The word "phyma" means swelling or bulb, while the word "rhino" denotes the nose. The nose can become severely affected by rosacea. Initially, the nose becomes red and shiny and appears bumpy. Then, blood vessels start to become prominent and there is progressive thickening of the skin leading to hypertrophy or enlargement of the nose. Eventually, the nose becomes deformed, with the formation of a nodule like structure over it.
This rhinophyma, alongside other features such as puffy, flushed cheeks and red, swollen eyes combine to give a characteristic rosacea appearance.
Rhinophyma primarily affects middle-aged or elderly Caucasian males. The lower two thirds of the nose are more commonly affected than the upper one third.
There are several types of rhinophyma and these include:
- Glandular Rhinophyma
This describes an enlargement of the sebaceous glands over the nose (sebaceous glands secrete an oily substance called sebum that maintains suppleness of the skin and prevents its drying). The surface of this type of rhinophyma is pitted or indented and the swelling is asymmetrical. When the skin surface is compressed between fingers, there may be secretion or oozing of sebum, along with dead skin cells and bacteria. The nasal skin may acquire a secondary bacterial infection that can lead to complications such as scarring.
- Fibroangiomatous rhinophyma
This condition causes the nose to turn red or copper in colour. The nose appears to be edematous with visible veins on its surface and there may be pustules across the surface.
- Actinic rhinophyma
This type involves the development of nodules of elastic tissue across the nose.
In addition to rhinophyma, there may be other phymas or enlargements and deformities of facial features including the following:
- Chin (called gnathophyma)
- Forehead (called metophyma)
- Ears (called otophyma)
- Eyelids (called blepharophyma)
Treatment options for rhinophyma include surgical resection of the skin lesions which may involve:
- Electrocautery (destroying the tissues with electrically generated heat)
- Cryosurgery (destroying tissue with extremely cold temperature)
- Laser ablation (destroying tissues with laser beams)
Surgery, however, may cause excessive bleeding, pain and deformity of the nose.