Rhinophyma Treatment
Rhinophyma is the condition behind the enlarged, thickened, bumpy nose that develops in some patients with long-standing rosacea. It is not caused by drinking, whatever the old myth says, and it is not something you brought on yourself.
Treatment is carried out by Dr Malcolm Willis, who qualified from Imperial College London in 1979 and has spent over 40 years working with skin lesions. We are CQC registered, based at Poringland just outside Norwich, and we see patients who travel from well beyond Norfolk for this.
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What is Rhinophyma?
Rhinophyma develops out of rosacea that has been untreated or difficult to control. Over years, the sebaceous glands in the nose, the glands that produce the skin’s natural oil, become enlarged, and the connective tissue around them thickens. The nose gradually becomes:
- Larger and more bulbous
- Red or purplish in colour
- Uneven in texture, often bumpy, pitted or rough
- Oily, with visibly enlarged pores
The condition itself is benign. That does not make it a small thing. We see patients who have stopped having photographs taken, who avoid meetings, who have been putting up with assumptions about their drinking for years.
Why rosacea and rhinophyma develop is not fully understood. Sun exposure, alcohol, heat and genetics are all thought to play a part. Controlling rosacea can slow it down, but once the tissue has thickened, laser treatment is the most effective way to improve the appearance.
Something You Should Know Before Treatment
Skin cancers, basal cell carcinoma in particular, can develop within rhinophyma. They are easy to miss, because the skin is already thickened, red and uneven, and a new lesion does not stand out the way it would on normal skin.
This matters more than it might sound. CO2 laser resurfacing destroys the tissue it treats, which means nothing is left to send to a laboratory afterwards. If something were hiding there, the evidence goes with it.
So the nose is examined carefully before any laser is switched on. If anything looks suspicious, we arrange for it to be removed and tested properly rather than resurfaced. It is not a common finding, but it is the reason this should be done by a doctor.
Can Rhinophyma be Treated?
Yes. CO2 laser resurfacing is a well-established option and may be effective for many patients with rhinophyma. It allows the excess tissue to be sculpted back and the skin surface resurfaced with a good degree of precision.
It does not cure the underlying rosacea. Nothing does. What it can do is reduce the size and irregularity of the nose, and for most patients that is the thing they came in about. Results vary from person to person.
Treatment at The Doctors Laser Clinic
CO2 laser resurfacing
CO2 laser treatment uses controlled laser energy to ablate the thickened tissue, meaning it vaporises it in fine layers so the shape of the nose can be worked back gradually. It also prompts collagen remodelling underneath, the process by which the skin rebuilds its own supporting structure as it heals.
Treatment is carried out under local anaesthetic. How deep and how extensively we resurface is planned around how advanced the rhinophyma is and what you want out of it.
This approach avoids surgery and the risks that come with a general anaesthetic.
What to expect
Consultation. A full assessment first. Dr Willis will examine the nose, go through your medical history including how your rosacea is currently managed, and be straight with you about what is achievable. Photos will be taken at the initial consultation and Dr Willis will show you before, during and after photos of previous patients who have given permission for their cases to be shown.
The procedure. The procedure is performed in an operating room with 12 air changes per hour. It is a two person procedure performed by Dr Willis and Mrs Helen Bunn, his Senior Laser Technician who have worked together for over 10 years accumulating considerable experience across a wide range of conditions. Performed under local anaesthetic. Session length depends on how much there is to treat. Expect some discomfort during and afterwards as the anaesthetic wears off.
Recovery. This is the part patients underestimate, so here it is plainly. The nose will be red, swollen and crusted while it heals. Most patients see improvement within a few weeks, and full healing and final results may take a few months. Plan to be out of anything public-facing for at least the first couple of weeks. After the procedure you will be asked to send in photos on WhatsApp every day for several days so Dr Willis can keep a close eye on progress and provide commentary for you.
We encourage our patients to use postoperative Calecim stem cell serum drops.
They are included in the price as our experience of much reduced complications, infections and better aesthetic outcomes over the past few years.
