What Is Rhinophyma, or Alcoholic Nose?

What Is Rhinophyma, or Alcoholic Nose?

Rhinophyma, sometimes referred to as alcoholic nose, is a condition that affects the nose and surrounding facial features. This condition can be embarrassing for many people as it alters the appearance of the face, resulting in worsening self-esteem. Rhinophyma can also be uncomfortable, depending on the severity of the symptoms.

Rhinophyma may be called alcoholic or whiskey nose, but there's little connection between the condition and drinking. Alcohol doesn't cause rhinophyma, but it can make it worse. Learn more about rhinophyma, the relationship with alcohol and what treatment options are available.

What Is Rhinophyma?

Rhinophyma is a skin condition that affects the nose, causing a deformed appearance. The nose may appear red, large or bumpy. Men are more likely to develop the disease than women, mainly Caucasian men, though the exact reason is unknown. Many people experience rhinophyma due to severe rosacea.

People once believed that rhinophyma was caused by alcohol consumption, primarily due to media portrayals of drunk individuals with red, swollen noses. However, the link between alcohol and rhinophyma has since been disproven. While alcohol doesn't cause rhinophyma, it can worsen many symptoms.

Drinking alcohol will cause additional facial flushing, contributing to inflammation and swelling. Other factors can also contribute to these symptoms, worsening the condition.

Causes of Rhinophyma

The exact causes of rhinophyma aren't known. People with this condition are often in the later stages of rosacea, which causes a red face with small, pus-filled bumps often mistaken for acne. While the causes of rhinophyma are unknown, understanding rosacea can help you understand when rhinophyma may develop.

Similar to rhinophyma, the cause of rosacea isn't clear, but there is more information and research about the condition and what may cause flare-ups. Some research indicates that rosacea could be caused by an overactive immune system, genetics or the environment. There's a myth that poor hygiene can cause rosacea, but there's no evidence for this. Rosacea is also not contagious. Some of the potential causes for flare-ups include:

  • Alcohol
  • Extreme temperatures
  • Spicy food or drinks
  • Vigorous exercise
  • Emotional situations
  • Certain cosmetic products
  • Sun and wind exposure
  • Medications that dilate blood vessels

Most people with rosacea won't develop rhinophyma. However, those who do won't develop rhinophyma until they reach the later stages of rosacea. It's also possible to develop rhinophyma without rosacea, but the exact cause of this development is unknown. Managing your triggers for rosacea flare-ups is the best way to prevent rhinophyma from developing.

Risk Factors of Rhinophyma

Only a few individuals with rosacea will develop rhinophyma since it's a rare disorder, but specific individuals will be more prone to developing the condition than others. People without rosacea can also develop rhinophyma, but it's not as likely. While the disease is rare, different factors can increase the risk of rhinophyma, including:

  • Age: Certain age groups are more likely to develop rhinophyma than others. People between 50 and 70 are at a greater risk of developing the condition than any other age group, especially if they have a history of rosacea flare-ups.
  • Gender: Research shows that men are far more likely to develop rhinophyma than women at a rate ranging from 12 to 30:1. Women have a higher risk of developing rosacea, but men with the condition are more likely to have a severe case. Severe cases of rosacea can develop into rhinophyma.
  • Ethnicity: While men generally have a risk of rhinophyma, men of a specific descent have an even greater risk of developing the condition. Men of English, Irish and Scottish descent are most often diagnosed with rhinophyma, but women of the same ethnicity are also at risk for developing the disease.
  • Family history: If someone in your family has severe rosacea and rhinophyma, you're more likely to develop the condition at some point in your life.
  • Complexion: People with fair skin are often at increased risk for rhinophyma since rosacea affects people with a fair skin tone more often. However, people of any skin tone can develop the condition.
  • Rosacea: It's not necessary to have rosacea to develop rhinophyma. Some people can develop the condition without rosacea. However, having rosacea can increase your risk of developing rhinophyma.

Drinking alcohol may not be a risk factor for rhinophyma, but it can worsen the condition. When some people drink, their face flushes, especially people with rosacea. The additional redness and blood flow can worsen symptoms of rhinophyma, allowing the condition to develop more quickly. If you have rosacea and have any of the risk factors above, it's best to limit your drinking or seek help for alcohol misuse to prevent rhinophyma.

