Rhinophyma: Current Concepts in Pathogenesis, Clinical Evaluation, and Modern Surgical Management

Objective Rhinophyma is a progressive, disfiguring disorder of the nose characterized by sebaceous gland hyperplasia, connective tissue overgrowth, vascular proliferation, and chronic inflammation. Although traditionally considered a severe manifestation of rosacea, its pathogenesis remains incompletely understood. This review summarizes current evidence on the epidemiology, pathophysiology, diagnosis, classification, and contemporary treatment options for rhinophyma, with particular emphasis on modern surgical management. Methods A narrative review of the current literature was conducted, focusing on studies addressing the clinical presentation, histopathological features, differential diagnosis, medical management, and surgical treatment of rhinophyma. Special attention was given to recent advances in laser technologies, radiofrequency surgery, electrosurgical techniques, and reconstructive principles. Results Rhinophyma predominantly affects men in the fifth to seventh decades of life and frequently develops in association with longstanding rosacea. The disease results from a combination of sebaceous gland hypertrophy, chronic inflammation, fibrosis, and vascular dysregulation. Medical therapies may be beneficial during the early stages of rosacea but have limited efficacy in established rhinophyma. Surgical intervention remains the gold standard treatment. Current techniques, including scalpel excision, electrosurgery, radiofrequency surgery, CO₂ laser ablation, and combined approaches, provide excellent aesthetic and functional outcomes with low recurrence rates. Conclusion Rhinophyma is a benign yet potentially debilitating condition that may significantly affect both quality of life and nasal function. Contemporary surgical techniques allow effective restoration of nasal contour while preserving normal tissue architecture. Early recognition and individualized treatment planning remain essential for optimal outcomes.