The red swollen nose of rosacea is a much hated symptom. I know that this was the symptom that I despised most and indeed drove me 10 years ago to start to look for good information about how to treat rosacea. Incidentally, this drive lead to the creation of the internet based Rosacea Support Group in 1998.
I hated that I looked like I had adult acne and a constant sun-burned nose. Especially as I have somewhat fair skin, a red nose stood out a mile away.
There has been quite a lot of interest in a article I wrote titled “how to cure a red face (facial erythema or redness)“. That article gave some tips on how to deal with general facial redness. What about a red and swollen nose ? What can you do to treat a red rosacea nose ? Read on for some suggestions.
A rosacea nose has the extra complication that one might end up suffering from rhinophyma. Although rare, rhinophyma is also a much hated symptom of rosacea. While we don’t know for sure how any particular rosacea sufferer’s symptoms will progress, reducing your inflammation and flushing is a good start to winning the battle.
Here are my top tips for dealing with the red nose of rosacea.
Rosacea-LTD III
Rosacea-LTD was one of my first discoveries after starting to look for treatments on the internet in 1998. They consist of compressed disks of sulfur and various salts. You wet your face and glide them over the skin, leaving a thin film. For me these `disks’ did a great job of reducing the papules and pustules on my nose. I could feel them shrinking all those acne looking lumps and bumps. As much of my redness was associated with my papules and pustules, this treatment was a good step in the right direction. I continued to use rosacea-ltd for several years.
Disclaimer: rosacea-ltd is a site sponsor of rosacea-support.org
Oral Antibiotics
If the nasal swelling is associated with the papules and pustules normally seen in rosacea, then systemic antibiotics along with topical metrogel or finacea may also be of benefit. Once the papules and pustules are under control, the associated swelling may be reduced enough to see an overall benefit in appearance. One of the newer antibiotics on the market is a low dose form of doxycycline called Oracea, which may be useful in helping to maintain a long term benefit from antibiotic usage.
Accutane
Accutane or roaccutane has been used for many years to treat cystic acne. There is a good body of evidence to say that you can successfully treat rosacea with accutane. Additionally there are some published papers that deal specifically with treating rhinophyma with accutane.
Isotretinoin has also been demonstrated to decrease nasal volume in rhinophyma. The most significant regression has been noted in younger patients with less advanced disease.
…
Isotretinoin has also been demonstrated to decrease nasal volume in rhinophyma. The most significant regression has been noted in younger patients with less advanced disease.
Biopsy specimens from phymatous skin prior to isotretinoin therapy showed numerous large sebaceous glands. During isotretinoin therapy, the glands diminished in size and number. Other studies have confirmed the usefulness of isotretinoin for phymatous change.
Accutane is not a drug to be taken lightly. If you would like to try this as an option, the above references might help you find a doctor that can support you using this as a treatment option. You may also want to discuss the option of low-dose accutane with your doctor.
Covering Up
As you start to reduce the inflammation, you will probably also benefit from covering over some of the redness. Some options include the easily available Clinique Redness Solutions, or Eucerin Redness Relief which may be able to offer some relief from the redness. Additionally the green tinted version of the Tone Perfecting Cream may cover some redness.
Perhaps you can find some foundation or tinted moisturizer that you can also include in your daily regime. It might not be easily obtainable worldwide, but The Cancer Council in Australia has a range of tinted moisturiser SPF 25 that looks interesting. Don’t discount a liquid foundation as a possibility, even if you are a guy.
IPL and Lasers
We now know that IPL is excellent for treating a red face and broken blood vessels. Will any of the benefits of IPL also help a red swollen nose ? In general IPL and pulsed dye lasers are useful in reducing the redness flushing, burning, itching, dryness and swelling of rosacea.
The AAD suggests that for thickening of the skin on the nose and cheeks as seen in rhinophyma, the CO2 laser and erbium:YAG laser can be used.
Surgical Options
When the growth of the nose tissue becomes impossible to manage with topicals or isotretinion, surgical intervention can be an option. Surgery can naturally have its own risks. With the removal of extra tissue also comes the risk of scarring.
CO2 Laser
A 2004 paper; The Gold Standard for Decortication of Rhinophyma: Combined Erbium-YAG/CO2 Laser, details how the authors suggest that the combined YAG/CO2 laser is superior to other lasers, scalpel, radiotherapy and skin grafts in dealing with rhinophyma.
