The Journal of laryngology and otology · 2026
Evidence-based management of rhinophyma according to disease severity and clinical grade.
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Bayar Muluk Nuray
Аннотация
OBJECTIVES: This review evaluates contemporary therapeutic strategies for rhinophyma, emphasising evidence-based treatment selection according to disease severity and clinical grading.
METHODS: A structured literature search of PubMed/Medline, Scopus, Embase and Web of Science was performed for studies published between 1990 and 2025 evaluating medical, surgical and laser-based rhinophyma treatments.
RESULTS: Medical therapy, including doxycycline and isotretinoin, is primarily beneficial in early inflammatory disease (Clark Grade I). Established fibrotic rhinophyma (Grades II-IV) generally requires surgical intervention. Current Level III-IV evidence supports partial-thickness sharp excision combined with adjunctive laser contouring using CO₂, Er:YAG and emerging blue laser technologies to improve haemostasis, tissue preservation and cosmetic outcomes. Histopathological assessment remains essential because occult malignancies may coexist within rhinophymatous tissue.
CONCLUSION: Treatment should be individualised according to clinical severity. Combined excisional and laser-based approaches currently provide the most favourable functional and aesthetic outcomes, although prospective comparative studies remain limited.
METHODS: A structured literature search of PubMed/Medline, Scopus, Embase and Web of Science was performed for studies published between 1990 and 2025 evaluating medical, surgical and laser-based rhinophyma treatments.
RESULTS: Medical therapy, including doxycycline and isotretinoin, is primarily beneficial in early inflammatory disease (Clark Grade I). Established fibrotic rhinophyma (Grades II-IV) generally requires surgical intervention. Current Level III-IV evidence supports partial-thickness sharp excision combined with adjunctive laser contouring using CO₂, Er:YAG and emerging blue laser technologies to improve haemostasis, tissue preservation and cosmetic outcomes. Histopathological assessment remains essential because occult malignancies may coexist within rhinophymatous tissue.
CONCLUSION: Treatment should be individualised according to clinical severity. Combined excisional and laser-based approaches currently provide the most favourable functional and aesthetic outcomes, although prospective comparative studies remain limited.