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.
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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.
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26 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.
I appreciate this exchange of information and this is my first comment. I have had mild rosacea for 10 years and now have rhinophyma. I have tried all of the normal stuff, except for accutane. I have had phenomenal success in the last three weeks with twice daily Face Dr Rejuvenating Soap and “green” light treatment. I started this because I have a cancer on my nose and after the biopsy the dermatologist ‘burned” the area to stop the bleeding. I have used green light for years on burns (quickly relieves pain and speeds healing). My nose cleared up completely within two days, the burn healed in one week and I have not had any papules, pustules or redness. YES, I am also surprised. You can try this easily as the soap is readily available (i.e., Drug Emporium) and a green light bulb can be purchased at Walmart, labeled “party bulb”. Good luck, Joe
By the way, I used some spray on Coppertone yeaterday and I had a slightly red bumpy nose until I retreated. Need to find some sunblock that doesn’t irritate my newly smooth skin.
Hey Joe, My nose is pretty bad right now, I’d like to try what your doing. The green light can be found in what dept.? And how do you use this light? IE: how often, how long is the treatment, how close to your skin, etc.?? I’d appreciate your input…
Thnx, Steve B
Steve – I bought a regular light bulb that is tinted green, it was labeled a “party light” in the same section as the regular light bulbs. I put the green light bulb in a fixture that allows me to hold it within 6 inches of my face for 5-10 minutes (the Dr who told me about the green light said to use the light for as long as it feels good – I have never used it longer than ten minutes). I always do the green light after using the Face Doctor ‘Rejuvenating Soap’ (~ $20 a bar, but it lasts 2-3 months used per the directions on the package). Let us know how it works for you.
I would suggest trying out the wonderful products at Skin Actives as an option. Their rosacea control serum certainly worked for me, compared to the prescription topicals usually suggested. For cleansing, the sea kelp bioferment is a great alternative to traditional cleansers. They also have about the only suncreen I don’t react to.
Many rosacea ’suffers’ mix up their own custom formulas too.
Thanks for an excellent web site resource.
Hello Everyone,
I don’t have rosacea but found this website trying to remedy redness on my nose. I work in a tire manufacturing plant, which is a very dirty environment, very dusty. We use an elaborate dust collecting system, but carbon remains in the air. I find myself wiping my nose often, upon feeling I’ve inhaled it. What happens then? Breakouts on and around my nose. Currently my nose is red on the tip, with several pimples there as well. I know it will clear up eventually, but I can relate to the embarrassment of being in public with a Rudolph nose. It sucks. I just want you to know you are not alone, as this forum suggests, and to not lose hope! It pains me to read the outpouring of hurting hearts here, and I wish there was something I could do for you. So, it may seem like nothing, it may offend some, but I will be praying for you all.
My God is a strong tower, a place of refuge. He will never leave you or forsake you. Put your trust in him, and he will not disappoint you.
I know those of you reading this have a lot to offer the world. Don’t deny the world your giftings, talents, and abilities. Look for opportunities to share what you’ve learned through your ordeals and watch the difference you can make! BTW, I’ve noticed when I stop thinking about myself so much, I end up feeling much better about myself. When I look to others and focus on them, I get a satisfaction I can’t find anywhere else. Be encouraged and be encouraging!
hye,
I would like to know, how can we know if we have rhinophyma? I have a lot of broken capillarity on my nose and my cheek. I will have a pdl in september but recently, my skin texture changed. The size of my pore became huge on my cheek and on my nose and a lot of wrinkles appeared. My skin became very oily. I don’t have any swollen, it’s more like if my skin lost its elasticity because of the pemanent redness … (like the skin of an old person who would have had too much sun exposure)
But now, I wonder if it can be a beginning of a rinophyna. Is it because we have large pores and alot of blackhead that we have a phytomatous rosacea?
thanks
Hi
Could you please let me have the address of the Rosacea support group for a friend who has no e-mailing facilities?
Thank you
Jennifer Thompson
Hi Jennifer,
I don’t know of any such groups. I have looked in that past, but I believe that the only active and functioning rosacea support groups are online.
davidp.
I have a red face.I went to the doctor and he done lazer.It worked and got rid of some reddness.However after geting it done i could not go anywhere for a week because Marks appeared on my skin then disapppeared after a week.I heard that IPL is better than lazer as it leaves no marks that need to be healed and also does a larger surface area of your face.Is that true and do you think its better?
Hi Tommy,
IPL can have less downtime, as can other more gentle forms of laser like V-beam. As to whether IPL is generally considered better than laser, that is a difficult question to answer categorically. If you find a good IPL doctor then I think you can expect good results for your rosacea.
You might find the Laser & IPL Forum helpful.
davidp.
Hello, friends:
I am frustrated about this rosacea condition. I had it diagnosed this year on January and I have been through different medical treatments with no significant improvement. I am a 40 years old female. I have the papulopustular subtype of rosacea. I have had even deep scars because before I used the oral doxycicline, some abscesses came out producing very visible scars. I have been two times using doxycicline 200 mg twice a day for 1 month with significant improvement (no papules or pustules) but still redness. Two weeks after I finish the 1 month course of oral doxycicline, the papules and pustules come back. A physician told me that I should not use doxycycline for more than 1 month because it could cause liver problems on the long run.
