Bulbous Nose (Rhinophyma): Causes, Symptoms, and Treatment

Bulbous Nose

Sometimes, we come across people who have a nose that is differently shaped, or slightly larger. Though this can be simply a genetic trait, it can also be a medical condition known as “Rhinophyma”, also referred to as bulbous nose.

To put it simply, rhinophyma is a skin condition wherein the tip of the nose grows in size and becomes roundish in shape.

A bulbous nose is more commonly found in men than women, especially men 25 to 50 years of age.

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What is bulbous nose

What Is Bulbous Nose?

Rhinophyma, or bulbous nose as its commonly known, is a skin disorder that causes a large, red and bumpy (or bulbous) nose.

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While the exact cause of bulbous nose is unknown, it is considered to be a subtype of rosacea (a common, chronic inflammatory skin condition).

According to the National Rosacea Society, more than 16 million Americans are affected by this disease. Rhinophyma is identified as subtype three of rosacea, and it forms gradually over several years.


Symptoms of Bulbous Nose (Rhinophyma)

A bulbous nose does not develop overnight; it grows gradually, and there are specific signs of a bulbous nose that one must look out for, especially in its initial stages. Some of the common symptoms are:

1. Swelling

This is the first, and probably the most apparent, sign of bulbous nose. The nose begins swelling and gradually increases in size until the patient undertakes a proper course of treatment.

Swelling begins with the tip of the nose; the other parts get progressively affected.

2. Visible Oil Glands

Another symptom of a bulbous nose is the appearance and increasing visibility of sebaceous (oil) glands on the tip of the nose.

While these normally stay hidden under the skin, they become more visible as yellow bumps for those suffering from this condition.

3. Redness

Some redness may develop around the swollen parts of the nose. This redness may be accompanied by pain also.

4. Thickening of the Skin

Swollen skin starts becoming coarse and thickens a few days into the condition. Its color may also change as pores develop on it. The texture of the skin will also worsen as the condition worsens.

5. Waxy and Yellowish Appearance

As oil glands develop in the infected area, the skin will develop a more yellow and waxy appearance.

6. Face Flushing

Sometimes, not just the nose, but other parts of the face may also become flushed.

For instance, parts of your cheeks may become red when suffering with rhinophyma, but this flushing may only be a temporary occurrence.

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What Causes Bulbous Nose?

As previously mentioned, not much information is available about what causes bulbous nose. However, it is acknowledged as a severe form of Rosacea, and factors that trigger Rosacea act as triggers for the bulbous nose as well.

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Bulbous Nose

Let’s look at some of these factors:

  • High Caffeine Consumption: Hot beverages with high levels of caffeine, like coffee, can trigger serious symptoms of a bulbous nose.
  • The Sun: Exposure to excessive heat and harmful ultraviolet rays can trigger this condition. Heat worsens the redness and inflammation of the nose. Since the skin is susceptible, one might even develop a sunburn.
  • Temperature Changes: A drastic change in temperature may trigger a bulbous nose. For instance, if you move from a hot climate to a cold environment.
  • Spicy Foods: Consumption of spicy foods increases the blood circulation in various parts of the body, including the nose. If one is suffering from bulbous nose already, then the intake of spicy foods will be more damaging to the condition.
  • Exercise: Exercising consistently at a very high rate, especially in hot temperatures, can cause harm to the nose. Any kind of exercise in excessive heat can be very damaging.
  • Blood Thinners: If one is already suffering from a bulbous nose, it is very important for them to avoid blood thinners as they can greatly worsen the condition.
  • Genetics: Sometimes, the development of bulbous nose is genetic. People who are born with a round nose fall under this category.

Who Gets Bulbous Nose (Rhinophyma)?

Like most diseases, there are some risk factors that one must keep in mind. Risk factors for bulbous nose include gender and age. Men have more chance of developing rhinophyma than women.

Bulbous nose, as a condition, develops after the initial stages of Rosacea have set in, normally between the ages of 25 and 50. However, gender and age are not the only factors for developing rhinophyma.

