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Long-term Satisfaction with CO2 Laser Treatment for Moderate to Major Rhinophyma: A Single-centre Study.

Acta Derm Venereol

January 2025

Dermatology and Venereology Division, Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden; Dermato-Venereology Clinic, Karolinska University Hospital, Stockholm, Sweden; Nordiska kliniken, Stockholm, Sweden, Sweden.

Rhinophyma, a severe manifestation of rosacea, predominantly affects Caucasian males aged 50-70 and is characterized by thickening and enlargement of the nasal skin. The condition can seriously both impact cosmetic appearance and obstruct nasal breathing. While its appearance is distinct, conditions such as basal cell carcinoma can mimic it, complicating diagnosis.

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Experts have widely discussed rhinophyma treatment, proposing and testing various therapies over the years. The aim of this retrospective study was to compare the aesthetic outcomes of patients undergoing the cold blade technique at the Department of Plastic Surgery and ablative fractional carbon dioxide (CO) laser treatment at the Department of Dermatology at Zealand University Hospital. We assessed rhinophyma severity using the RHISI scale with pre-and post-operative photographs evaluated by senior consultants from each department, who were blinded to the treatment method.

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Background: Rhinophyma, a benign condition resulting in nasal sebaceous tissue hypertrophy, predominantly affects Caucasian males. There are numerous surgical and medical treatments for rhinophyma with varying degrees of success. This review aims to provide a comprehensive overview of ablative therapies, highlighting our preferred treatment approach.

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Rhinophyma, characterized by hypertrophy of sebaceous glands, often necessitates surgical intervention. This is the second case report of the off-label use of the Versajet II Hydrosurgery System (VJHS) (Smith & Nephew, London, UK) in the United States for the treatment of rhinophyma and the first systematic review of the literature, emphasizing its efficacy and safety for this indication. A surgical debulking and resurfacing was performed on a patient with rhinophyma.

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Article Synopsis
  • Rhinophyma is a severe form of rosacea that can lead to physical and psychological issues, often requiring surgical treatment due to complications associated with standard methods, such as bleeding and scarring.
  • The study assessed 28 patients who underwent treatment with a five-blade scratcher, finding significant improvements in various severity scores 6 months and 5 years post-surgery, along with a relatively low recurrence rate of 25%.
  • Results showed a notable decrease in pro-inflammatory factors in patients after the five-blade scratcher surgery, indicating its effectiveness and safety as a treatment option for rhinophyma.
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