Symptoms of Rhinophyma

In most cases, rhinophyma results from severe cases of rosacea. Keeping an eye out for the symptoms of rosacea can help you manage the condition and prevent it from developing into rhinophyma. Common symptoms of rosacea include:

  • Flushing: Rosacea can cause additional blood flow to the face, resulting in a flushed or red appearance. The flushing will appear around the nose and cheeks. This symptom may be more challenging to notice in people with darker skin tones.
  • Swollen bumps: People often mistake these bumps for acne since they can appear like regular pimples. These bumps can also fill with pus. Popping these bumps can spread the pus, leading to an infection.
  • Visible veins: Rosacea can make the veins in the face more visible, particularly the smaller blood vessels around the nose and cheeks. These veins are sometimes called spider veins.
  • Burning: People with rosacea may feel a burning sensation in the area of their face that's affected, especially where they experience redness or flushing.
  • Eye trouble: People with rosacea may experience eye problems, including irritated, dry or swollen eyelids. Rosacea that spreads to the eyes is also called ocular rosacea. Some people will experience these eye symptoms before their skin symptoms. Eye problems can worsen later in life if it starts to affect your vision.

If a person's condition progresses, they can develop an enlarged nose, one of the main symptoms of rhinophyma. There are additional symptoms of rhinophyma you can watch for, which include:

  • Enlarged pores around and on the nose
  • Oily skin and visible glands
  • Thicker skin or a bumpy texture around and on the nose
  • Expansion or swelling around the tip of the nose
  • Red, flushed face
  • Waxy, rough or yellow skin

Some of these conditions will worsen over time, especially if you're exposed to triggers that can cause rosacea flare-ups. Drinking alcohol can also worsen rhinophyma symptoms, which is why some believe the two are related. While drinking alcohol can't cause the condition, avoiding alcohol can help prevent the disease from worsening.

Diagnosis of Rhinophyma

Your doctor will conduct a physical exam to determine if you're developing rhinophyma. First, they'll ask you what symptoms you're experiencing and look at your face to see if your nose is starting to show the signs.

If your doctor believes that you might have rhinophyma, they might perform a skin biopsy, a process where they take a small sample of your skin and send it off to a lab for analysis. A skin biopsy isn't always necessary but can rule out other, more severe conditions. A biopsy may also be done for patients whose rhinophyma is resistant to treatment. 

Once you are diagnosed with rhinophyma, you'll work with your doctor to create a personalized treatment plan to help you prevent the condition from worsening and improve your cosmetic appearance.

Treatment for Rhinophyma

Rhinophyma can cause intense feelings of embarrassment and anxiety in individuals, encouraging them to seek treatment to reduce the enlarged appearance and redness of their noise. Various treatment options are available to help improve the appearance and function of your nose, including:

  • Medication: Medications used to treat severe acne can help improve rhinophyma caused by rosacea. Antibiotics can also treat inflammation or redness around the nose, cheeks and other affected areas. Your doctor may also recommend incorporating a moisturizer into your skin routine to prevent your skin from drying out. 
  • Laser resurfacing: Targeted lasers can help treat various symptoms of rhinophyma and resurface the skin, evening out textures and restoring your nose and the surrounding skin to its former appearance. The heat from the laser can also help tighten skin, reducing wrinkles or fine lines, further restoring your appearance.
  • Dermabrasion: Dermabrasion is another technique that can resurface the skin and improve the appearance of rhinophyma. This technique uses a rapidly rotating device that removes the top layer of your skin. You can get dermabrasion treatment on its own, or you can combine it with other methods to improve the appearance of your rhinophyma. 
  • Surgical reconstruction: Plastic surgery is another popular option for rhinophyma treatment. Plastic surgery can help remove the bulbous parts of the nose that damage your appearance and constrict your airflow. Before you get plastic surgery, you'll consult with a specialist to determine what shape you want and what shape you can expect. Surgical reconstruction is also the best option for tissue contouring. 
  • Skin grafting: Skin grafting removes skin from one part of the body and puts it on another to improve your appearance. Skin is usually removed from a location that isn't often seen, such as the inner thigh. Skin grafting can help cover any scars that appear from other forms of treatment or remaining deformities. 

