While the ravages of subtype 3 (phymatous) rosacea have been well documented throughout history, today a multitude of options are available to restore a red, swollen or bumpy nose (rhinophyma) to normal appearance.
Although subtype 3 (phymatous) rosacea often involves excess tissue, it can be effectively treated with a range of options appropriate for the severity of the case, according to the standard management options for rosacea recently published by the National Rosacea Society.1
Rhinophyma, in which the enlargement of tissue results in a bulbous and bumpy appearance of the nose in some rosacea sufferers, may usually be effectively addressed with laser surgery, according to Dr. Jeffrey Dover, associate clinical professor of dermatology at Yale University.
"Although rhinophyma may be generally unresponsive to oral or topical therapy, it is usually very amenable to surgical approaches," he said. "Besides manual surgery, electrosurgery and lasers are often very effective in reducing the excess tissue and returning the nose to a more normal appearance."
While many individuals may fear the growth of excess tissue on the nose that often heralds subtype 3 rosacea (phymatous rosacea), a bulbous enlarged nose need not be permanent. Today, surgical methods such as electrocautery and laser surgery may be used to take away the distorted shape and bring back a normal appearance.
Joseph Sheehan may be a thick-skinned individual, but when his rosacea got out of control, it was more than he could bear.
Sheehan, a naval architect who teaches ship design, developed rosacea around 60. "At first it was basically just a redness, and oily skin around the nose," he said.
He tried a few home remedies and lived with the symptoms for about a year. Finally, he saw a dermatologist.
"He prescribed an oral antibiotic, but I didn't like the idea of having to use it indefinitely," Sheehan said. "So I never took it."
While a National Rosacea Society survey showed that more women experience rosacea symptoms on the cheeks and chin, the enlargement of the nose is usually seen in men. According to a recent article by Drs. Thomas Jansen and Gerd Plewig in the new medical textbook, Clinical Dermatology, this is the ultimate reaction to rosacea in males.1
The unsightly redness, papules and pustules of rosacea can be controlled with medical therapy combined with lifestyle modifications. But untreated symptoms may progress to rhinophyma, a conspicuous condition that sometimes appears at the advanced stage of this common and embarrassing disorder. Most often occurring in men, rhinophyma is the red swollen nose often mistakenly attributed to heavy drinking, such as in the case of the late comedian W. C. Fields.