Sometimes there’s some truth to the myth. The red, swollen and bumpy nose of rosacea was long associated in popular discourse with heavy alcohol consumption; it’s been historically referred to as drinker’s nose, and W.C. Fields referred to the bumps on his trademark nose as “gin blossoms.” The reality, however, is that even those who have never had a drop of alcohol can develop rosacea and a red nose — but now a new study suggests that excessive drinking may indeed be a factor in the severity of this condition.¹

Before the advent of modern medicine, it was commonly believed that rosacea was a side effect of excessive drinking. Today, of course, we know that rosacea is not a symptom of alcoholism, nor is there any reason to think that people with rosacea necessarily drink more than the average adult — in fact, even a teetotaler may have the condition. 

Yet despite the increased information and awareness about rosacea, the misconception persists. Ruddy cheeks and bumps and pimples were even used in the recent film Girl on the Train to telegraph the protagonist’s struggle with alcohol. 

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

Q. Is there a link between chronic nasal blockage and rosacea?

A. Chronic nasal obstruction has many potential causes, and there is no evidence linking this condition to rosacea. Even patients with rhinophyma usually can breathe well through their noses. A typical stuffy nose is commonly associated with inflammation of the mucous membranes from various causes, often allergies or viruses.

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."

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

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