Author: Dr Francisco Flores, Dr Maryam Ameen, and Dr Brittany Tsai, Ross University School of Medicine (2024)
Reviewing dermatologist: Dr Ian Coulson (2024)
Edited by the DermNet content department
A 77-year-old male presented with facial redness and discomfort for the past year.
Physical examination shows thickened and bumpy nasal skin; and pink patches with telangiectasia and red papules on the face, most prominently on the medial cheeks and forehead.
This is rhinophyma, and he also has associated papulopustular rosacea.
General skincare (emollients, soap substitutes) and lifestyle advice is important in managing rosacea in general. Keeping a symptom diary to identify and avoid triggers (eg, foods, hot beverages, spices, alcohol) for flare-ups can be helpful. Cool compresses are often used for flushing and various topical or systemic medications may be considered for symptom control. Sunscreens may help as many sufferers experience exacerbation with sunshine.
This patient was prescribed the tetracycline antibiotic doxycycline, and advised to avoid spicy foods, alcohol, caffeine, and stress. He was also recommended to seek plastic surgery consultation to consider cosmetic facial resurfacing.
Oral isotretinoin has also been reported to be useful in treating rhinophyma; the drug reduces the enlarged sebaceous glands that characterize rhinophyma.
See: Rhinophyma.
