Treatment of rhinophyma with carbon dioxide laser

Rhinophyma is a slowly progressive, disfiguring disorder of the nose which represents the end stage of acne rosacea. The cosmetic deformity is often the reason for patients to seek medical attention. Over the years many treatment modalities, including dermabrasion, electrocautery, excision and grafting, decortication and cryosurgery amongst others, have been described to treat this condition, but none of them are very satisfactory. Special concern about the droplet dispersion of blood in dermabrasion have made this method less acceptable as it poses a potential risk to health workers. We describe a technique in which this proliferative disorder can be treated, using carbon dioxide laser excision and vaporization. This method provides a very dry surgical field which allows the sculpting of the hypertrophic areas to be very effective, giving a very satisfactory cosmetic result.