Now I am using oral prednisone 2.5 mg twice a day, topical clindamycin 1 % gel twice a day, and evening primrose oil capsules 1300 mg taken orally twice a day, with some control but still not good enough. I still keep getting the so bothersome papules and pustules (not the abscesses) which leave small scars. And they appear in different places in the cheeks and chin. I have been like 7 months trying all kinds of antibiotics (Metronidazole gel , clindamycin gel) and prednisone with no satisfactory improvement. I do not hate the redness, but I hate the pustules and papules.
I want to know if somebody has had a naturopathic or medical treatment that has kept the papulopustular rosacea under control with no or minimal symptoms for short or long time. Or if somebody has discovered a miraculous home remedy to avoid the pustules or papules coming out again for a considerable time or to make them disappear quick. Please let me know by posting at this website and/or by emailing to my email address sheila092001@yahoo.com. I will be eternally grateful if you could help me with my rosacea problem, please.
Sheila,
I was told by a cupuncturist that Rosacia can result from Candida overgrowth. Candida is in everyones intestines but can leave the intestine and grow in your body in excess. Candida feeds off of sugar. Not just regular sugar but foods that turn into sugar in the body. Some are white flour,fruits, potatoes,juices ,ect…Wheat is something to avoid,chocolate,soda’s. especially coke,diet coke,pepsi.,too much caffein,alcohol,oranges,trans fats,too much grains,.
What I did Sheila is go to your local heath food store and ask the workers there for info. on your situation,they should help you with advice. Online look up Candida overgrowth on different homeopathic sites so that you can educate yourself. I take Nicomide(a natural supplement from dermatologist but I refuse to take an antibiotic for this because I believe taking them for acne 5 years ago for a long period of time reulted in candida overgrowth. The antibiotic killed most of my good bacteria . I nw take a refridgerated probiotic everymorning a half an hour before I eat to put the good flora back into my intestines. Educate yourself on this manner Sheila. Healthy eating habits with help your body heal, lots of filtered water, and exercise three times a week doing something you enjoy. The best to everyone! Anne
hi i am a 15 yr old girl frm asia…..n i have acne rosacea on my nose………the face n cheeks have cleared bt i find it difficult to deal with the nose
Another option for people to try is Vitamin A tablets, which seem to be working very well for me. I am still on doxycycline, but doxy and rosex alone were not enough to control my symptoms. The reason I decided to experiment with vitamins was 1. frustration and 2. that I read that Accutane/Roaccutane can be helpful for rosacea and from what I understand it is a purified form of vitamin A. Since taking the vitamins, there has been a dramatic reduction in pimples and my skin feels much smoother. I have even stopped using rosex which was causing my skin to flake uncontrollably. The supplements I use contain 1500UI and it says on the bottle the recommended daily dose of vitamin A from all sources is 2500UI. I guess you just need to be careful not to overdose. Interested to know if anyone else has had success with vitamin supplements.
Hi Dave,
) but I might have a bit worse rosacea, because I think you wrote somewhere it is one of your worst photos, and for me this is rather normal condition and I think my skin is already thickened a bit. On top of it when it flares-up in cold or when i touch it, then its all intense RED, really, I sometimes look like a clown 
.
as I look at your photo, then I think it could be mine, because I have very similiar condition on my nose (and a similar nose shape and brown eyes
A question. Did you find laser treatments you made effective for redness/flare-ups?
Thanks,
Marcin
Hi Marcin,
not personally no. I haven’t ever had IPL, but did have a few rounds of Pulse Dye Laser that caused severe purpura but the rosacea returned even before the skin had healed fully. PDL and IPL have progressed as rosacea treatments since my treatments many years ago, so my less than spectacular success might not be indicative.
If you are able to find a laser/ipl doctor with experience treating rosacea you should expect to get some relief from your flareups.
davidp.
Hi Dave,
I am a female in my early 30’s. I started having phymatous rosacea on my nose last May and was on Oracea for almost 6 months until I experienced some serious side effects and had to quit. My nose is now swollen again and I was wondering if there are other options other than antibiotics or lasers? Do you still have rhinophyma? We have heard that P & P can go into remission, do you know if anyone with Rhinophyma went into remission? Does that light bulb thing really worked? Any suggestions?
Thanks!
I had IPL treatment and it took away some of the visible capillaries on the sides of my nose.
I also had Rhinoplasty, and as it reduced the size of my nose bridge, it did nothing for the tip of my nose.
The surgeon has now given me an estimate for more surgery to correct the extra skin on the tip of my nose.
It will cost an additional $2800.00. I am disappointed that this was not corrected with the initial surgery – I thought this was going to be fixed – that is, I thought the tip of my nose would have been reduced. Now I feel like my bridge is small and the tip of my nose is light a bulb!
Very disappointing, to say the least.
Nancy, i don’t know. Your surgeon needs to give you a deal because who needs a surgery that didn’t work then another one? Wasn’t the tip of the nose the whole point? wierd that he thinks it’s okay to charge you again…
I’ve used face doctor soap and a combination borax and hydrogen peroxide solution to calm my rosacea,in addition to oral antibiotics. My recipe is one tablespoon each of borax(yes the detergent) and H2O2 and two tablespoons water. Sometimes i’ll leave it on all day or all night. Change mixture every two or three days. I also will make a bentonite mask with a few drops tea tree oil and use that. I let it dry and rinse off. I’m about to start finacea tonight. I started zinc and cod liver oil recently with some improvement. Just read about milk of magnesia and plan to try that. I much prefer natural treatments or at least non-pharmecuticals. The nose is definitely my trouble spot…I hope everyone feels better soon.
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