Growing evidence now confirms that rhinophyma, the excess growth of tissue on the nose that represents the most advanced stage of rosacea, is a result of the chronic lymphedema (swelling) that often appears in rosacea, according to a new study published in the Journal of the American Academy of Dermatology.1
"This study's findings have tracked the link between the vascular system and the more permanent disfiguring effects of rosacea," said Dr. Jonathan Wilkin, director of Dermatologic and Dental Products, U.S. Food and Drug Administration. "This new finding emphasizes the importance of avoiding flushing to prevent later excess tissue growth that cannot be treated with medication."
Lymphedema is the swelling that occurs when excess fluid accumulates because of the lymphatic system's flawed ability to clear it away normally.2 The study, by Dr. Filippo Aloi and colleagues at the University of Turin in Italy, documented microscopic changes that indicate chronic edema leads to excess tissue. The researchers noted that inadequate drainage may be due to a mechanical obstruction.
An early sign of rhinophyma may be an indentation on the bridge of the nose after wearing glasses, Dr. Wilkin said. Some physicians have even noted that heavy glasses themselves can contribute to swelling of the nose. Opting for a lighter pair of glasses may help.
Aloi F, Tomasini C, Soro E, Pippione M: The clinicopathologic spectrum of rhinophyma. Journal of the American Academy of Dermatology. 2000;42:468-472.
Wilkin JK: Rosacea: Pathophysiology and treatment. Archives of Dermatology. 1994;130:359-362.