Evidence-based management of rhinophyma according to disease severity and clinical grade
- 1Otorhinolaryngology Department, Kırıkkale University, Faculty of Medicine, Kırıkkale, Türkiye
Abstract
Objectives: This review evaluates contemporary therapeutic strategies for rhinophyma, emphasising evidence-based treatment selection according to disease severity and clinical grading.
Methods: A structured literature search of PubMed/Medline, Scopus, Embase and Web of Science was performed for studies published between 1990 and 2025 evaluating medical, surgical and laser-based rhinophyma treatments.
Results: Medical therapy, including doxycycline and isotretinoin, is primarily beneficial in early inflammatory disease (Clark Grade I). Established fibrotic rhinophyma (Grades II–IV) generally requires surgical intervention. Current Level III–IV evidence supports partial-thickness sharp excision combined with adjunctive laser contouring using CO₂, Er:YAG and emerging blue laser technologies to improve haemostasis, tissue preservation and cosmetic outcomes. Histopathological assessment remains essential because occult malignancies may coexist within rhinophymatous tissue.
Conclusion: Treatment should be individualised according to clinical severity. Combined excisional and laser-based approaches currently provide the most favourable functional and aesthetic outcomes, although prospective comparative studies remain limited.
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BibTeX
@article{muluk2026evidencebased,
title = {{Evidence-based management of rhinophyma according to disease severity and clinical grade}},
author = {Nuray Bayar Muluk},
journal = {The Journal of Laryngology and Otology},
year = {2026},
month = nov,
doi = {10.1017/s0022215126105362},
url = {https://doi.org/10.1017/s0022215126105362},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Evidence-based management of rhinophyma according to disease severity and clinical grade
AU - Nuray Bayar Muluk
PY - 2026
DA - 2026/11/06
JO - The Journal of Laryngology and Otology
DO - 10.1017/s0022215126105362
UR - https://doi.org/10.1017/s0022215126105362
AB - Objectives: This review evaluates contemporary therapeutic strategies for rhinophyma, emphasising evidence-based treatment selection according to disease severity and clinical grading. Methods: A structured literature search of PubMed/Medline, Scopus, Embase and Web of Science was performed for studies published between 1990 and 2025 evaluating medical, surgical and laser-based rhinophyma treatments. Results: Medical therapy, including doxycycline and isotretinoin, is primarily beneficial in early inflammatory disease (Clark Grade I). Established fibrotic rhinophyma (Grades II–IV) generally requires surgical intervention. Current Level III–IV evidence supports partial-thickness sharp excision combined with adjunctive laser contouring using CO₂, Er:YAG and emerging blue laser technologies to improve haemostasis, tissue preservation and cosmetic outcomes. Histopathological assessment remains essential because occult malignancies may coexist within rhinophymatous tissue. Conclusion: Treatment should be individualised according to clinical severity. Combined excisional and laser-based approaches currently provide the most favourable functional and aesthetic outcomes, although prospective comparative studies remain limited.
SN - 0022-2151
SN - 1748-5460
ER -