Treatment of Rhinophyma with a Radiofrequency Device

Abstract

Background: Rhinophyma is an uncommon complication of long-standing rosacea that is caused by sebaceous gland hypertrophy. There is no consensus regarding the treatment of rosacea. Retinoids, steroids, antibiotics, electrocautery, ablative laser therapy, dermabrasion, and excisional modalities have been used, but no single treatment method has proved effective for all patients. Objective: Radiofrequency has been shown to decrease sebaceous gland activity in acne vulgaris. Thus, the authors postulated that it could also improve the clinical course and severity of rhinophyma by acting on the hypertrophied sebaceous apparatus. Methods: A 77-year-old man presenting with long-standing rhinophyma received 2 monopolar radiofrequency treatment spaced 3 months apart. Results: Two months after treatment, the patient reported significant improvement in symptoms. Specifically, the frequency of pustular flares decreased notably from once weekly before treatment to once every 3 weeks after the second treatment. The intensity of flares also decreased significantly, from 7–8 on a 10-point scale before treatment to 3–4 after the second treatment. The patient has continued to do well 5 months after his initial treatment, using only topical maintenance therapy. Conclusions: Monopolar radiofrequency can effectively improve the clinical course and severity of rhinophyma. This noninvasive, nonablative modality may be a valuable adjunct in managing this often refractory and therapeutically challenging condition.