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Rosacea on the nose: what it looks like and what helps

Rosacea can cause the nose to become bulbous. We explain how such a so-called rhinophyma develops and what can help against it.

In the past, deceptively, there was talk of a “drunk nose”. Today it is clear that a bulbous and enlarged nose is a symptom of a skin disease: rosacea (also known as rosacea).

In rosacea, the skin of the face becomes inflamed in stages, which manifests itself, among other things, by redness (“flushing”), which initially fades and then persists. In some of those affected, the inflammation also causes the connective tissue to proliferate and the sebaceous glands to enlarge permanently.

This can happen on the cheeks, chin, forehead, ears, and eyelids. The best known is probably the bulbous deformation of the nose caused by rosacea, also called rhinophyma.

Bulbous thickening usually extends to the tip of the nose, bridge of the nose, and nostrils, so that the overall nose appears significantly larger than it did before the onset of the disease. On the other hand, some affected people develop localized growths that are more resembling a tumor.

In many cases, the skin of the nose is also red and crossed by visibly dilated blood vessels.

Rosacea in the nose: alcohol as a cause?

Although rosacea affects people of all genders, rhinophyma mainly affects men. Why it is not clear. It is sometimes claimed that excessive alcohol consumption is the more common reason among men than among women.

However, this has not been proven and is not even plausible. Alcohol is one of the most common triggers for rosacea, that is, those influences that can trigger new flare-ups. However, these are by no means accompanied by a thickening of the nose in all patients. There are also people with rosacea who do not drink alcohol and still develop rhinophyma.

Rosacea on the nose: what helps?

The deformity of the nose caused by rosacea does not go away on its own. However, there are various ways to remove excess tissue. These methods have not yet been sufficiently tested in scientific studies to be able to clearly assess their effectiveness. Consequently, it is not clear which of these is more suitable.

Based on previous studies, experts recommend three methods in particular:

All of them aim to remove the thickened layers of the skin. However, different means are used for this: in laser treatment a CO2 laser or an Er: YAG laser, in dermabrasion a special grinder and in dermabrasion a scalpel.

While these procedures can significantly improve the appearance of the nose, they also come with risks. For example, pain may occur during and after the procedure, scarring may also occur, and / or the treated skin areas may be lighter than the rest of the skin on the face due to the weaker pigmentation.

Are there any medications for nasal rosacea?

Isotretinoin, which is taken in capsule form, can possibly help with an incipient, that is, slightly pronounced rhinophyma. Individual studies provide evidence that ingestion counteracts deformation. So far, however, there is no reliable scientific evidence for this.

For this reason, isotretinoin is not yet approved for the treatment of rosacea. Doctors can therefore only prescribe the drug “off-label”. This means that they must first explain to the patient that the drug is not yet approved for rosacea therapy and explain the risks of attempting treatment.

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