The racial background can also play a part in the development of this condition. Rhinophyma commonly affects people who have fair skin, such as the Irish, English, Scottish, Scandinavian, and Eastern European.


Does Alcohol Play a Factor in Bulbous Nose?

It is a common belief among many that bulbous nose and alcohol are connected. However, according to John E. Wolf, Chairman of Dermatology at Baylor College of Medicine, alcohol does not cause Rosacea and is not a direct cause of bulbous nose; it only triggers the condition.

In fact, sunlight, heat, and environmental stress are more immediate causes of this skin condition.

Additionally, it is important to remember that not all alcoholic spirits have the same effect on skin conditions. For instance, the reaction of red wine to the skin is 76%, while vodka is 33%, and scotch is 21%.


Bulbous Nose Treatment

The treatment for bulbous nose or rhinophyma will depend on whether it’s still in the initial stage or has developed to a later stage of the condition. The treatment may also differ depending on the extent of the condition.

For instance, some people experience less swelling, while others experience all symptoms in the extreme.

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Consulting a doctor is important. Thorough examinations by a physician, such as a biopsy, can be very useful in determining the exact cause of the condition.

Some types of bulbous nose treatments are:

Medication

Treatment of rhinophyma requires oral doses of antibiotics, which help by reducing inflammation and redness.

Some antibiotics which are commonly prescribed to control the condition are erythromycin, tetracycline, and minocycline. Medicines like benzoyl peroxide, tretinoin, or metronidazole work well for swelling.

Non-Surgical Treatments

Many people are terrified of surgery, while others cannot afford the medical bills that follow them. Fortunately, there are alternatives such as injectable rhinoplasty or dermabrasion.

Injectable rhinoplasty corrects the condition without surgery and costs less than surgery by almost half. Dermabrasion involves removing the top layer of skin using a small rolling tool.

Surgery

Surgical treatment of a bulbous nose usually involves a traditional surgery aimed at reshaping the nose.

Doctors might also suggest a laser resurfacing to remove the outgrowth of tissues. Cryosurgery is another painless surgical method of removing abnormal tissue growth from the nose.


Bulbous Nose (Rhinophyma) Prevention

We have established that bulbous nose is a subtype of Rosacea. Therefore, preventing Rosacea from developing is an essential step towards preventing bulbous nose.

There are some things to keep in mind when trying to avoid potential triggers of this condition. Avoid spicy foods since they raise the blood pressure and can act as a potential trigger.

Additionally, it is advisable to avoid beverages with elevated levels of caffeine, be extremely careful when making the transition from an extremely hot environment to a cold one, and do not over expose yourself to sunlight for extended periods

Experts also recommend a healthy skin care routine, especially for individuals suffering from Rosacea. They often prescribe regular use of sunscreen with SPF 15 or higher. Skin moisturizers and proper eye care should also be used.

Lastly, it is important to educate yourself and others about the causes of rhinophyma, especially to remove social stigmas prevailing in society against the condition.

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Sources:
Giorgi, A., “Rhinophyma: Causes, Risk Factors, and Symptoms,” Healthline web site, November 12, 2015; https://www.healthline.com/health/rhinophyma#prevention
“Bulbous Nose – Causes, Pictures, Reduction,” (n.d.) retrieved from Hello Mr. Doctor web site February 21, 2018; https://hellomrdoctor.com/bulbous-nose/
Anderson, C., “The Cause of a Bulbous Nose,” azcentral web site, September 30, 2017; https://healthyliving.azcentral.com/the-cause-of-a-bulbous-nose-12414290.html
Kirchheimer, S., “The Link Between Rosacea and Alcohol,” WebMD web site, February 18, 2004; https://www.webmd.com/skin-problems-and-treatments/news/20040218/link-between-rosacea-alcohol#1
“Rhinophyma,” NCBI web site, last accessed May 1, 2015; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4426765/