LLR Policy for Rhinophyma

Category

Threshold Criteria

Rhinophyma is a skin disorder characterised by a large, red, bumpy nose. It can occur as part of a phymatous rosacea. The exact cause is not known but is considered to be a sub type of severe rosacea. Although commonly believed to be due to alcohol, there is no link between Rhinophyma and excessive drinking

Although there is no cure for rhinophyma, treatments can be effective in improving the appearance and prevent deterioration.

Treatment of established rhinophyma can be very challenging and can include a combination of different treatment options. Oral treatments do not usually work very well in established rhinophyma, and surgery is often necessary. The aims of surgical treatments are to remove the excess tissue and restore the natural shape of the nose as much as possible by shaving off the extra layers of skin.

Eligibility

The LLR ICB will support the referral of a patient to secondary care in the following situations

Routine dermatology referral

• Persistent symptoms that are causing psychological or social distress
• Papulopustular rosacea
• Uncertain diagnosis

Referral to a plastic surgeon

• Severe phymatous disease
• Prominent Rhinophyma

Routine referral to an ophthalmologist

• Ocular symptoms are severe
• Ocular symptoms fail to respond to maximal treatment in primary care

Urgent referral to an ophthalmologist

• Suspected keratitis when there is eye pain, blurred vision or sensitivity to light

Guidance