How Rhinophyma Affects Your Nose

Medically Reviewed by Zilpah Sheikh, MD on May 02, 2024
Written by Angela McPhillips
6 min read

Rhinophyma is a skin disorder affecting your nose. It causes your nose to grow larger and appear red, bumpy, and rounded.‌

Medical professionals believe that rhinophyma results from severe rosacea that goes untreated. Rosacea is a chronic skin condition that inflames your skin so that it looks swollen and red across your nose and cheeks.‌‌

You may have heard that rhinophyma is caused by heavy alcohol intake, but that's a myth. Rhinophyma affects both drinkers and non-drinkers equally. When left untreated, rhinophyma damages your nose to the point that it restricts your ability to breathe.‌

Rhinophyma is a rare disorder. The exact cause is largely unknown. Some people with rosacea develop rhinophyma, but people without rosacea can have this disorder, too.  

Rhinophyma risk factors

Some factors that put you at a greater risk for developing the skin condition, including:

  • Being male or assigned male at birth
  • Being between the ages of 50 and 70
  • Having fair skin
  • Having heritage that is Irish, English, Scottish, Scandinavian, or Eastern European ‌
  • Having a family history of the skin condition
  • Having a rosacea diagnosis

Rhinophyma and alcohol

Many people think that drinking too much alcohol causes rhinophyma, but this isn't true. While the exact cause of this skin condition isn’t known, there's no proven connection between alcohol consumption and rhinophyma. The stereotype that people with rhinophyma are always heavy drinkers can create social and emotional stress if you have this condition. But knowing the facts about rhinophyma can help you deal with the stigma associated with it.

There are four stages of rosacea, and rhinophyma occurs in the last, or late, stage. Because rhinophyma often develops following a severe case of rosacea, it’s important to watch out for symptoms of this unique skin condition.

Rhinophyma early stages

In the early stages, symptoms of the skin disorder may appear mild and include:

  • Skin turning a reddish color
  • Spidery red or purple veins on your nose
  • Your nose appearing swollen without any improvement

The early symptoms of rhinophyma may occur in cycles that gradually get worse. Symptoms may progress to include: 

  • Visible oil glands on your nose 
  • Enlarged pores on your skin
  • Skin growing thicker‌ and bumpier
  • The surface appearing waxy, rough, and even yellowish in color‌
  • A swollen, bulbous nose 

First, your doctor completes a physical exam to look for signs of rhinophyma. If they suspect this skin condition, they will order more tests for an exact diagnosis. Your doctor may take a small sample of the skin cells on your nose to send to a lab for biopsy. This is especially important if your doctor tries treatment options and your condition doesn’t improve.‌

Early treatment is important in preventing long-term damage that requires surgery.‌ ‌Before trying surgery, your doctor may prescribe different medications to treat your symptoms. These include antibiotics you take by mouth, such as tetracycline, doxycycline, and metronidazole. If antibiotics don’t work, your doctor may try an oral acne medication called isotretinoin. It is a retinoid that is usually prescribed for patients with acne. While it won’t cure rhinophyma, the medication may help to reduce redness and slow or reverse the growth of oil glands that cause enlarged pores and bumpy skin texture.‌

The most common treatment for rhinophyma is surgery. Depending on how severe it is, a plastic surgeon can change the shape of your nose and help your breathing by:

  • Reshaping your nose
  • Removing any overgrown tissue‌
  • Minimizing blood vessels that are oversized‌‌

Rhinophyma surgery

Surgery techniques to achieve your desired results include:

  • Laser resurfacing to change the shape of your nose
  • Dermabrasion using a small device that spins to scrapes off the top layers of your skin 
  • Using a small knife to shave off bulky tissue and allowing the underlying area to heal
  • Grafting skin from other parts of your body‌
  • Reconstructing the inside of your nose‌

Repairing damage from rhinophyma may not be a one-time surgery. Your doctor may need to do additional reconstruction at a later date if the damage from your condition is severe.‌

Surgery recovery

If you have surgery to treat rhinophyma, it is important to take good care of your skin while it heals. How your skin looks and feels after surgery depends on the type of surgery you have to treat your skin disorder. You may or may not have a bandage on your nose afterwards. Your doctor will give you specific instructions to follow after your procedure. In general, the following tips are important for your recovery:

  • Watch for signs of infection like pus draining from your skin or fever
  • Don't swim in chlorinated pools or hot tubs to avoid infections
  • Take medication as prescribed to treat pain

Contact your doctor right away if you have any signs of infection or other concerns about how your skin is healing. 

While rhinophyma is rare, rosacea is a common skin condition. If you have rosacea, the blood vessels in your face begin to show, causing redness and swelling. In some cases, the condition causes bumps that fill with pus.‌

Rosacea often happens in flare-ups that can last weeks or months before your skin calms down and the symptoms disappear. Rosacea is frequently misdiagnosed as acne or other similar skin conditions. It can affect anyone but is most common among middle-aged women with lighter complexions.

Poor skin hygiene doesn’t cause rosacea, although it may contribute to the condition worsening. The cause is largely unknown but believed to be both hereditary and environmental. Factors that lead to flare-ups of rosacea include:

  • Hot drinks
  • Spicy food
  • Alcoholic drinks, especially red wine
  • Very hot or cold weather
  • Exposure to sunlight
  • Severe wind
  • Stress and other strong emotions
  • Exercising
  • Using medications that cause your blood vessels to dilate, including blood pressure medicine‌
  • Cosmetic products

While you may not be able to completely prevent rhinophyma, you can take steps to protect your skin from damaging elements. You should use sunscreen on your face every day that is at least 30 SPF. This protects you from sun damage that can add up over time, even if you don’t experience sunburn from daily sun exposure.‌

Use gentle skin care products to wash and moisturize your face. Trade harsher soap bars or face cleaners for natural alternatives. Avoid perfumes and added chemicals that may lead to skin irritation. Moisturizer is especially important if your skin tends to be dry or sensitive.‌

Rhinophyma is a rare skin condition without a known cause. It is linked to rosacea and isn't caused by drinking alcohol. If you’re at risk of getting rhinophyma, it’s important to watch for mild symptoms and receive treatment early before the disorder gets worse and you need surgery.

How can you get rid of rhinophyma?

Your doctor will treat early rhinophyma with oral medications, such as antibiotics or isotretinoin. If these medications don’t work, a plastic surgeon can use different surgery techniques to change the shape of your nose and improve your breathing. You may need more than one procedure if your condition is severe.

What do the early stages of rhinophyma look like?

You may have a reddish color to your skin, spidery red or purple veins across your nose, and a swollen nose that does not improve over time.

Is rhinophyma reversible?

Surgery can reverse rhinophyma. Symptoms can return after surgery, but this is rare.