Rhinophyma
Rhinophyma is a progressive skin condition affecting the nose, characterised by thickened skin, enlarged sebaceous (oil) glands, visible pores, and prominent redness or blood vessels. Over time, the nose may become bulbous, irregular, or nodular, leading to significant cosmetic and functional concern.
Rhinophyma is a subtype of rosacea—not caused by alcohol—and develops gradually as inflammation, tissue overgrowth, and gland enlargement distort the normal shape of the nose. Over time, rhinophyma can significantly alter nasal contour, but it is highly treatable with modern laser techniques.
The Science Behind It
Rhinophyma develops through a combination of chronic inflammation, vascular dysfunction, and sebaceous gland hypertrophy, all occurring within the structural framework of the nasal skin. It is considered the most advanced manifestation of phymatous rosacea.
1. Vascular Dysregulation
The underlying rosacea process causes instability of the superficial dermal blood vessels of the nose. This leads to:
- Persistent vasodilation
- Leakage of plasma proteins
- Chronic low-grade inflammation
- Progressive fibroblast activation
Over time, this contributes to thickening, redness, and vascular proliferation.
2. Sebaceous Gland Hyperplasia & Hypertrophy
Sebaceous (oil) glands on the nose become:
- Enlarged (hypertrophy)
- Increased in number (hyperplasia)
This results in:
- Prominent pores
- Oily, pitted surface texture
- Overgrowth of glandular tissue
- Nodular thickening
The nasal skin contains the highest concentration of sebaceous units on the face, making it particularly prone to this process.
3. Fibrosis & Connective Tissue Overgrowth
Chronic inflammation activates fibroblasts in the dermis, leading to:
- Collagen overproduction
- Elastosis
- Scar-like thickening of the skin
- Irregular surface architecture
This fibrosis is what ultimately distorts nasal shape.
4. Cartilage and Support Structure Preservation
Rhinophyma affects the skin and dermis, not the underlying cartilage. However, the overlying tissue can become so bulky that it obscures normal anatomical boundaries and nasal contour.
5. Why Laser Works
CO₂ and Erbium:YAG lasers:
- Vaporise hypertrophic sebaceous and fibrotic tissue
- Reduce vascular congestion
- Smooth surface irregularities
- Restore natural contour while preserving deep structures
CO₂ provides controlled bulk removal; Erbium refines and blends, optimising aesthetic and functional outcomes.
Treatment at a Glance
Procedure time: 45–90 minutes (severity dependent)
Anaesthesia: Local anaesthetic, day-stay setting
Downtime: 14–21 days initial healing; residual redness may persist
Sessions: Typically one definitive treatment; refinement if required
Return to work/social activity: 3–4 weeks (case dependent)
Results: Immediate contour improvement with progressive skin refinement
Frequently Asked Questions
Rhinophyma is an advanced form of rosacea characterised by progressive thickening of the nasal skin, enlargement of sebaceous glands, and irregular surface contour. It can lead to both functional and aesthetic concerns if left untreated.
Important ACC & Treatment Disclaimer
ACC funding eligibility is determined by the Accident Compensation Corporation on a case-by-case basis. Approval is dependent on injury acceptance, clinical indication, and ACC policy at the time of application. Not all treatments offered at Scars & Lasers are ACC-funded. Private fees may apply for unfunded components of care.
Learn more about ACC IncidentsPrecision reshaping of rhinophyma with specialist-led laser dermatology — restoring natural contour, structure, and skin integrity.
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