While not a direct cause, drinking alcohol can worsen rhinophyma symptoms in people with rosacea.

Rhinophyma — also sometimes referred to as “alcoholic nose” — is a physical condition that many people assume is caused by alcohol use disorder (alcoholism).

But is that really a cause of this thickening of nasal skin? And what can be done to reverse the effects of this condition?

Keep reading to learn the real causes behind rhinophyma and how to put an end to the damage.

While rhinophyma is often dubbed “alcoholic nose,” the reality is that it’s a type of rosacea — meaning that heavy drinking isn’t actually linked to it.

Currently, no single thing has been shown as the direct cause of rhinophyma. However, several factors may contribute to the condition.

Rhinophyma is considered an advanced stage of rosacea. Therefore, a common cause of rhinophyma is having long-term rosacea. For people who develop rhinophyma, their face skin thickens, especially around the nose.

While anyone can develop rhinophyma, it’s most commonly reported in white males, especially over age 50. Experts theorize that androgenic hormones found in males may trigger rhinophyma.

Other common factors that might increase your chances of developing rhinophyma include:

  • light skin
  • an ancestry that’s Eastern European or Irish, English, Scandinavian, or Scottish
  • a family history of rosacea

Drinking alcohol has been debunked by research as a direct link to this condition. But we do know that drinking can cause more flushing in people with rosacea. Typically, alcohol use is not recommended when you have rosacea.

Not everyone with rosacea who develops thickened skin will go on to develop rhinophyma. But for people who do, having chronic infections is common, since fluids in the skin ultimately trap bacteria.

If you develop rhinophyma, your nose may appear red, large, and even bumpy or bulbous. The visual side effects are most obvious on the tip and lower part of the nose, since the actual bone structure is not affected by the condition.

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The results of a Combination surgical excision and fractional carbon dioxide laser for treatment of rhinophyma.
Kassir R, Gilbreath J, Sajjadian A. World J Plast Surg. CC BY 3.0

Treating rhinophyma tends to be a two-fold process, depending on how advanced the case is.

If inflammation is present because of a bacterial infection, then oral antibiotics such as tetracycline may be prescribed to manage the infection. However, multiple methods might be recommended to manage the thickened skin.

Topical treatments

Some people might be prescribed a low dose course of isotretinoin (Accutane) to help shrink enlarged oil glands that might also be contributing to skin thickening and symptoms. Topical retinoids might also be recommended for anyone who catches the condition in its early stages.

Other options include topicals like metronidazole or azelaic acid. By contrast, people with more advanced cases may be prescribed topical ivermectin, oral isotretinoin, or brimonidine.

Surgical treatments

For more advanced forms of rhinophyma, the most effective way to manage thickened skin is almost exclusively through physically removing excess tissue. Sometimes, this can include relying on ablative lasers or electrical currents (a treatment known as diathermy) to help remove excess tissue.

Out of these options, carbon dioxide laser surgery is considered the preferred option because it allows for the most precise removal of excess tissue. Still, many doctors may recommend a multi-solution approach that combines options such as carbon dioxide lasers with dermabrasion to better remove damaged tissue.

With surgical treatments, care must be taken to avoid disturbing cartilage while leaving enough skin to ensure proper healing with minimal scarring.

Some doctors may opt for dermabrasion and cryosurgery along with lasers and electrical currents.

Learn more about other treatments for rosacea here.

Although often referred to casually as “alcoholic nose,” we now know that rhinophyma is not caused by alcohol consumption at all. Instead, it’s a more advanced stage of rosacea that is associated with tissue overgrowth and swelling in the nose.

While the underlying causes aren’t fully understood, early treatment is considered the most effective solution.

Surgical therapy, along with topical treatments, are incredibly effective for helping return the nose to its original shape without harming the bone and cartilage structures.