Am I Too Old for Bulbous Nose Surgery?

Medically Reviewed by Jennifer Robinson, MD on April 24, 2023
3 min read

A bulbous nose is a condition called rhinophyma that is caused by rosacea. As rosacea gets worse, it can cause a large, bumpy, and red nose. It usually affects older men more than women, and the treatment is surgical procedures to remove some of the skin.

There are risks to surgery at every age and especially for older people, but you can safely have bulbous nose surgery at age 60.

Rosacea is a skin disorder that affects lots of people. It causes red, swollen skin that blushes and flushes easily. It usually starts between ages 20 and 30 and goes through different stages. The skin thickens, swells, and can be waxy, and oil glands and blood vessels get bigger. Rosacea can affect your eyes and cause problems with eyesight if it's not treated.

Some people are more likely to get a bulbous nose. These include:

  • Older people
  • Men
  • Fair-skinned people
  • People with a Scandinavian, English, Irish, Scottish, or Eastern European background
  • People with family members who have rosacea or bulbous nose

Women are more likely to get rosacea, but men are more likely to get a bulbous nose from rosacea.

The different stages of rosacea are treated differently. Your doctor might give you medications like antibiotic creams or pills, retinol or azelaic acid creams, or glycolic acid peels for early stages of rosacea. They might also suggest lifestyle changes that can help manage your skin.

Your doctor will usually try to help you avoid getting a bulbous nose by using different treatments to stop the skin from getting inflamed or swollen. But if you get a bulbous nose from rosacea, surgery is usually the best treatment for moderate to severe cases. 

Since most people are diagnosed with a bulbous nose between ages 50 and 70, it’s common to have bulbous nose surgery at age 60.

Lots of people feel embarrassed or stressed about the way their nose looks. This can cause a lot of emotional problems and affect your quality of life. Treating your bulbous nose with surgery can help you feel better about yourself. It can also help your skin.

The benefits of bulbous nose surgery include:

  • Removes extra skin and bumps
  • Reshapes a misshapen nose
  • Shrinks large blood vessels
  • Makes it easier to breathe
  • Improves appearance

Most types of surgery for a bulbous nose are done with local anesthetic in your doctor’s office. The benefit is that you don’t need to have general anesthetic or a major surgery. Your doctor can safely treat you in the clinic.

There are several options, including:

Surgery for a bulbous nose caused by rosacea can have side effects and risks. You will experience some symptoms from having surgery. These might include:

  • Redness
  • Swelling
  • Soreness
  • Skin peeling
  • Bruising
  • Visible blood vessels
  • Crusting sores
  • New skin that burns easily
  • A lot of pain

Many of these symptoms will go away within a few weeks and the skin will heal. The new skin will be sensitive to sunlight and might burn easily, so you will need to make sure you wear sunscreen. 

Rosacea is also a chronic skin problem, and it can’t be cured. This means it lasts a long time and you might need surgery or treatment again.

Sometimes lots of skin has to be removed. If this happens, you might need special bandages and wound care. You might also need to have a skin graft.

Sometimes bigger problems can happen after having surgery for a bulbous nose. These can include:

  • Scarring
  • Taking too long to heal
  • Burns
  • Uneven skin texture
  • Damage to your nose cartilage
  • Major bleeding
  • Infection

Scarring can happen if deep layers of skin have to be removed. It can also be caused by heat damage to the skin from laser surgery.

Rosacea can get worse. If you don’t treat your skin condition earlier in life, it can move into later stages that cause problems like a bulbous nose.

The best treatment for a bulbous nose is to treat rosacea early on. Part of treatment is to avoid triggers like certain foods, coffee, and alcohol that make your rosacea worse. Managing stress, using prescription creams and medications, and protecting your skin from the sun can also help.

If you pay attention to your triggers and keep a regular treatment and protection program for your skin, you can control your rosacea well.