Rhynophyma is a progressive disfiguring soft tissue hypertrophy of the tip of nose. This is usually caused by hyperplasia of the cells of sebaceous glands. It has been accepted as the end stage of chronic acne rosacea. In addition to the obvious cosmetic disfigurement it can also cause obstruction to vision. It can also become infected and may bleed.
This involves shaving of the lesion with cauterization of the bleeding vessels. Surgery should aim at removing the diseased tissue while conserving the normal underlying sebaceous glands which could facilitate in normal re-epithelization.
Microdebriders have been used with varying degrees of success in removing the diseased tissue. The bleeders if any can be controlled using flowseal.
Carbondioxide lasers have been used to manage this condition. Major advantage of laser is that the depth of excision is really precise and excess tissue removal is rare. There is very minimal risk of scar tissue formation.
Currently radiofrequency devices like coablators have been used in the management of this condition. Using this device there is very little risk of thermal damage to underlying tissue.
Numerous treatment modalities have been attempted to manage this condition. Oral antibiotics has shown excellent promise during early phases of this disease. Surgery will have to be resorted to in order to manage advanced rhinophymas.