Rhinophyma — SCE Dermatology MCQ
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Correct answer: B — Surgical debulking (CO2 laser ablation, electrosurgery, dermabrasion, or cold steel surgery)
Rhinophyma (the phymatous subtype of rosacea) does not respond adequately to medical therapy alone — definitive treatment requires surgical debulking to reshape the nose. Options include: CO2 laser ablation (precise tissue removal with haemostasis), electrosurgery/radiofrequency, dermabrasion, and cold steel surgery (scalpel/scissors). These techniques remove the hyperplastic sebaceous tissue and fibrosis while preserving the pilosebaceous unit-rich tissue for re-epithelialisation. Post-procedure wound care is essential. Oral Isotretinoin may have a role in preventing recurrence after debulking by reducing sebaceous gland activity. Medical therapy (Doxycycline, topical agents) addresses background rosacea but cannot reverse established rhinophyma.
Reference: BAD 2021 Rosacea; Dermatological Surgery