Harley Street, London Clinic
Return to yourself
- Any physical changes from Rhinophyma (even the most severe) can be fully and successfully treated with the right Lasers and specialist
- There is no reason to continue to suffer from the psychological stress and trauma from this distressing condition
We are here for you!
- It is very hard to find help – the NHS does not cover and cannot treat
- Even in the Private sector this is a highly specialised area with only a handful of trusted experts across Europe and the world
Typical Treatments just do not work
- Typical cutting tools are highly risky – Electrocautery cannot refine and shape, causing scarring and pigment loss
- Tissue shaving with a blade achieves very suboptimal results
- Dermabrasion and surgical dermaplaning cause excess bleeding with unrefined results
Lasers are truly the Gold Standard
- The most refined and safe treatment outcomes for Rhinophyma can only be achieved with Laser technology
Two key lasers achieve Perfection
- Lumenis Ultrapulse Alpha, released only in September 2022 globally – the world’s most powerful and precise ultrapulsed CO2 laser. DrHConsult was the first UK and European Centre to acquire this device
- Sciton Joule X Erbium YAG – Custom designed to allow extra power and precision for ultraprecise skin refinement surgery with no damage/scarring and perfect the cosmetic result
Successful Rhinophyma treatments require:
- Rigorous privately invested clinical training not offered in the NHS
- A deep grasp and passion of physics, knowing that Lasers are at the forefront of this condition especially
- Continuous review of technologies and investment in the right lasers for this complex issue
- A provable evidence-led portfolio of patient results driven by case load
Treatment at a Glance
1-2 hours total clinic time
Number of Treatments
Typically one session only
Initial 2 weeks at home recovery
Immediately after the procedure
Before and After Photos
Before and eight weeks post combined CO2 and Erbium YAG laser treatments for a severe Rhinophyma.
This was a single-stage life changing procedure for this gentleman.
Male with Fitzpatrick 4 skin type (Middle Eastern origin).
The ‘after’ photograph was taken three months after CO2 laser surgery was performed with the Lumenis Ultrapulse CO2 laser.
Progressive recovery of an Afro-Caribbean man with Fitzpatrick skin type 6 following combined laser surgery with both the Lumenis Ultrapulse CO2 and Sciton Erbiium YAG lasers for a moderate rhinophyma.
The nose can be seen to heal and repigment very quickly over a four week period.
One year post operative result of a moderate rhinophyma laser treatment using the Lumenis Ultrapulse CO2 laser.
I would not hesitate in recommending DrH to anyone.
My experience of the treatment itself and aftercare by Dr H and his clinical team was first class, second to none.
My specific treatment was for a rhinophyma and sebaceous hyperplasia by co2 laser and I also had a viral wart removed and checked.
Throughout the consultation, Dr H told me exactly what was going to happen including before, during and after my treatment.
He maintained contact every day during recovery and was very quick to respond, furthermore the team at the clinic were very supportive and helpful too.
I am truly delighted with my results – the changes in my appearance and improvements made are everything I was hoping for.
I had severe rhinophyma and had been searching for a true solution for some time. Then I found DrH on Google.
On attending a consultation with Dr H I came away convinced he was the right choice. He was so confident that I would get my old nose back and made me feel really relaxed about it.
The healing process was unbelievable and after one week the area look almost normal. DrH was on call, checking on me every day
DrH has turned my life around. If anyone has this problem, I strongly recommend you contact Dr H. I cannot speak more highly about his skills in this field and his dedication and care of his patients.
I must mention Debbie the Practice Manager – what a star! All the way through she put me at ease and was always on the end of the phone.
Frequently Asked Questions
You can then expect some inflammation and redness to be present for the following two weeks that will gradually subside fully over a 10-12 week timeframe.
During your visit to us, DrH will diagnose your specific concerns and explain the best treatment options to achieve optimal results.
DrH will explain the full procedure details along with associated risks, downtime, and aftercare during your initial consultation.
Prior to the procedure we will arrange for your ‘laser pack’ to be ordered and delivered to ensure you have everything you need for the initial two week at home recovery – this will include washes, creams and medication required. Our clinical team will also fully support you on a daily basis (as you require) with your specific daily aftercare process.
Following your procedure you will be required to send daily photo updates to Dr H daily via our virtual round number, Dr H himself will be in frequent communication with you to guide you through the recovery period.
What is Rhinophyma?
Rhinophyma is a skin condition that predominantly affects the nose. The skin of the nose becomes thickened and oil glands within the skin become enlarged (called sebaceous hypertrophy). The skin may have a normal colour but often there can be excess or enlarged blood vessels within the skin that causes it to have a red appearance. Individual red or purple vessels may also be visible.
