In its most advanced stages, untreated rosacea can result in thickening and textural change of the skin. The most visible manifestation of this is rhinophyma in which there is thickening and overgrowth of the skin on the nose. This is caused by massive overgrowth of the sebaceous (oil) glands and the surrounding connective tissue.
While Oral Antibiotics can prevent progression and Isotretinoin may cause some shrinkage of the sebaceous glands, no tablet or cream can reverse the tissue overgrowth. The only definitive and effective treatment for restoring the normal, anatomical contour of the nose is destructive treatments such as ablative lasers.
Carbon Dioxide (CO2) lasers and Erbium:YAG lasers are the gold-standard ablative devices used for this procedure. The laser energy vaporizes the excess layers of tissue. This allows sculpting of the nose to restore the appearance.
This is a surgical procedure and requires local anaesthetic injections. The treated area is left completely raw and heals by forming scar tissue over a number of weeks. It requires meticulous wound care with the application of occlusive ointments and dressings.
Despite the intense recovery period, ablative laser resurfacing for rhinophyma boasts has a high satisfaction rate in appropriate patients with severe rhinophyma, however the risk-benefit ratio is usually not favourale for early/mild rhinophyma.