Electrosurgery for the Treatment of Moderate or Severe Rhinophyma

Abstract

Rhinophyma, a rare and progressive disfiguring condition, is thought to be the final stage of rosacea. Several surgical treatments are available, including dermabrasion, cryosurgery, scalpel excision, electrosurgery, and carbon dioxide laser. The last 2 techniques are the most effective for the management of rhinophyma. We describe a series of cases of moderate or severe rhinophyma treated with high-frequency electrosurgery in the dermatology department of Hospital Simón Bolivar and in private clinics in Bogota, Colombia, between 2012 and 2016. The cosmetic result, as assessed by both the clinicians and the patients, was satisfactory in all cases. Three patients presented hypertrophic scars that were treated with steroid injections and silicone gel sheeting. Two patients presented persistent erythema. However, there were no serious infections and none of the patients required further surgery. Electrosurgery is one of the simplest and most cost-effective techniques currently available for the treatment of rhinophyma by dermatologists.

A Systematic Review of Surgical Techniques for Management of Severe Rhinophyma

“…19,20,31 All studies reported good hemostasis and the added benefits of short surgical times and cost-effectiveness. 16 –18,20,21…”

“…[16][17][18]20,21 In González et al case series of 7 patients with severe rhinophyma treated with electrosurgery, 3 patients presented postoperatively with obvious scarring and 2 presented with persistent erythema. 21 The case studies by Prado et al and Husein-ElAhmed and Armijo-Lozano both demonstrated mild nasal tip scarring a few months post-operatively, but these patients were still very satisfied with their cosmetic outcomes. 19,20 The other studies did not report postoperative complications including wound infection, scarring, hypopigmentation, or prolonged erythema.…”

“…19,20,31 All studies reported good hemostasis and the added benefits of short surgical times and cost-effectiveness. [16][17][18]20,21 In González et al case series of 7 patients with severe rhinophyma treated with electrosurgery, 3 patients presented postoperatively with obvious scarring and 2 presented with persistent erythema. 21 The case studies by Prado et al and Husein-ElAhmed and Armijo-Lozano both demonstrated mild nasal tip scarring a few months post-operatively, but these patients were still very satisfied with their cosmetic outcomes.…”

Advances in the Pathogenesis and Treatment of Rosacea: A Phenotype-Based Therapeutic Approach

“…Physical procedures, such as surgical treatments (e.g., electrosurgery, dermabrasion, cryosurgery, and scalpel excision), and ablative laser surgery with CO 2 laser (10,600 nm) and Er:YAG (2940 nm) are often necessary to correct the shape of a deformed nose in phymatous rosacea [152][153][154].…”