From the Research
Surgery is the gold standard for management of advanced rhinophyma, with options including carbon dioxide laser therapy, electrosurgery, dermabrasion, cryosurgery, or traditional scalpel excision to remove excess tissue and reshape the nose 1. For mild cases, medical management with topical antibiotics like metronidazole 0.75% cream applied twice daily, oral antibiotics such as doxycycline 100mg twice daily for 6-12 weeks, or isotretinoin 0.5-1mg/kg/day for 4-6 months may help reduce inflammation and prevent progression. Some key points to consider in the treatment of rhinophyma include:
- The use of low-dose oral isotretinoin as a safe alternative with a lower risk of complications 2
- The importance of histopathological examination of all removed tissue to rule out coincident skin cancer such as basal- or squamous cell carcinoma 1
- The need for post-procedure care, including keeping the area clean, applying prescribed ointments, avoiding sun exposure, and using high SPF sunscreen
- The potential benefits and drawbacks of different procedural techniques, including scalpel excision, resection with heated knives, dermabrasion, electrosurgery, and lasers 3 It is essential to note that each patient's case is unique, and the choice of treatment should be tailored to the individual's specific needs and circumstances. The treatment options for rhinophyma can be broadly categorized into:
- Medical management: topical and oral antibiotics, isotretinoin
- Surgical management: carbon dioxide laser therapy, electrosurgery, dermabrasion, cryosurgery, traditional scalpel excision
- Combination therapy: using a combination of medical and surgical approaches to achieve optimal results Ultimately, the goal of treatment is to reduce the symptoms and appearance of rhinophyma, improve the patient's quality of life, and minimize the risk of complications.