Usually the skin around the nose develops a bulbous and pitted appearance that can result in significant cosmetic deformity. In extreme cases the excess tissue can cause functional problems with breathing. Rhinophyma is a type of Rosacea. Rosacea is an inflammatory skin disorder.
Rhinophyma tends to affect the lower part of the nose – typically the tip and sides of the nostrils are most affected. This condition is far more prevalent in men.
Rhinophyma can be graded on a scale of 1-3 or Mild/Moderate/Severe. The photos below have been taken from the National Rosacea Society website and illustrate the difference grades.
Photographs illustrating; Mild rhinophyma (A), Moderate rhinophyma (B),Severe Rhinophyma (C) using the Standard Grading System for Rosacea – Journal of American Academy of Dermatology June 2004 Volume 50 Issue 6
Why do we get Rhinophymas?
The causes of rhinophyma are not fully understood. As yet there is no clear genetic link. Untreated sever facial rosacea is certainly a trigger factor for rhinophyma but it can also occur in people who do not suffer with rosacea.
It used to be a commonly held belief that rhinophyma was linked to excessive alcohol consumption with such historic names as ‘Whisky Nose’ and ‘Gin Blossom’. This is however totally incorrect.
Why is this issue hard to treat effectively often?
Due to the cosmetic nature of this problem that also often causes severe psychological distress for sufferers, the NHS does not treat rhinophyma in terms of the actual nasal deformity. Underlying rosacea is however treated in the NHS but this will not return the nose to its prior shape and volume.
Often due to the lag time / difficulty of obtaining a GP referral in the UK to a dermatologist, preventative treatment for rhinophyma is delayed which may further exacerbate the condition. Consequently, thickening and texture changes of the nasal skin begins to progress without active treatment.
GP prescribed treatments such as creams and low dose oral or topical antibiotics are often not be enough to control this problem.
In its early and mild stage, rhinophyma can settle with oral treatments. However, with further development, the skin thickness and shape of the nose will only resolve with surgical intervention. As nose shape is a cosmetic issue rhinophyma treatment is not available on the NHS unless the case is so sever it may cause issues with breathing or eating, but not for psychological distress.
Most cases of rhinophyma have to be treated privately. As a result of lack of rhinophyma treatment in the NHS, UK dermatologists and plastic surgeons are not often trained and equipped with the necessary skills to operate on rhinophyma cases. This is why our patients find it difficult to find a centre in the UK that specialises in rhinophyma treatments specifically.
The gold standard treatment of rhinophyma also requires either or both the powerful CO2 and Erbium YAG lasers. There are more primitive techniques that involve electrocautery or shaving of the thickened tissue with a blade. This however is certainly not the most effective way, and the cosmetic outcome or result may be less than optimal.
UltraspulseCO2 and Erbium YAG lasers are only available in a few NHS departments across the entire UK and use of this resource is not permitted for treatment of cosmetic conditions like rhinophyma. Consequently there is a lack of training and education in the use of these devices for this problem. The use of Ultrapulse CO2 laser and Erbium YAG laser in rhinophyma requires years of training and experience in the use of ablative lasers.
Lack of experience in treating rhinophyma with ablative lasers would make any attempt by an inexperienced user dangerous. There are essentially very few doctors and specialists in the UK who have the knowledge, training and experience in treating rhinophyma with ablative lasers.
In short there are not many UK centres that have the adequate experience, skills and equipment to treat this issue. DrH is one of the few UK specialists who has the necessary knowledge, equipment and experience to safely and effectively treat rhinophyma. We routinely perform this procedure safely and effectively.
How do most Clinics typically treat this condition?
Very often treatment for rhinophyma is not supported by most private dermatology or plastic surgery clinics. This, as discussed earlier is a combination of lack of training and lack of access to appropriate equipment.
Treatment with techniques such as electrosurgery where tools that cut and cauterise the skin lack the finesse and refinement of ablative lasers. These electrosurgical tools would certainly be good for trimming down a really bulbous severe rhinophyma, however at the stages where precision is requires when most of the thickened tissue is removed the use of these tools near the normal nasal skin would cause scarring and loss of pigmentation due to heat damage to the structures at the base of the skin. This uncontrolled heat damage is not due to lack of surgical technique necessarily but more a case of electrosurgical tools lacking the precision and refinement that is required to precisely shape the nasal skin for a good cosmetic result.
