Rhinophyma: Taking Care of the “WC Fields” Nose

To summarize and critically review etiology and management of rhinophyma, with emphasis on operative interventions. The mainstay of treatment for rhinophyma is operative, with use of partial-thickness procedures that allow wound healing via secondary intention. Dermabrasion and laser therapy can be performed under local anesthesia with acceptable hemostasis and good outcomes. However, as malignancies have been identified in rhinophyma tissue, histopathologic analysis is an important consideration. Surgical excision using electrocautery may allow for improved hemostasis compared to cold steel, but both excisional methods are simple, have short operative times, and allow for histopathologic analysis. Postoperative care, including gentle cleansing, infection prophylaxis, occlusive ointments, and avoidance of sun exposure, is vital to promoting re-epithelialization. Rhinophyma remains a complex and poorly understood condition that can severely impact quality of life. Surgical intervention is the main treatment modality, with excision via electrocautery and consideration of laser therapy as the preferred method to control hemostasis and allow histopathologic analysis.