Phymatous Subtype

Marked by thickening of the skin, irregular skin texture, edema, hypertrophy and hyperplasia of sebaceous glands, connective tissue, and vascular bed of the nose (rhinophyma).  These changes can also be seen on the chin (gnathophyma), ears (otophyma), forehead (metophyma), and eyelids (blepharophyma).  Almost exclusively in males.

  • This severe form of rosacea requires maximizing medical therapy with systemic antibiotics, and sometimes use of isotretinoin.  Once the medical regimen has been maximized, the patient is a candidate for surgical/ laser resurfacing of the affected area by a dermatologist.
  • Electrosurgical sculpturing, resurfacing laser, dermabrasion or cold-steel surgery are surgical options for the management of phymatous changes.