With front-and-center real estate on our faces, the nose is often one of our main focal points. It helps define the symmetry of the rest of our face and often can be the first thing we notice when we look in the mirror. This is why it can be frustrating for people who live with rhinophyma.
Rhinophyma is a skin disorder that causes the nose to enlarge and become red, bumpy, and bulbous. It’s caused by excessive enlargement of sebaceous glands on the nose. Experts believe it comes from untreated, severe rosacea, which is a chronic inflammatory skin condition that causes facial redness. While rhinophyma is not-life-threatening nor painful, it can be a bothersome condition that can affect one’s self esteem.
The good news is that there are several out-patient, non-surgical dermatological treatments that can target the causes of rhinophyma and help to correct your complexion to bring back the skin you feel most comfortable in.
The exact causes of rhinophyma are unknown. But there are known factors that can increase the risk. These factors include:
Rhinophyma typically develops in more severe cases of rosacea. Signs and symptoms include:
Although mild forms of rhinophyma may respond to medical treatment, in most cases resurfacing procedures such as dermabrasion and Co2 laser resurfacing are needed for optimal outcome. You and your doctor can decide which treatment is best for you.
There is no known way to prevent rhinophyma. However, there are factors that can aggravate rosacea. Try to avoid:
A dermabrasion treatment can result in a smoother, more even skin texture. Scarred skin can become more uniform, as well. Dermabrasion can also improve pigment or color changes on the skin.
Dermabrasion is a safe and effective procedure. Still, there are some short-term side effects to be aware of, such as:
Dermabrasion is performed in our office. On the day of the procedure, do not wear any makeup or facial creams and be sure to wear clothes that do not need to be pulled over your head.
The care team at Dr. Khorasani's office will apply topical anesthesia to decrease sensation and numb your skin.
Dr. Khorasani does not use a rotary device and does the polishing manually with his hands, in order to avoid unnecessary trauma to the skin. Dermabrasion can take anywhere from a few minutes to an hour, depending on how much skin is being treated.
After the treatment, skin will be covered with a biological hydrocolloid dressing called DuoDERM®. At home, the dressing should be changed daily and Aquaphor will be applied with frequency as directed by Dr. Khorasani. Swelling will decrease within a few days to a week, but it will take longer for your skin tone to return to normal. The color will transition from red to pink over the next few months. Most wounds require two to eight weeks to recover from dermabrasion, although redness of the site may linger for six months or more. Occasionally, Dr. Khorasani may recommend the use of Acell on your wound in order to boost the healing process. Acell is an FDA approved xenograft, or tissue graft, which has the ability to recruit cells to the wound for faster recovery and cell regeneration.After the treatment, skin will be covered with a biological hydrocolloid dressing called DuoDERM®. At home, the dressing should be changed daily and Aquaphor will be applied with frequency as directed by Dr. Khorasani. Swelling will decrease within a few days to a week, but it will take longer for your skin tone to return to normal. The color will transition from red to pink over the next few months. Most wounds require two to eight weeks to recover from dermabrasion, although redness of the site may linger for six months or more. Occasionally, Dr. Khorasani may recommend the use of Acell on your wound in order to boost the healing process. Acell is an FDA approved xenograft, or tissue graft, which has the ability to recruit cells to the wound for faster recovery and cell regeneration.
While you're healing you can expect:
PreciseFX is a continuous wave CO2 laser used to debulk skin. It ablates the tissue without leaving any collateral damage. Since the ablative laser is more of a tissue removal, it allows for better contour of the nose. The procedure is performed with topical anesthetic ointment as well as injection of lidocaine for extra comfort and takes about fifteen to twenty minutes, depending on the size of the area being treated. Follow-up care after a PreciseFX is similar to dermabrasion (see above). Since no sutures are used, you may return to your normal routine immediately.
The key benefit of the PreciseFX device is the ability to determine the exact depth of penetration. Using the precision of laser energy, PreciseFX is able to debulk tissue evenly with minimal scarring.
