Carbon dioxide laser treatment of rhinophyma: a review of 124 patients

Summary Background Rhinophyma is a progressive, localized or generalized nasal deformity resulting from hypertrophy of sebaceous and connective tissue. The CO2 laser has been used for treatment of rhinophyma, but the long‐term efficacy of the treatment is unknown. Objectives To review the outcome of 124 patients with rhinophyma treated with the CO2 laser between 1996 and 2008 in our centre. Patients and methods Exuberant sebaceous tissue was ablated using the Sharplan 40C CO2 laser (Sharplan Lasers UK Ltd, London, U.K.) under local anaesthesia. The technique varied with the severity of rhinophyma; the laser was used in a continuous mode to debulk the larger rhinophymas, and in a resurfacing mode (Silk Touch® scanner; Sharplan, 4–7‐mm spot at 20–40 W) or continuous mode (10–20 W using a defocused 2–3‐mm beam) to reshape the nasal contours. Outcomes were determined by case notes, clinical review and questionnaire. Results Laser treatment was completed in a single session in 115 of 124 patients. All patients were reviewed 3 months post‐treatment. Results were classified as good to excellent in 118 and poor in six patients. All patients were sent a satisfaction questionnaire in 2008 and 52 patients replied. Patients reported high levels of satisfaction following treatment. The post‐treatment response at 3‐month review was maintained long term. The main complications were pain associated with injection of local anaesthetic, scarring and hypopigmentation (four patients) and open pores (two patients). Conclusions The CO2 laser is an effective and durable treatment for rhinophyma. Treatment carries a low risk of side‐effects and is associated with high patient acceptability and satisfaction.