Rosacea Treatment
Thickening Skin
Subtype: Phymatous rosacea

Surgical procedures are generally used to remove the thick skin and re-sculpt the area.

  1. Surgical Treatments
    Lasers and other light therapies, dermabrasion, and electrocautery are surgical procedures used by dermatologists to re-sculpt the skin. To achieve best results, more than one these surgical procedures may be used. The following describes each of these treatments:

  • Lasers and other light therapies. While earlier laser treatments removed the top layers of the skin, the newer erbium lasers and the fractional laser can smooth the skin without removing a significant portion of skin. Other lasers and light therapies also may be used.

    To see best results, 1 to 3 treatments are generally necessary for laser surgery. Treatments are typically scheduled for every 4 to 8 weeks. Other light therapies may require more treatment sessions. For instance, intense pulsed light (IPL) may require 1 to 5 sessions, with a patient returning every 3 weeks for another treatment.

  • Dermabrasion. This surgical resurfacing technique treats deep defects of the skin such as acne scars, heavy wrinkles, and the thickening skin of rosacea. To resurface the skin using dermabrasion, a dermatologist uses a surgical tool that sands off the upper layers of the skin. As the skin heals, new layers of skin appear that are smoother in appearance.

  • Electrocautery: During this surgical procedure, a dermatologist removes the thickened skin with the hot tip of an electrode. As the skin heats up, the top layers of excess skin are scraped off.

Before treatment for rhinophyma

Before treatment

After treatment for rhinophyma

After treatment
with electrocautery

(Photos used with permission of the American Academy of Dermatology
National Library of Dermatologic Teaching Slides)

Effectiveness: All of these surgical treatments can be effective in treating thickening skin. Which procedure is used depends on a number of factors including the patient’s medical history.

Side effects: The risk of side effects is low in the hands of a physician who has experience using these devices and in-depth medical knowledge of the skin. In skilled hands, side effects tend to be limited to temporary bruising, redness, or swelling. Darker or lighter spots on the skin and scarring can occur.

  1. Other Treatment Options
    In some cases, your dermatologist may discuss treatment to control early sights of thickening skin, and less commonly used treatment may be an option.

American Academy of Dermatology. “Acne and Rosacea Getting You Down? Laser, Light and Cosmetic Treatments Give Patients a Much-Needed Boost.” News release issued February 3, 2008. Last accessed June 4, 2008.

Crawford GH, Pelle MT, James WD. “Rosacea: I. Etiology, pathogenesis, and subtype classification.” J Am Acad Dermatol 2004; 51: 327-41; quiz 42-4.

James WD, Berger TG, Elston DM. “Rosacea.” In: Andrews’ Diseases of the Skin, 10th edition. Canada. Saunders Elsevier: 2006. 246-8.

Pelle MT, Crawford GH, James WD. “Rosacea: II. Therapy.” J Am Acad Dermatol 2004; 51: 499-512; quiz 3-4.

Webster GF. “Rosacea and Related Disorders.” In: Bolognia JL, Jorizzo JL, Rapini RP et al, editors. Dermatology, Spain, Mosby Elsevier; 2008. p. 509.

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  • Visibly thickening facial skin

  • In the beginning: Skin swells a bit and becomes smoother and oiler

  • As progresses: Pores become more visible and swelling increases

  • Skin eventually develops thick, bumpy appearance (When the skin on the nose thickens, the condition is called rhinophyma. Thickening skin also can develop on the cheeks, chin, forehead, one or both ears, and eyelids.)






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