The nose is the centre most part of the face is also the most noticeable. Any deformity or even minor blemishes on the nose can be a cause of unnecessary distraction.
Rhinophyma is thickening of the skin of the nose and it is usually considered the last or most severe stage of acne rosacea. But many patients with rhinophyma may not have rosacea at all. Nearly all patients with rhinophyma will have oily or greasy skin. It is the thickening of the oil glands referred to as ‘sebaceous glands’ that leads to a build-up of ‘sebum’ and distortion of the skin of the nose. Rhinophyma occurs almost exclusively in middle-aged to elderly Caucasian men but Dr Vishal Madan MBBS (Hons), MD, FRCP has treated a few women and darker skin patients who had rhinophyma.
It is not uncommon for patients with rhinophyma to be stigmatised by their condition. Although there is little evidence to suggest the role of chronic alcoholism in rhinophyma, the term ‘whisky nose’ unfortunately almost always gets associated with this condition. I have seen many patients with rhinophyma who are teetotallers and most of my patients consume very little alcohol or drink in moderation.
Rhinophyma can be of varying severities. Minor-if there is redness, broken blood vessels and mild thickening and coarsening of the nasal skin texture. Patients often complain of oily skin and on squeezing the skin of the nose, oily secretion ‘sebum’ can be expressed from the pores. Some patients may complain of whitish discharge often with offensive odour from the pores of the nose. Major or severe rhinophyma is one which has prominent lumps on the nose leading to distortion of the architecture of the nose and may also lead to obstruction of nasal passages, and breathing difficulty. Most patients have moderate rhinophyma, the severity of which lies between the minor and major spectrums.
Generally speaking, medical treatments tend not to work very well. The acne medication, Isotretinoin (Accutane or Roaccutane) may reduce the very early or minor rhinophyma.
Whilst there are many available treatments options, including:
Carbon dioxide laser- Perhaps the best treatment. I say this because I have compared the results of other treatments with carbon dioxide laser and I am impressed with the outcomes that can be achieved in a short span without too many risks. Of course, if you speak with laser experts who do a lot of laser treatments, you will learn that carbon dioxide laser is the most challenging lasers to use with a potential of significant harm in the inexperienced hands. So, please always check with the practitioner their experience in use of this device especially for treating rhinophyma.
Usually only one session is needed to achieve satisfactory results.
Let me explain in brief, my technique of carbon dioxide laser treatment of rhinophyma.
I undertake this procedure under local anaesthetic and employ a ‘3 injection technique’ to numb the nose. Total anaesthesia is achieved within 5 minutes. The procedure is then totally painless. It takes 30-45 minutes to resurface the entire skin of the nose and even the most ‘challenging’ cases can be dealt with within this time frame. My specialist nurses, then apply antiseptic ointment to the treated site under dressings which the patient can take off in 48 hours. There is no need to stay overnight in the hospital. The affected area then needs to be washed twice a day following which antiseptic ointment is again applied. The crust formed after laser treatment washes off naturally, and the burnt appearance seen immediately after laser treatment gives way to red skin in 7-10 days. Healing process continues and complete new skin formation occurs in 3-4 weeks. So are there any side-effects of the treatment? – Whilst, the procedure is extremely safe, no surgical/laser procedure is entirely free from side effects. Risks include redness that may last for up to 3 months following laser treatment, scarring, and pale skin. Another question that I get asked quite often is how long do the benefits of laser treatment last? Whilst there are no exact figures available, the effects are long standing and even permanent. In one of the largest series published worldwide, I found that the recurrence is extremely low.
At Everything Skin Clinic™, we have a team of highly trained Consultant dermatologists, who have completed specialist training in Dermatology and are on the specialist register of the General Medical Council. All our consultants hold substantive contracts with the best Dermatology centres in leading NHS hospitals. Therefore, you can be certain of the highest quality private care.
“All the staff at this clinic were very helpful and friendly and helped me to feel less nervous . Dr Madan was really approachable and kind and the Mohs procedure was done efficiently and with minimum discomfort. I would thoroughly recommend this clinic for peace of mind if, as I did, you find you could be waiting up to 40 weeks for NHS Basal Cell cancer treatment.”
“I attended the clinic to seek advice about the removal of a mole. All the staff were very professional and courteous and I was seen on time. Ten minutes after my arrival I was leaving the clinic minus my mole. Amazing! And they have a carpark which in Cheadle is a real asset.”
