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 and there may be recurrent 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.
Surgical treatment reduces the size of the nose, usually with the assistance of a laser or electro surgical (‘cautery’) device.
PROCEDURE:
If you are taking drugs such as Aspirin or Warfarin which increase bleeding, please let me know before the procedure. Please let me know if you have had cold sores on the nose as anti-viral medication needs to be started before the procedure.
Your nose will be photographed and injected with local anaesthetic. Your eyes will be covered to protect them from the bright theatre light.
First, excess tissue is removed then the laser or electrosurgical device is used to shape the nose. A smoke evacuator is used to remove fumes – this sounds like a vacuum cleaner. The procedure itself takes about one hour. Once it is over the nurse will apply a 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 or Panadeine 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 (or 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, 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 with gauze. Do notget 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 Vaselineapplied 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.
COMPLICATIONS:
Most people will still have a large nose after the treatment but it will have a better shape. The surface is usually smooth and shiny. Scarring and an uneven surface (due to underlying cysts) may occur.
Other complications are rare and include infection, prolonged redness and hyperpigmentation (brown patches). Hyperpigmentation is more common in olive or darker skin and sunscreen is essential for prevention.
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)