When is electrosurgery recommended for rhinophyma?

Rhinophyma is advanced thickening of the skin and oil-producing structures of the nose, often associated with rosacea. Electrosurgery uses a heated instrument or electrical energy to remove or reduce selected tissue. For rhinophyma, the aim is to improve contour and create a smoother surface while limiting injury to nearby skin. It is generally considered when tissue enlargement is established, affects the shape of the nose, or causes practical concerns such as difficulty keeping the surface clean. A clinician may consider other tissue-removal methods as well, depending on thickness, location, skin characteristics, and experience.

Arrange an in-person assessment before choosing a procedure. The clinician should examine the nose, confirm that the growth is consistent with rhinophyma, review rosacea symptoms and previous treatments, and discuss anaesthetic, wound care, healing, and the possibility of more than one treatment session. Tell the clinic about medicines that affect bleeding, a history of poor wound healing, cold sores near the treatment area, and any tendency to form raised scars. Follow the aftercare plan closely: keep the treated area clean, avoid picking at crusts, protect healing skin from sunlight, and attend the planned review.

Seek prompt clinical advice if a treated area develops worsening pain, spreading redness, increasing warmth, pus, fever, or bleeding that does not settle with the instructions provided. Before treatment, arrange assessment for a rapidly changing, ulcerated, persistently bleeding, or unusually painful nose lesion rather than assuming it is rhinophyma. New breathing difficulty also warrants medical attention because it may require assessment beyond surface treatment.

Ask whether the nose changes are suitable for electrosurgery, how much tissue reduction is realistic, which anaesthetic will be used, how the wound will be dressed, and what signs would suggest infection or delayed healing. Ask how rosacea control fits into the plan and whether a tissue sample is needed if any area looks atypical.