the same results.

In theory yes, it has been done, but you will need 4-8 sessions. Ablative lasers are much better- one session only with healing of 14 plus days. (compared to 7 -9 days per session of Fraxel RePair multiplied by 8).Video shows how I perform this procedure. Dr Davin Lim Laser DermatologistBrisbane, Australia.