Treatment of Rosacea with Disfiguring Rhinophyma and Phymatous Growth of Sebaceous Glands
This protocol addresses rosacea presenting with disfiguring, hyperplastic growth of sebaceous glands on the nose and other facial regions — collectively referred to as phyma. The most commonly encountered form is rhinophyma, a hallmark feature of subtype III (phymatous) rosacea.
Phymatous changes represent a distinct and often progressive complication of rosacea. The disfiguring enlargement of sebaceous glands, particularly on the nose (rhinophyma), is characteristic of subtype III rosacea and typically requires a specific management approach distinct from other rosacea subtypes.
Management of phymatous rosacea involves procedural and surgical interventions — specifically, ablative or surgical techniques targeting the hypertrophic tissue. These may be combined with systemic medical therapy to complement the physical approach.
Full regimen, drug selection, dosing, and sequencing available via the structured protocol below.DOI: 10.1111/jdv.14349
- Disfiguring growth of hyperplastic sebaceous glands on the nose and other facial regions is seen in subtype III rosacea.
- Most often encountered is rhinophyma.
- For phymatous rosacea, ablative laser treatments as well as classical surgery are available (level of evidence: C).
- In subtype III, systemic treatment with isotretinoin 0.3 mg per kg bodyweight once daily off-label (level of evidence: A) or with low-dose doxycycline (level of evidence: A) together with surgical interventions are typically used.