Reclaiming Your Nose from the Damage of “Rhinophyma”

By Christina Smitley

Princess Diana’s gossamer beauty – recreated in Netflix’s “The Crown” – could not seem further from the wisecracking Depression-era actor W.C. Fields. But they shared a common trait. Both suffered from rosacea, with the bulbous-nosed Fields exhibiting the severe form of the disease known as “rhinophyma”.

According to the not-for-profit National Rosacea Society, about 16 million people in the United States suffer from rosacea, a chronic skin condition that typically starts as occasional facial flushing but can progress to permanently reddened and damaged skin.

Overall, most rosacea patients are adult women. But with rhinophyma, far more men are affected.

Researchers continue to explore the causes of rosacea, which appears to be a misfire of the body’s neurovascular and immune systems.

Over time, the frequency of blushing or facial flushing can increase, and the redness can become permanent. Some patients’ skin may become more sensitive. Others may experience changes that include acne-like breakouts, swelling, or visible blood vessels.

And in cases of ‘phyma, it progresses to thickening skin, which becomes bumpy and oily. Most often, this occurs on the nose, hence the name “rhinophyma”.

Left untreated, those afflicted with rosacea can face serious challenges. The National Rosacea Society reports that seventy percent say the condition negatively impacts their personal and professional lives, contributing to depression, anxiety, and low self-esteem.

In particular, states rhinophyma can carry a toll, as it has been inaccurately linked with alcoholism. W.C. Fields’ hard-drinking persona may have contributed to that misperception – which is incorrect and can further distress patients. In addition to the emotional and psychological burden of rhinophyma, if left unaddressed, it can interfere with breathing.

Rhinophyma responds well to treatment. And the sooner patients start, the more quickly they can reclaim their appearance, control symptoms – and prevent rosacea from disrupting their lives.

With that in mind, I offers the following tips:

5 Tips to Successfully Treat Rhinophyma:

1. Get a clear diagnosis:

   Rhinophyma is a more advanced form of rosacea, appearing after earlier symptoms, so patients may already have a diagnosis. That said, it’s important that the skin be evaluated for other conditions, including skin cancer, which can co-occur in the affected area.

2. Treat ASAP:

   Early intervention can slow rhinophyma and minimize its appearance. This can reduce the need for more extensive treatment to remove excess skin and reshape the nose.

3. Understand the roles of meds and surgery:

   Once the skin has become thicker, only removal can reduce it. Depending on the extent, dermatologists can remove excess skin with different surgical techniques, including lasers. Medications, in particular isotretinoin, can play an important role in slowing ongoing thickening, and may be prescribed after surgery to help block reoccurrence. With isotretinoin, it’s important patients fully understand potentially serious side effects so they can make an informed decision.

4. Stick with post-treatment “musts”:

   Number one? Always avoid the sun: SPF 30, protective clothing, seeking shade. Next? ID your triggers: Possibilities include temperature extremes, spicy foods, hot beverages, alcohol, certain medications, stress, health and beauty products. These can all spark flares that contribute to reoccurrence. The National Rosacea Society’s website has a diary booklet patients can use to record exposures and identify those they are susceptible to. Your skin specialist can help you evaluate your individual triggers.

5. Make self care skin friendly:

   Your dermatologist, can help you choose health and beauty products that avoid “trigger” ingredients like menthol, camphor, or sodium lauryl sulfate, as well as provide guidance in following a careful skin care routine: Cleansing is important, but it must be gentle. And moisturizing is a must, with a “friendly” cream that steers clear of irritants.

Restorative treatments and supportive care give patients tools to control rhinophyma so that they can feel empowered in their lives.

Christina Smitley, FNP-C, is a family nurse practitioner with Advanced Dermatology pc, is board-certified through the American Academy of Nurse Practitioners.

Advanced Dermatology P.C. and the Center for Laser and Cosmetic Surgery (New York & New Jersey) is one of the leading dermatology centers in the nation, offering highly experienced physicians in the fields of cosmetic and laser dermatology as well as plastic surgery and state-of-the-art medical technologies. www.advanceddermatologypc.com