Bulbous nose

Alternative names
Rhinophyma; Nose - bulbous; Phymatous rosacea

Rhinophyma is a large, bulbous, ruddy appearance of the nose.

Causes, incidence, and risk factors

Formation of an enlarged, red nose was once thought to be caused by heavy alcohol consumption, but this is not the case. Rhinophyma occurs equally in those who do not drink at all and those who drink alcohol in quantity. It is seen almost exclusively in men over age 40.

The cause of rhinophyma is unknown, though it is generally regarded as a severe form of rosacea. It is a relatively rare disorder involving thickening of the skin on the nose and the presence of many oil glands.

Although rhynophyma is a cosmetic disorder, it may cause emotional distress if symptoms are obvious or extensive.


Symptoms involve an abnormal appearance of the nose:

  • Thickening  
  • Bulb shape  
  • May be reddish  
  • Waxy, yellow surface

Signs and tests

Rhinophyma may usually be diagnosed without any testing. A skin biopsy may be needed to confirm the diagnosis in unusual cases.

Surgical reshaping of the nose is the best known treatment for rhinophyma. This may be accomplished by laser, scalpel, or dermabrasion. Some physicians have reported good results from treatment with the acne medication Accutane.

Expectations (prognosis)
Rhinophyma can be corrected surgically, but the condition may recur.

Emotional distress can be caused by the change in appearance.

Calling your health care provider
Call for an appointment with your health care provider if you have symptoms of rhinophyma and would like to discuss treatment.

Johns Hopkins patient information

Last revised: December 6, 2012
by Dave R. Roger, M.D.

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