What is the best procedure for a brown skin male with rhinophyma?

Hello BM3.  If the primary concern is how bulbous (large) the nose is becoming, then laser treatments are the next step.  The challenge with a darker skinned patient is that there is a higher risk of hypopigmentation (lightening) of the skin when using the CO2 laser.  An alternative that's safer for darker skin types and works very similar for Rhinphyma is the Erbium laser.  The laser can accomplish the same goals of shaving down the excess tissue, but has a lower risk of lightening the skin.  Best of luck.

Rhinophyma requires co2 laser or radiowave. I recommend getting a formal evaluation with a cosmetic dermatologist. For rosacea, I like a combination approach, using lasers (ProYellow, Pulsed Dye/Vbeam, Excel V), peels and botox to the cheeks. This makes dramatic changes in color and symptoms. See an expert. Best, Dr. Emer

In general, the best treatments for rhinophyma are surgical including loop cautery and CO2 laser. Topical treatments, such as retinoids, can also be used. And, as you mentioned, Accutane can be helpful. The problem is, depending on your skin type, laser and other surgical procedures could leave behind permanent pigment change on your skin. My best advice would be to get in with an area board-certified dermatologist and go over all of your options and limitations to the treatment. Seeing someone with a strong cosmetic background could be a good idea as well, as they will likely have more lasers to utilize for darker skin types. All the best!