Can Rhinophyma Be Treated? What actually works (and what doesn’t)

Yes – rhinophyma can be effectively treated, most commonly using CO₂ laser or surgical techniques to remove excess tissue and reshape the nose. Many people live with rhinophyma for years, believing nothing can be done, when in fact effective treatment is available. The best approach depends on the severity of the condition and the clinician’s experience.

Rhinophyma is a swelling of the nose that mostly affects people with rosacea.

As the condition progresses, the nose becomes redder, and swelling creates a bumpy surface that alters the nose’s shape.

Initially, people may experience mild flushing, redness, or a few spots as early symptoms of rosacea. As inflammation progresses, more scar-like tissue and swelling of the sebaceous glands form the bumps under the skin as they enlarge.

Very rarely, phymatous swellings occur in other areas, such as the forehead, cheeks, ears, or chin.

We don’t fully understand what causes rhinophyma, but we know with certainty that it is not due to alcohol abuse. It is not hereditary either.

We see rhinophyma as an end stage of severe rosacea, but there are a small number of cases in which it occurs without any symptoms of rosacea.

Many patients are told nothing can be done, and while it’s true that there is no cure for rhinophyma, treatments can help control it.

CO₂ laser treatment

CO₂ laser treatment is considered to be the modern gold standard treatment, despite not having long-term data due to it’s comparitive newness:

• It is precise: this matters because it causes minimal blood loss
• It allows for a more refined reshaping
• It has the shortest downtime
• It is the most commonly used treatment nowadays

Surgical excision

Used very rarely, with different techniques available. The longer downtime, less refined results and more traumatic patient experience have made it less and less popular.

Why creams and medications don’t work

They may be effective in controlling symptoms in the early stages or during episodes of infection in a particular area, but for advanced rhinophyma, topical or oral treatments are insufficient due to excessive swelling, tissue thickening, and tissue deformity. At this point, only treatments which remove the excess tissue and reshape the nose are effective.

Why results vary between clinics

There are multiple factors that affect the end results:

• The different lasers that can be used: at Discover Laser, we use the Ultrapulse by Lumenis, which is considered the gold-standard, most powerful CO₂ laser in the world. Less powerful machines may deliver inferior results.
• The different techniques that can be used: Dr Montero prefers a customised approach that depends on the clinical and functional presentation.
• The severity of the initial presentation:
• Patient compliance with post-procedure protocols: To ensure our patients achieve the best possible outcomes, we provide detailed, easy-to-follow post-procedure instructions.
• The experience of the operator: Dr Montero has been treating rosacea for 18 years, and Rhinophyma for 5, following training with renowned plastic surgeons and laser experts Dr Matteo Tretti Clementoni and Mr Max Murison. The aesthetic outcome matters to us at the clinic as much as it does to our patients, and although it is not always possible to restore the previous appearance exactly, we try to get as close as possible. We strive to deliver a normal-looking nose shape and texture. Dr Montero’s approach is based on all of the above, with clinical expertise, technical knowledge, an amazing team and attention to detail, helping us to deliver results that are life-changing.

CO₂ laser can significantly improve the appearance of the nose by reducing thickened skin and restoring contours to a more natural shape.

At Discover Laser, it helps us deliver cosmetic and functional improvements, with many patients reporting improvements in breathing, a runny nose, and other associated symptoms.

All those changes help to explain the improvement in self-esteem and confidence that more of our patients experience.

If you’re looking for rhinophyma treatment in Lancashire or the North of England, it’s important to choose a clinic with experience in treating this condition.

At Discover Laser in Burnley, Dr Miguel Montero provides specialist CO₂ laser treatment for rhinophyma, helping patients restore the natural shape of the nose with precise, controlled techniques.

Many of our patients travel from across Lancashire and beyond for treatment, particularly where more advanced or refined approaches are required.

No, rhinophyma cannot be fully reversed, but it can be substantially improved with CO₂ laser surgery. Also, a lot of the symptoms associated with breathing difficulties can be greatly improved, if not fully corrected, with the treatment.

Yes, rhinophyma is permanent if left untreated because it is a chronic condition and will not correct on its own. However, the aesthetic and functional changes can be improved through treatments such as CO₂ laser surgery.

No, rhinophyma treatment with CO₂ laser is not very painful when performed by an expert practitioner. At Discover Laser, we only use local anaesthetic injections. No sedation or general anaesthesia is necessary. The majority of our patients have minimal or no sensation at all, due to the nose being anaesthetised.

The downtime is usually 10 to 14 days, when only Vaseline can be applied on the superficial scabs until they completely drop off. At that point, suncream can be applied, and, if desired, some make-up to camouflage the redness can be used as well. It is expected that the residual redness settles down by 3 to 4 months on average. We recommend lifelong sun protection after the treatment and, when possible, sun avoidance.

If you’re living with rhinophyma, it’s natural to feel unsure about treatment – particularly if you’ve been told that little can be done.

At Discover Laser, Dr Miguel Montero provides specialist CO₂ laser treatment designed to reshape the nose with precision and achieve natural-looking results.

You can view real patient results and learn more about the treatment process here:

View rhinophyma treatment and results