Rhinophyma: What are the treatments for rosacea on the nose?

Severe forms of rhinophyma are typically treated through mechanical destruction. This often involvesinvasive procedures utilising various surgical techniques.

An effect of cryosurgery on rhinophyma?

Cryosurgery is a local treatment that destroys excessive tissues present in the nose through the application of intense cold. Guided by an ultrasound, the doctor inserts cryogenic probes into the area to be treated through the skin in order to freeze the skin tissues between -40° and -60 °C. This causes the instant cooling of the tissues, leading to the formation of micro ice crystals within the cells and their destruction. In the case of rhinophyma, the gas most often used is liquid nitrogen. Cryosurgery allows for a precise destruction of tissues while preserving the nasal cartilage.

Is dermabrasion beneficial in combating rhinophyma?

Commonly used to treat rhinophyma, dermabrasion is a procedure during which the upper layers of the skin are removed using a rotating device equipped with abrasive burrs after the rhinophymatous tissue has been reduced with a scalpel. It helps to smooth the surface of the nose and reduce the appearance of nodules and irregularities. Dermabrasion presents less significant scarring risks compared to surgery.

Is surgical removal possible in the case of rhinophyma?

It is also possible to perform a surgical removal to eliminate rhinophyma. This method involves removing the excess skin tissue on the nose using a scalpel or a surgical knife. It involves surgically cutting the hypertrophied tissues of the nose to reshape them and make them more aesthetically pleasing. The surgical knife blade is often heated between 150°C and 200°C and used to remove significant rhinophymatous tissues. The heat of the blade cuts the tissues and coagulates the blood vessels. This technique carries relatively few risks of recurrence. Surgical removal is often used in cases of severe rhinophyma, presenting a significant amount of hypertrophied rhinophymatous tissues.

Can rhinophyma be treated with electro surgery?

Finally, rhinophyma can be managed through electrosurgery. This technique utilises a high-frequency alternating electric current to cut and remove the hypertrophied tissues of the nose. It can be performed using an electrocautery device or an electric scalpel. However, it is important to note that electrosurgery carries significant risks of burns, hence the need to have it performed by a competent healthcare professional whom you trust. Moreover, haemostasis, that is, the return to normal blood circulation, can prove challenging after the operation.

Radiofrequency is a treatment method that utilises electromagnetic waves to generate controlled heat within the skin tissues. This heat induces the coagulation of blood tissues and the contraction of collagen fibres, which can reduce the size of nodules and growths associated with rhinophyma. Radiofrequency also aids in reducing the size of excessive nose tissues and enhancing its appearance.

Radiofrequency treatment can utilise various techniques based on a similar mode of operation. Among these, fractional radiofrequency, thermocoagulation by radiofrequency, and microneedle radiofrequency are generally favoured in cases of rhinophyma.

Finally, laser treatment is an effective option for managing rhinophyma and enhancing the appearance of the nose.

The CO2 ablative laser for treating rhinophyma.

The CO2 ablative laser is a fairly common technique for treating rhinophyma. The CO2 ablative laser generates very short and intense pulses of light. This type of laser emits electromagnetic waves within a mixture of several gases: CO2, nitrogen and helium. In this way, the CO2 molecules are excited and raised to a higher energy level. This energy is then absorbed by the water present in the skin tissues, leading to a controlled evaporation of the upper layers of the skin. This precise ablation allows for the smoothing of skin surface irregularities and the reduction in size of the growths associated with rhinophyma.

How does the Pulsed Dye Laser (PDL) work on rhinophyma?

The PDL laser emits light pulses at a specific, adjustable wavelength of 585 to 595 nanometers selectively absorbed by the haemoglobin present in the blood vessels. The PDL laser can be used to target dilated or abnormal blood vessels in the nose, in order to reduce their diameter. This helps to alleviate the redness and inflammation associated with rhinophyma.

What is the significance of the Nd:YAG laser in the case of rhinophyma?

The Nd:YAG laser emits light at a specific wavelength of 1064 nanometers, which is absorbed by the melanin pigments in the skin. It can be used to target pigmented or hyperpigmented lesions on the nose, thereby helping to even out the skin colour and improve its appearance.

Using the KTP (potassium titanyl phosphate) laser to get rid of rhinophyma?

The KTP laser is a so-called vascular laser, meaning it targets blood vessels to reduce their diameter. It belongs to a subclass of YAG lasers and uses the same mechanism of action. The KTP laser emits at a wavelength of 532 nanometers.

Is the Er:YAG laser effective against rhinophyma?

The Er-YAG laser, also a subclass of YAG laser, emits waves that penetrate deeply into tissues. It has a photoablative effect, meaning it induces pure tissue ablation without thermal injury. This laser emits light at a wavelength of 2940 nanometres.

Despite the effectiveness of all the treatments presented, a recurrence of rhinophyma remains possible.