Rhinophyma: The truth behind 'alcoholic nose' and how it reshapes skin

Rhinophyma, often mistakenly called 'alcoholic nose', is a severe form of rosacea that causes the nasal skin to thicken. Despite its nickname, alcohol does not affect the condition. It most commonly affects white men over 50, particularly those with fair skin or a family history of rosacea.

The condition develops as an advanced stage of rosacea, leading to a red, enlarged, and bulbous nose. Symptoms usually appear on the tip and lower part of the nose, creating a bumpy texture. Genetic factors play a key role, with abnormalities in immune peptides like Cathelicidin and Kallikrein 5, as well as variants in the BTNL2 gene, increasing inflammation. Hormonal changes in older men, combined with vascular dysfunction and overactive oil glands, also contribute.

Early treatment is essential to manage the condition effectively. Doctors often prescribe oral antibiotics to reduce inflammation and topical treatments, such as isotretinoin or ivermectin, to slow skin thickening. In more severe cases, surgical options like carbon dioxide laser surgery may be needed. These procedures remove excess tissue and help restore the nose's original shape.

Rhinophyma primarily affects older men with light skin and a genetic predisposition. Without treatment, the condition can worsen, but early intervention with medication or surgery can control symptoms. Proper management helps prevent long-term changes to the nose's appearance.