Electrosurgical Tangential Decortication for Severe Rhinophyma: A Case Report

Rhinophyma represents the advanced phymatous stage of rosacea and is characterized by progressive sebaceous hyperplasia, connective tissue overgrowth, and vascular proliferation resulting in nasal deformity. Surgical intervention remains the definitive treatment for rhinophyma once fibrotic hypertrophy is established. Although CO₂ laser therapy has been widely adopted due to precision and hemostasis, electrosurgical tangential decortication remains an effective and economically accessible alternative. We report the case of a 53-year-old male patient with severe rhinophyma secondary to long-standing rosacea, treated with electrosurgical loop-assisted decortication. Layered excision was performed with preservation of deep pilosebaceous units. Complete re-epithelialization occurred by postoperative day 35 with restoration of nasal contour and no complications. This case underscores that electrosurgery, when performed with meticulous depth control, offers outcomes comparable to laser modalities while maintaining broader accessibility and reduced cost.