Results. Many patients see a reduction in the size and irregularity of the nose, and a smoother, more even skin surface. More advanced cases may need a second session. Results vary from patient to patient.
Follow-up
A follow up appointment is included in the price.
Is it Suitable for Me?
Treatment can be appropriate for mild through to severe rhinophyma where you want to improve the shape and texture of the nose without surgery. Suitability is confirmed at consultation, not before it.
We would not usually treat during an active rosacea flare-up. Where possible, we will want your rosacea settled first.
Managing Rosacea Alongside Treatment
Because rhinophyma is driven by rosacea, keeping the rosacea under control after treatment matters for how long the result holds. We can advise on skincare, sun protection and medical management at your consultation.
Rosacea treatment is available at the clinic too. More about rosacea treatment in Norwich.
Cost of Rhinophyma Treatment
The cost for most common Rhinophyma treatment is £2,750. More severe cases requiring two stage procedures can cost up to £4,000.
If your case needs more than one session, that is discussed openly at consultation, so you will have the full picture before anything is booked.
The consultation with Dr Willis is £50. It is non-refundable, but it comes off the cost of any treatment you go ahead with.
Full details are on our price list.
Who Will Treat You
Dr Malcolm Willis graduated from Imperial College London in 1979 and works as a general practitioner with extensive experience in dermatology and laser treatments. He founded The Doctors Laser Clinic in 2010, following a period as an Honorary Senior Lecturer at the University of East Anglia, and now concentrates on mole and skin lesion removal, xanthelasma, and rhinophyma.
The clinic is registered and inspected by the Care Quality Commission.
- Doctor-led assessment and treatment
- CQC regulated clinic
- Local anaesthetic used
- Over 40 years of skin lesion experience
- Clear pricing before you book
Explore Our Other Services:
CO2 Laser Resurfacing for Rhinophyma
Rhinophyma at The Doctors Laser Clinic is treated with CO2 laser resurfacing. The laser removes the thickened tissue in fine, controlled layers, allowing the shape of the nose to be worked back gradually with a good degree of precision, whilst prompting the skin to rebuild its own supporting collagen as it heals. Treatment is planned and carried out by a doctor, under local anaesthetic.
FAQ Rhinophyma Treatment
During your consultation with us, we’ll answer any questions or concerns you may have.
Is CO2 laser the right treatment for rhinophyma?
CO2 laser resurfacing is a well-established non-surgical treatment for rhinophyma and can produce a worthwhile improvement for many patients. Surgery is an alternative for very advanced cases, but it carries greater risk and a longer recovery.
Is rhinophyma treatment painful?
It is performed under local anaesthetic, which numbs the nose during the procedure. Expect discomfort and tenderness afterwards as the anaesthetic wears off and the skin heals. Aftercare and pain relief will be explained before you leave.
How long is the recovery?
The nose will be red, crusted and swollen while it heals. Most patients see improvement within a few weeks, and full healing and final results may take a few months. Plan to avoid public-facing activities for at least the first couple of weeks.
How many sessions will I need?
Many patients see a worthwhile improvement after one session. More advanced rhinophyma may need a second, once healing from the first has been fully assessed.
Will it come back?
CO2 laser treatment can improve the appearance but does not cure the underlying rosacea, so rhinophyma can return if the rosacea is not well managed. Good skincare and sun protection reduce that risk.
Does the NHS treat rhinophyma?
NHS treatment may be available depending on your local commissioning policy, and waits can be long. Your GP is the person to ask about that. Many patients choose private treatment for faster access.
Is rhinophyma caused by drinking?
No. This is a persistent and unfair myth. Rhinophyma is a form of rosacea. Alcohol can be one trigger among several for rosacea flares, but it does not cause the condition, and plenty of patients with rhinophyma drink little or nothing at all.
Disclaimer: This page is intended to give general and educational information and should not be substituted for in-person medical advice. A consultation is advised if you have any concerns at all.
Book a Rhinophyma consultation
All treatments start with an initial consultation with one of our team. During your consultation we learn about your areas of concern and treatment goals.