Rhinophyma

What is Rhinophyma?

Rhinophyma is the uneven swelling of the nose, as caused by advanced-stage rosacea. It is almost exclusively seen in elderly patients and represents the full extent of what rosacea is capable of dong to the skin. Its exclusivity is a factor of time; Rhinophyma takes a very long time to develop, usually, and is not generally affected by environmental factors in the same way normal rosacea is. That is to say, it is difficult to provoke except by factors that make rosacea itself worse.

The swelling of the nose is not even, as is normally witnessed with age (the nose never stops growing, however slowly). It is also different from the swelling of the nose that can occur from a history of alcohol abuse. Rhinophyma swelling is always uneven, and can look like advanced scarification as a result of the skin thickening. Rhinophyma can be quite unnerving to look at due to its profound impact on a person’s appearance.

Who gets Rhinophyma?

Rhinophyma can afflict anyone who suffers from rosacea long enough. It will only affect individuals that suffer from rosacea, as it is a distinct condition that can only form from advanced rosacea progression. It is important to remember this distinction, as it separates rhinophyma from the many other conditions that can cause the nose to swell.

Rhinophyma has a tendency to form in the elderly. It is almost exclusive to them, in fact, as rhinophyma implies advanced rosacea with no regard for how inflamed the case of rosacea actually is.

As a condition connected to rosacea, the usual stipulations apply for a predisposition, with the primary different factor being age (rosacea usually develops in the middle-aged). Caucasians are far more susceptible to rosacea and rhinophyma by reason of this.

What causes Rhinophyma?

Rhinophyma is caused by the thickening of the skin as a result of damage incurred over time by the progression of rosacea. It is, notably, n ot a result of alcohol abuse or physical trauma, although it is frequently confused for these. Because alcoholism and rosacea are both conditions that are not uncommon, the two issues are frequently conflated, but there is no true link.

Rhinophyma is not inflamed by the many factors that make rosacea worse. Advanced rosacea that has been affected by various external stimuli may result in a more rapid onset of rhinophyma, but they will not cause rhinophyma on their own. To reiterate, stimuli such as heat, stress and etcetera that contribute to outbreaks of rosacea do not have equivalent effects on rhinophyma.

Rhinophyma can be made worse by alcohol abuse and other factors that cause damage to the cartilage, but these are merely influences contributing to a condition that already exists. They are not causes by any metric.

What does Rhinophyma cause?

Rhinophyma causes the advanced swelling of the nose in an uneven fashion. This can restrict nasal passages to a certain extent, but this is not considered a primary symptom and is not a common result.

Most of the impact rhinophyma has is social and psychological. The rhinophyma can be quite disfiguring and cause a dramatic change in appearance. Whereas rosacea can be fairly mild, and even covered with cosmetics in its more advanced forms, rhinophyma cannot be disguised to any extent. Many people liken rhinophyma to a classic ‘witch’ nose, as it can make the nose seem to be overrun with severe warts (even though this is not the case at all).

This can lead to social ostracization, although not to the same extent as other skin conditions like eczema, acne or rosacea. The difference is primarily made due to age group, as the elderly are far more likely to suffer from rhinophyma and also generally less likely than adolescents to make character judgments based on cosmetic conditions. That is to say, the peer group plays a profound role in the social aspect of things.

On the other hand, the psychological effects remain no less potent than as can occur with advanced cases of acne and its subsequent scarring,a nd other disfiguring facial conditions. The change in appearance can be discouraging and in extreme cases feel like a loss in identity. Thus, it is important to monitor individuals suffering from rhinophyma to make sure they don’t come to suffer from any advanced psychological effects.

How serious is Rhinophyma?

Rhinophyma is more profoundly serious than rosacea but still does not constitute a true risk to health. Any possible restriction of nasal passages will be effectively superficial, making breathing somewhat more difficult rather than truly preventing it. Rhinophyma has no mortality rate. Rhinophyma further does not constitute the risk of damage to other systems in the way that rosacea may; rhinophyma cannot damage the eyes in and of itself. That said, rhinophyma can be the hallmark for eye damage through rosacea, and is sometimes considered the third stage of rosacea progression, with eye damage being the fourth and final stage.

Rhinophyma is more serious than rosacea for its advanced aesthetic and, consequently, psychological effects. Most of its impact stems from this alone. It is important to monitor individuals suffering from advanced-stage rosacea and rhinophyma for any psychological impact, as many individuals become quite susceptible to depression when they have undergone such a profound (negative) change to their appearance.

What does Rhinophyma treatment look like?

Rhinophyma treatment is difficult. Like rosacea, it cannot be truly treated at the source. Unlike rosacea, it also cannot be directly mitigated; if rosacea progresses to such a point as to cause damage to the skin sufficient to induce rhinophyma, rhinophyma will persist. That said, any preemptive actions that arrest the progression of rosacea can help to prevent the onset of rhinophyma.

Any reversal of damage caused by rhinophyma will require surgical intervention. This is possible, but will almost always result in painful inflammation for a period of weeks, and carries with it the risk of post-operative infection, along with the other risks that surgery constitutes. That said, it is possible to reverse rhinophyma damage with surgical reconstruction. It is simply a matter of one being willing to seek and pay for such treatments, which insurance will usually not cover.

The damaged look of the skin that rhinophyma carries can be assuaged somewhat with lotions and cosmetics to make the skin look healthier, but these will not actually reverse the damage nor hide the difference in physical shape. This may be sufficient for early stages of rhinophyma, however.

Individuals suffering from depression brought on by rhinophyma may be assisted by therapeutic or psychiatric intervention. This will naturally vary from person to person, and not everyone who suffers from rhinophyma will feel a strong enough emotional impact to pursue such treatment, which can be costly. Support groups and advocacy groups exist for individuals with rosacea and its variants, and these organizations will frequently have resources that can be a boon to individuals affected by rhinophyma.

How do I know if I have Rhinophyma?

Rhinophyma is very easily identifiable by the uneven thickening of the skin and the formation of hard nodules of skin and flesh. It only follows an advanced case of rosacea and almost always occurs in the elderly, making it very, very easy to single out. An individual familiar with rosacea and rhinophyma can easily distinguish it from the other possible causes of the nose swelling, including and especially alcohol abuse. However, it is important for an actual doctor to identify and advise, as with all skin conditions. Self-diagnoses are frequently harmful to rely on.

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