Advanced case of Rhinophyma.

I have a severe case of Rhinophyma (i.e. unsightly bulges at the tip my nose). I've suffered with sinus-related issues for the better part of 30 plus years. I suspect one is a result of the other. I would like to know what type of doctor could help me with resurfacing my nose to get it back to looking normal again. I've called an ENT and a plastic surgeon to no avail. I've had MRI's and I know its nothing more serious. I've also had steroid shots that abate the issue for a short time only.

Doctor Answers 6

Advanced Rhinophyma Referral

You have received excellent responses and may wish to consult with Dr. Anthony Brissett, a Facial Plastic Surgeon at The Houston Methodist Hospital for an evaluation. I have seen his work with patients who suffer with rhinophyma and it is superb. Best Regards. 

Houston Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

Advanced case of Rhinophyma

Hello DrStelly2870,For rhinophyma I would recommend you consult with a facial plastic surgeon.  These are the ones who would have the most training in treating this condition.  There are various treatments out there depending on how things look.  I would reiterate what Dr. Velargo said that in cases of advanced disease most of the treatments will involve a therapy designed to help sculpt the nose to closer to what it used to look like.  This may involves lasers, dermabrasion, electric cautery, simply cutting the area, etc.  As mentioned above, I would recommend you consult with a facial plastic surgeon to help with your concerns. I hope this helps and good luck.  

William Marshall Guy, MD
The Woodlands Facial Plastic Surgeon
5.0 out of 5 stars 23 reviews


Rhinophyma treatment poses a unique problem.  The goal in treating rhinophyma involves removing much of the diseased skin and tissue, and yet allowing enough tissue to remain so that healing can occur without scarring.  Multiple techniques exist.  My preferred technique involves the use of  a radiofrequency device followed by a laser to improve the overall shape.  This procedure can be performed under local anesthesia.

J. Kevin Duplechain, MD, FACS
Lafayette Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

Rhinophyma treatment

Great question about rhinophyma!  The final stage of acne rosacea progression is what causes most cases of rhinophyma. It is not caused by sinus issues or infections but may also be caused by a Demodex mite infection in some individuals. Hallmarks of rhinophyma include massive enlargement of the nasal oil glands, redness, and nasal disfigurement. While certain creams can help with rhinophyma early on, once it causes significant skin changes or deformity, surgical correction is indicated.I typically use two techniques for rhinophyma resection: scalpel sculpting of the desired nasal contour followed by dermabrasion for a final smoothing effect (note this is not microdermabrasion). Resection of rhinophyma takes great skill and is much like sculpting a nose out of clay. I will typically send a sample of the resected tissue to a pathologist because certain skin cancers can hide within the rhinophyma.Check out some of my photos for examples of this procedure. Good luck to you!

Parker A. Velargo, MD
New Orleans Facial Plastic Surgeon
5.0 out of 5 stars 42 reviews

Treatment of advanced rhinophyma

Laser resurfacing can provide excellent results for patients with advanced rhinophyma. I have had excellent success treating various degrees of rhinophyma using a Sciton Erbium:Yag laser using topical and local anesthesia in the clinic setting. In advanced cases, this may require multiple treatments to achieve the ideal nasal contour and shape. Your best bet would be to find a board-certified facial plastic surgeon, plastic surgeon, or dermatologist in your area who has experience treating patients with rhinophyma. Good luck! 

Sachin S. Pawar, MD
Milwaukee Facial Plastic Surgeon
5.0 out of 5 stars 23 reviews

Advanced case of Rhinophyma.

Hello drstelly2870 - Thanks for your question.  Treatment for nasal rosacea (rhinophyma) involves the use of laser resurfacing or dermabrasion after the disease itself is brought under control.  If you can't find an ENT or plastic surgeon to help you, I would recommend that you consult with a dermatologist who specializes in lasers in your area.  Also a specialist in facial cosmetic surgery would be a possibility as a treating physician.  It is important to note that your treatment may be limited by the amount of skin pigment you have (your Fitzpatrick score). A consultation will be necessary. Good luck, Dr. Shah

Manish H. Shah, MD, FACS
Denver Plastic Surgeon
4.7 out of 5 stars 45 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.