Rhinophyma - Symptoms, Causes & Treatment
Medically reviewed by Dr. Anand S. Urhekar, MD, MD Pathology, Clinical Advisor · Last updated July 2026
A late, uncommon stage of rosacea in which the skin of the nose thickens, the oil glands enlarge and the nose becomes bulbous, red and irregular with prominent pores. It develops slowly over years and affects men far more often than women.
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Quick Answer
Rhinophyma is progressive thickening of the nose caused by advanced rosacea, producing a bulbous, red, irregular nose with enlarged pores. Despite the old myth, it is not caused by alcohol. Early inflammation responds to oral doxycycline or isotretinoin, but once tissue has thickened the effective treatments are surgical: CO2 laser resurfacing, electrosurgery or dermabrasion to reshape the nose.
Symptoms
- Gradual thickening and enlargement of the nose
- Bulbous, irregular, lumpy contour
- Prominent, dilated pores
- Red or purple discolouration with visible vessels
- Occasionally nasal obstruction in severe cases
Causes & Risk Factors
- Long-standing untreated rosacea
- Male sex and age over 50
- Genetic predisposition
- Chronic sun damage
- Not caused by alcohol, despite the common myth
Treatment & Management
- Oral tetracyclines (doxycycline) for the inflammatory component
- Oral isotretinoin to reduce gland size early on
- CO2 or erbium laser resurfacing
- Electrosurgery, dermabrasion or scalpel debulking
- Ongoing rosacea maintenance therapy and sun protection
When to See a Doctor
See a dermatologist as soon as the nose starts to thicken. Early intervention with medication can prevent the need for surgery; severe cases affecting breathing should be referred promptly.
Frequently Asked Questions
Is rhinophyma caused by drinking?
No. The 'drinker's nose' label is a long-standing myth. Rhinophyma is a complication of rosacea. Alcohol can flush the face and aggravate rosacea, but it does not cause the tissue thickening.
Can rhinophyma be reversed without surgery?
Only in the earliest phase, when swelling is still inflammatory. Established fibrous thickening does not respond to creams or tablets and requires a resurfacing or debulking procedure.
Related Conditions
Medical References
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Medical Disclaimer: This information is for educational purposes only and is not intended as medical advice. The content on this page should not be used to diagnose or treat any health problem. Always consult with a qualified healthcare professional for proper medical evaluation, diagnosis, and treatment of your condition.