On the day of your procedure, Dr. Khorasani will meticulously mark the site with a specialized surgical pen. The treatment area will then be numbed with a local injection of lidocaine, which may sting for five to ten seconds as it is being administered. After you are numbed, you should not experience pain; however, you may experience sensations of heat as the laser targets the treatment area. If at any time during the procedure this heat becomes too uncomfortable, please inform Dr. Khorasani and he will provide you with additional measures to ensure your comfort. These include our in-office Pro-Nox system which employs nitrous oxide (“laughing gas”) to reduce anxiety and the experience of pain. Pro-Nox can be self administered by you as needed, to address any discomfort.
The longest part of the procedure is the precise marking and numbing process, which requires ten to fifteen minutes to complete. The laser treatment itself requires less than twenty minutes.
After your procedure, we will carefully cover the treated area with a thick layer of Aquaphor. DuoDERM®, a highly specialized dressing that facilitates optimal wound healing, will then be used to bandage the treated area. During your recovery period, you will continue this same regimen 4-5 times per day (Aquaphor + DuoDERM). It is of utmost importance to keep the treatment site moist at all times to maximize your aesthetic outcome. Fortunately, the DuoDERM bandage can be tailored to the exact shape and size of your wound, allowing for minimal disruption of your daily routine. Since there is no cutting involved you will not have any sutures. This means that you can go back to your normal routine after a few days.
Most wounds require two to eight weeks to recover from the PreciseFX laser, although redness of the site may linger for six months or more. Occasionally, Dr. Khorasani may recommend the use of Acell on your wound in order to boost the healing process. Acell is an FDA approved xenograft, or tissue graft, which has the ability to recruit cells to the wound for faster recovery and cell regeneration.
Patients that want to speed up the resolution of redness will likely benefit from a treatment with Vbeam, a specialized laser that selectively targets the small blood vessels responsible for the red appearance of healing skin. Find out more about Vbeam on our Vascular Lasers for Redness and Veins page.
DeepFX is a fractionated ablative Co2 laser. As opposed to PreciseFX which ablates epidermis and superficial dermis in continuous fashion this laser emits laser energy deeper into the skin in order to shrink sebaceous glands. It can be combined with PreciseFX in order to achieve a multi layer treatment. Overall, resurfacing lasers are most appropriate for patients looking to dramatically improve skin texture and can tolerate some amount of downtime. These lasers need to be used with caution in patients with a darker skin complexion.
DeepFX is used to treat a variety of skin conditions, including:
DeepFX is a fractionated laser which means that it ablates around 15-20% of the scanned skin surfaced. The remaining 80-85% of the skin is then allowed to repopulate the ablated tissue for fast recovery. This technology reduces downtime and provides significant results.
Treatments can last anywhere from 15 minutes to an hour. Before the procedure, Dr. Khorasani will apply a topical anesthetic to the area that is going to be treated. As the laser is used, you may experience a warm, tingling sensation. A DeepFX treatment penetrates deep into the skin to correct imperfections.
Immediately after the treatment, your skin will appear red and slightly swollen. The swelling should resolve within a few days. Within a week you should start to see smoother looking skin that will progressively improve over the next few months. However, you will have residual pink/redness for up to a few months.
Dr. Hooman Khorasani is quadruple board-certified in Dermatology, Cosmetic Surgery, Facial Cosmetic Surgery and Mohs micrographic surgery. Additionally he led the Division of Dermatologic and Cosmetic Surgery at Mount Sinai for 10+ years. His passion for providing patients with cutting-edge treatments to facilitate their cosmetic goals has led to his involvement in multiple research projects investigating novel applications and advanced clinical techniques for laser-based skin resurfacing. Dr. Khorasani’s internationally recognized proficiency in cosmetic medicine has led many health professionals to seek his mentorship and learn from his best practices so that they too can provide their patients with optimal aesthetic outcomes.
Armed with this advanced clinical and academic competency, Dr. Khorasani carefully crafts a therapy plan for each patient that adheres to the highest standards of medical care and is optimized to produce the greatest results possible. Personalization is infused into every aspect of our practice, from the treatment itself to our highly-skilled office personnel that are available 24/7 to answer any questions or concerns. Together as a team, we can help your skin look its very best!
Dr. Khorasani and his highly-specialized team look forward to working with you to transform your medical or aesthetic goals into reality. To expedite a request for a consultation, message us securely, or contact Dr. Khorasani’s Manhattan office by phone at 212-230-3378. For more information about how to get in touch:CONTACT US