Erbium Yag or Fraxel for Rhinophyma?

Question

I'm beginning to show signs of Rhinophyma. There are a few nodules on one side of nose and some thickening on tip of nose which I absolutely hate.  Which of these two lasers, Erbium Yag or Fraxel, would improve my condition? These two seem, from what I have read, have less downtime than the CO2. Thank you for responding. I am on Tazorac and cream antiobiotic. It helps somewhat but my main concern is the thickening on end of nose.

Michael A. Persky, MD · Answer

Hi Barbara,
You should treat rhinophyma with CO2 ablative laser.  I have not been impressed by the results of Fraxel re:store or re:pair on rhinophyma.
Good luck and be well.
Dr. P

Larry S. Nichter, MD, MS, FACS · Answer

It all depends on the agressiveness of the treatment - settings of power, intensity, number of passes etc.The Confluent CO2, Fraxel Re:pair, or Erbium in the right hands can all improve the appearance of a Rhinophyma.

William Groff, DO · Answer

We have all 3 lasers that you have mentioned in your question, and my 1st choice would be the CO2 laser. The Fraxel is not designed to target individual nodules, so it is not ideal. The erbium could be used, but the downtime would be the same as the CO2. I just submitted some photos of a patient with the issue that you are concerned about to RealSelf, and I treated him with CO2 on the nose, and Fraxel Repair on the rest of the face. Look for them under my name of photos of Fraxel Repair...should be up in next 2 days. Take care, Dr. Groff

Raffy Karamanoukian, MD, FACS · Answer

Ablative lasers work well for rhinophyma, as this is a proliferative condition of the sebaceous glands of the nose. In some cases, less invasive and simpler other modalities are used to treat rhinophyma such as CO2 laser, chemical peels, and surgery.

Quenby Erickson, DO, FAAD, FACMS · Answer

It is best to have an in-person consultation to develop a the best individualized treatment for you.  That being said, I typically use electrosurgery to shave down the bigger nodules and reshape with the ablative laser. Both C02 and Erbium are ablative lasers and both work equally well. Sometimes in the early stages of Rhinophyma the fractional lasers can be used and can improve the more subtle early signs of the problem and prevent it from becoming worse. There is really a lot of improvement that can be made at all stages of rinophyma.

Erbium Yag or Fraxel for Rhinophyma?

Answers (5)