“I went in enquiring about Laser Resurfacing, and have to say, Sarah, the Secretary of Dr Madan is fantastic. She is v helpful and her manner is v professional. I just have to work out if I want to go for the consultation now.”
“Dr Madan was able to address all our concerns in a very professional and timely fashion, I was particularly impressed by the precision in applying the stitches, very neat and clean finish and the scar is barely visible after 2 weeks. Strongly reccomend”.
“Dr Madan was extremely helpful in diagnosing my Rosacea and prescribing my treatment... Dr Madan was very reassuring and I started my treatment straight away. My skin has really calmed down and I feel a sense of security knowing that if/when it flares up again, I will be in safe hands.”
“The entire team at Everything Skin Clinic were extremely helpful. From organising the appointments, helping with directions, responding extremely promptly to emails and helping with general queries."
“impressive set up, latest equipments and knowledgeable doctor.”
“The service that I received was very professional and personal. First class. I recommend Everything Skin to anybody considering using a skin clinic. Worth every penny.”
“Very happy experience with service provided. Would recommend Dr Madan”.
"Dr. Maden took his time to answer my questions over email. I am in the states but heard about great work he’s done and he responded same day with very helpful answers. Appreciate the willingness to help!”
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“Excellent and prompt service ,all the staff are very nice and the clinic is open 6 days a week which works well as I could attend my appointments on a Saturday.”
“The service provided by Everything Skin Clinic is exemplary. From the initial consultation with Dr Madan and throughout all of my personally affective treatments performed by him I felt completely at ease being in the hands of someone so courteous, specialist and consummate in their field. Without hesitation and with great assurance I would recommend his services at Everything Skin Clinic.”.
“I have been under the care of Dr Madan for the last 12 months, the care I have received under his supervision has been outstanding. Undergoing laser treatment as a young woman is extremely daunting, however, his expertise in the field never …” Click to read full review
“I’ve been impressed with this clinic. They’re always running on time and the staff called me after my treatment to ensure I was doing well, and when I wrote in with an aftercare question, Dr Madan wrote back personally and put my worries to rest right away.”
“Had Dr Madan recommended for a rosacea problem. The consultation went well as did the pulse dye laser treatment ! Found Dr Madan very informative and he put me at ease during the treatment, explaining what was happening and about after-care….”
“I highly recommend Dr Madan. He is an excellent dermatologist. He is polite and professional. Very happy with the treatment received for dark circles”
“I was extremely impressed by the Clinic and its staff. I was welcomed warmly and was attended to almost immediately. The Consultant was kind and professional and answered all my questions which allayed any concerns. I would thoroughly recommend the Skin Clinic to friends and family"
“As soon as I walked though the door I was made to feel as ease , very professional, clean . In the consultation I was made to feel at ease and the treatment was fully explained to me and luckily could do it on the day of my consultation, I would highly recommend this clinic infact I have to my son”.
“Would highly recommend this clinic. Great care, very efficient, professional and excellent communication.”
“I have seen Dr Madan for over a year now after removal of Melanoma but this was my first time at the Everything Skin Clinic... The appointment itself is first class with Dr Madan being very professional and calm with his digital mole mapping being an excellent tool for keeping a check on any moles. I would highly recommend the services here.”
“holistic approach. thank you.”
“Appointments arranged very fast, staff and facilities are second to none, small procedure carried out without fuss, exceptionally pain-free and reassuring!”
“Quick, highly efficient service. Very professional. Would definitely recommend and use again. Thank you Dr Madan”.
“Really excellent, prompt and effective service. Dr Madan was excellent, friendly, extremely professional and delivered a small procedure without drama, without pain and with a super outcome. I have come away extremely impressed with him and his team and can highly recommend them.”
“I attend the clinic and I’m so so happy with my results thanks to Sarah and Dr Maden”
“The staff who I met at the Everything Skin Clinic all had a friendly, knowledgeable, reassuring, welcoming and professional approach to my queries. I f you have been diagnosed with skin cancer and face a worrying wait for NHS….”Click to read full review
“Great experience, excellent clinic, pro team. Dr Madan is thorough, professional, insightful, and actually listens. Others in the field shrug off difficult issues. Dr Madan owns them and finds solutions! Highly recommended. A++++++++”.
“Excellent treatment from Dr Madan at Everything Skin. He removed 2 basal cell carcinomas on my face using Mohs surgery and now after 2 months it is difficult to see any sign of the scars. In addition there is peace of mind knowing that as far as possible all of the BCC was removed in one go.”