Treatment of Rhinophyma
INTRODUCTION:
Rhinophyma is a type of acne rosacea in which there is a slow increase in the size of the end of the nose. This is often associated with redness, broken blood vessels and pustular lesions. The cause is unknown and contrary to popular opinion, the enlarging red nose has nothing to do with alcohol intake.
Creams and tablets may be helpful in stopping the pustules and reducing the redness.
Rhinophyma treatment permanently reduces the size of the nose, using a combination of surgery and laser reshaping and sculpting.
After reshaping the nose, IPL or the Nd YAG laser may be used to treat broken blood vessels.
BEFORE THE PROCEDURE:
If you are taking blood thinning medications such as Aspirin which increase bleeding, please let me know as we may need to cease these before the procedure. Please let me know if you have had cold sores on the nose as anti-viral medication needs to be started the evening before the procedure and continued 2 x daily for a few days.
PROCEDURE:
Your nose will be photographed and injected with local anaesthetic. Your eyes will be covered to protect them.
First, excess tissue is removed then the laser is used to shape the nose. A smoke evacuator is used to remove fumes – this sounds like a vacuum cleaner. The nose usually bleeds during the procedure, please don’t be worried by this. The procedure itself takes about one hour. Once it is over the nurse will apply a large dressing to the nose.
POSTOPERATIVE CARE:
The treated area will look red and raw, rather like a grazed knee. Vaseline or antibiotic ointment and a dressing will be applied. When the anaesthetic wears off, Panadol and/or Ibuprofen may be used. Swelling around the nose and the eyes may be quite marked and is worst at 2-3 days after surgery. Please apply ice packs (e.g. packet of frozen peas in a clean tea towel) hourly for 10-15 minutes on the day of surgery to reduce swelling. If the nose is oozing, apply the cold pack firmly and continuously (no peeking) for 20 minutes.
Starting the day after surgery, go into the shower, get the dressing wet and remove it. The treated area should be dressed daily as follows:
- Use gauze or cotton buds with hydrogen peroxide or saline to remove all crusts, and then dry gently with gauze. Do not get peroxide in the eyes.
- Apply Vaseline generously.
- Apply 2 layers of Hypafix tape. Areas such as the nostrils where a dressing cannot be applied, should have Vaseline applied every 2 hours.
The wound will be reviewed in the first few days. The dressings will need to continue for approximately 10-14 days until healing is complete. The nose will remain pink for a further 2 to 3 months and must be protected with sunscreen everyday for 3 months. Use a flesh coloured zinc stick sunblock and a hat if outside. Once the nose has healed, it usually has a smoother, slightly shiny surface and is somewhat lighter in colour than previously. Most people will still have a large nose after the treatment but it will have a better shape.
COMPLICATIONS:
Scarring and an uneven surface (due to underlying cysts falling out during the procedure) are rare complications. Other rare complications include infection, prolonged redness and hyperpigmentation (brown patches). Hyperpigmentation is more common in olive or darker skin and sunscreen is essential for prevention. It is very rare for regrowth of the nose to occur but treatment may be repeated if needed in the future.
If you have any questions or problems during the course of your treatment please call: Adelaide Skin & Eye Centre 8211 0000 (Monday to Friday 9am to 5pm).