Techniques such as dermabrasion and surgical dermaplaning have been largely abandoned due to the nature of the excessive bleeding that occurs with these techniques. Cautery to stem the bleeding would often be needed and the resulting uncontrolled heat damage from cautery would cause the nasal skin to scar and lose pigmentation.
How do we treat Rhinophyma?
DrH is the only UK laser surgeon with the skill, technology (uses the most advanced surgical ablative lasers in combination) and experience to perform rhinophyma surgery in all skin types.
The following lasers are used:
- Lumenis Ultrapulse Alpha – Released only in September 2022 globally, this is the world’s most powerful and precise ultrapulsed CO2 laser. DrHConsult was the first UK and European Centre to acquire this device. DrH is a world authority and key opinion leader in the use of C02 lasers in skin surgery
- Sciton Joule X Erbium YAG – DrH had his Erbium YAG laser custom designed with two Erbium YAG units combined in one laser. This allows the necessary power and precision needed to perform ultraprecise skin refinement surgery which enables the skin tissue on the nose to not be damaged by too much heat. This minimises scarring risk and optimises the cosmetic outcome as a result. DrHConsult is the only centre in the UK that has a custom built double-headed Sciton Joule X erbium YAG laser
More complex or severe rhinophyma cases require two sessions of treatment. In the first session DrH will use the CO2 laser to debulk the excess tissue surgically. The nose will then be allowed to heal for around six to eight weeks. At this point a second refinement procedure will be performed with a combination of CO2 and Erbium YAG laser in order to safely optimise the shape of the nose.
Performing these more complex cases in two stages minimises the risk of adverse effects such as scarring and loss of pigmentation. It also allows DrH to achieve the best cosmetic outcome possible in more severe cases.
This is a simple daycase laser surgical procedure. The patient will typically be in clinic for no more than 3 hours.
A powerful short pulsed surgical grade CO2 laser should be used (Lumenis Ultrapulse CO2 is the most appropriate laser – it has the shortest possible pulse width and greatest power) and not a cosmetic grade fractional CO2 laser. Lower powered lasers can result in a greater risk of burn, scar and pigmentation loss due to overheating and insufficient vaporisation of the tissue.
The procedure is performed under local anaesthetic. The nose if completely numbed with a technique called nasal ring block. Dr Hussein also likes to prepare the nose with anaesthetic gel as well. Once the anaesthetic is applied the procedure is painless. Nothing will be felt when the CO2 laser is firing on the nose. As can be seen in the video the patient is awake, comfortable and still while having laser.
Dr Hussein will clean and prepare the nose and mark the affected areas prior to applying the anaesthetic gel. The anaesthetic gel will be left on for 40 minutes and then the patient will be transferred to the resurfacing suite. Here the gel will be removed and the nasal anaesthetic ring block injected.
Once the nose is completely numb Dr Hussein will begin work with the CO2 laser. Initially the excessive skin tissue will be debulked. Depending on how much excess tissue there is different methods can be used. If there is a large lump or nodule then this can be actually cut off with the laser. Usually the CO2 laser is used in high power output continuous wave mode to debulk and remove excess tissue. Once most of this tissue has been removed Dr Hussein will then use a pulsed mode to precisely sculpt and shape in order to return to the original shape of the nose. Finally the rest of the nose will be laser resurfaced with controlled full ablation to blend the skin and avoid any obvious demarcations.
Rhinophyma is usually treated in one sitting. For complex and larger rhinophyma occasionally a supplementary session is required fro any surviving bridges of excess tissue.
Following treatment aquaphor cream or vaseline are applied to form a protective barrier over the nose. This must be used for a period of at least fourteen days. The nose will be washed twice daily along with the rest of the face and the aquaphor/vaseline reapplied for fourteen days. Dr Hussein will regularly photo monitor the healing process. The skin of the nose will return to a functional and normal but red/pink appearance after 14 days. Full recovery with reduction of redness can take up to 3 months.
Why is our approach different and better?
- Dr Hussein use the appropriate ablative lasers:
- Lumenis Ultrapulse Alpha
- Sciton Joule X Erbium YAG (custom built double headed unit)
- Dr Hussein routinely performs this procedure and performs the most rhinophyma cases per annum in the UK using ablative laser
- Dr Hussein has over a decade of experience in laser skin surgery. Rhinophyma cases are referred to him from all over the UK by dermatologists and plastic surgeons
- Dr Hussein is the only UK dermatologist with extensive experience in the use of ablative lasers in darker skin types. This means he is the only specialist in the UK to be able to safely perform rhinophyma laser surgery on all skin types