Also some related comments from the AAD page Is laser treatment right for your rosacea? ;
Some patients with longstanding rosacea develop thickening skin on the nose and cheeks, which is called rhinophyma. The CO2 laser and erbium:YAG laser can be used to remove this thickening skin and improve the contour of the nose. Other surgical procedures used to treat this condition include dermabrasion and excision with a scalpel. Treatment options may be combined to obtain best results.
Dermatologists recommend early treatment of rhinophyma to help prevent the condition from progressing and becoming more difficult to treat. In the advanced stages, rhinophyma can cause difficulty breathing through the nose. It also is possible for the nostrils to collapse.
Other Surgical Methods
A 2003 paper; New surgical adjuncts in the treatment of rhinophyma: the microdebrider and FloSeal details a novel technique using a standard microdebrider followed by a haemostatic sealant to eliminate bleeding.
Now Over to You
What have you found to be useful in your battles with a red nose ? Please help your fellow rosacea sufferers by leaving a comment below.
7 comments ↓
Three years ago, at age 55, I was diagnosed with mild to moderate P&P rosacea on my nose. I’ve been prescribed with various antibiotics in conjunction with topicals (Metrogel .1% and Tazorac). Generally, each of the antibiotics that I was taking lost its effectiveness within 3 to 6 months. It resulted in immediate flare-ups until I was prescribed a different antibiotic.
Nine weeks ago I bought the hand-held, Omnilux Clear-U (http://www.phototherapeutics.com/clear-u/) and have been very pleased with the results. Omnilux recommends a course of 2×20 minute treatments per week for 4 weeks of alternating blue and red light. For normal acne, this treatment should be effective for 6 months. Omnilux states that the light doesn’t damage the skin and therefore, there’s no limit to the amount of treatments one can have. Therefore, my intent is to continue weekly treatments indefinately. There hasn’t been any studies, yet, to determine if LED therapy loses its effectiveness if used consistently over long periods of time.
I’ve stopped taking antibiotics 3 weeks ago and, so far, no flare-ups. My nose hasn’t looked this good for quite awhile. This blue/red LED light therapy seems to be a very effective way to control P&P.
The only downside to this unit is that it costs approximately $300 and that the LED flat panel is rather small, so it only treats areas within its physical area. Omnilux informed me that its only effective when held against the skin and up to one half inch above the skin.
thank you for the article Digital Davo
is there a way i can contact you through messages? i don’t want to explain everything in this message until i can contact you properly but i suffer from this, im 15 and i need some of your help.
Hi Jeff,
I’m not keen to exchange too much information in personal email for 2 main reasons. Firstly I’m not a doctor so I can’t offer personal or medical advice.
Secondly; if and when people discuss their thoughts, problems, solutions etc. on a board the threads remain for others to learn from at a later time.
As well as the blog here there is also an email group: Rosacea Support Group and several online forums such as Rosacea Support Community.
This requires you to understand all of the privacy implications of going online of course.
davidp.
alright thats fine
im wondering which would you recommend more, the laser or rosacea LTD?
since you used it for 7 years or however many years has it shown very good improvement? how are you doing with it??
I did have pulse dye laser twice many years ago, but never recommend it as a cure because it only helped my symptoms about 10% I reckon.
I kept using rosacea-ltd for several years because it continued to keep the papules and pustules at bay. After a few years I found that I no longer needed them.
hope that helps ?
davidp.
Hi Davidp.
You mentioned that you no longer needed to use rosacea-ltd after a few years. Is that because your p&p eventually disappeared?
I bought rosacea-ltd, but never used it because its instructions called for stopping all topical medications and drinking water almost every hour. Did you follow these these instructions or just simply applied the disks?
Do you know if one can eventually “outgrow” rosacea?
Thanks!
- Marty
Hi Marty,
My papules and pustules did slowly subside after all the bits and pieces of treatment started to work. I don’t recall drinking that much water at the time. The disks do make it hard to use other topicals, especially if you are using jojoba oil and applying the disks to wet skin.
I’m not a real believer in outgrowing rosacea - if your rosacea is related to flushing or hormones, sun exposure without sunscreen for etc. then if your exposure to your triggers wanes or your life changes then your rosacea can appear to go away. I have more belief in this sort of reason that symptoms wax and wane - rather than just outgrowing rosacea.
davidp.
Leave a Comment