You can combine multiple treatments to ensure that you get the best results. Treating rhinophyma as soon as possible helps prevent worsening symptoms and permanent disfigurement. You'll consult with your doctor about the best course of action to help you reduce the appearance of rhinophyma so you can get your confidence back. 

During treatment, you may also have any overgrown tissue removed. The inside of your nose may also be reconstructed if rhinophyma interferes with your breathing. Your doctor may also ask you to bring a picture of when you were younger so they can try to restore your former appearance. 

If your rhinophyma is caused by rosacea, you can work with your doctor to identify any triggers that could be causing flare-ups. Avoiding these flare-ups can keep rhinophyma from getting worse or resurfacing after treatment.

How to Prevent Rhinophyma

If you have rosacea or any of the risk factors that could cause rhinophyma, you can take action to prevent the condition from affecting you. While rhinophyma isn't only diagnosed in individuals with severe rosacea, similar triggers can cause flare-ups, which may also cause the condition to develop. You can prevent rhinophyma by avoiding the following triggers for flare-ups:

  • Alcohol: Alcohol doesn't cause rhinophyma, but eliminating alcoholic drinks from your diet can reduce flushing and inflammation in the face caused by rosacea. Lessening rosacea outbreaks can prevent the condition from worsening and causing rhinophyma to develop. 
  • Tobacco: Rosacea is more common among individuals who smoke. Smoking tobacco can increase your risk of developing severe rosacea, which could lead to rhinophyma. Smoking can also worsen existing symptoms and make flare-ups far worse. 
  • Spicy food: Spicy food can have benefits, but individuals with rosacea may experience more flare-ups after a spicy meal. Avoid spicy foods if you have rosacea so the condition doesn't worsen, which could lead to rhinophyma. 
  • Rubbing the face: Rubbing your face will spread any existing bacteria around and cause facial inflammation. Both factors can contribute to rhinophyma's development, so avoiding touching your face and frequently washing your hands can help prevent unnecessary inflammation that could lead to severe rosacea. 
  • UV exposure: UV rays can damage the skin and cause excessive redness and inflammation, especially in people with rosacea. Using sunscreen when you go outside and finding shade whenever possible can help you prevent rhinophyma and manage your symptoms if you have rosacea. 
  • Extreme temperatures: Like the sun, extreme hot or cold temperatures can worsen your skin condition due to excessive dryness or sweat production. Avoiding these extreme temperatures can help you prevent flare-ups and manage any symptoms you may have.

If you're worried about developing rhinophyma, you can take steps to prevent the condition. Taking care of your skin and watching out for potential triggers can help reduce your risk and will help you keep your skin healthy as you age. 

Diamond House Detox Is Here to Help

While alcohol doesn't cause rhinophyma, drinking can worsen the condition. If you have an alcohol use disorder alongside rhinophyma, the symptoms could become severe, causing extreme deformities that could impact your appearance and breathing ability. You can get control of your symptoms by seeking treatment for alcohol addiction and reducing your flare-ups.

At Diamond House Detox, we help patients overcome their addiction through various treatments, including group counseling, dual diagnosis treatment, addiction education and personalized treatment programs. We'll help curate a treatment plan based on your individual needs so you can reach sobriety and improve your quality of life. Take the first step and revolutionize your life by contacting us today to learn more about our treatment programs.

Resources:

  1. https://www.ncbi.nlm.nih.gov/books/NBK544373/#:~:text=However%2C%20rhinophyma%20is%20most%20commonly%20found%20in%20white%20men%20over%20the%20age%20of%2050%20with%20a%20male%20to%20female%20ratio%20of%205%20to%201%20to%2030%20to%201
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4426765/#:~:text=Historically%2C%20rhinophyma%20was,rum%20nose.%E2%80%9D4
  3. https://patient.info/doctor/rosacea-and-rhinophyma
  4. https://www.mayoclinic.org/diseases-conditions/rosacea/symptoms-causes/syc-20353815
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  7. https://www.aad.org/public/diseases/rosacea/what-is/causes#:~:text=Women%20are%20a%20bit%20more,can%20get%20this%20skin%20disease.
  8. https://www.winchesterhospital.org/health-library/article?id=20097#:~:text=Although%20rosacea%20can%20develop%20in,in%20people%20with%20fair%20skin.
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