What is Alcoholic Nose or Rhinophyma?

If you have ever heard someone refer to a person’s nose as an “alcoholic nose” or “drinker’s nose”, they were likely talking about a skin condition called rhinophyma that can make a person’s nose and face look red and bumpy.

People who have this medical condition usually have a red nose that is swollen and bumpy, and which probably looks worse during a period of heavy drinking and chronic alcohol use.

But while alcohol can make a person’s skin look worse, it is important to understand that rhinophyma is actually a side effect of rosacea and that alcohol use or alcohol addiction are not direct causes of “drinker’s nose”.

Fortunately, rhinophyma is relatively rare and also very treatable, and people who are living with this condition have several options, including lifestyle changes, to help them feel more confident about their appearance.

Rhinophyma is commonly misunderstood as a condition that alcohol causes, particularly long-term alcohol addiction, or chronic and long-term alcohol abuse.

And while alcoholism does not directly cause rhinophyma, the two are still connected in that alcohol use has the potential to worsen any existing skin condition that a person has, including rosacea and its symptoms.

Thus, a person who has been a heavy drinker for a long period of time might experience more frequent rosacea flare-ups as well as the development of rhinophyma on their face, which can present itself by a bulbous and enlarged nose.

Rosacea flare-ups can also be caused by the consumption of other substances, such as hot drinks, chocolate, or spicy foods.

Rhinophyma is a type of skin disorder that is considered to be a subtype of rosacea. It only affects a person’s skin and not any underlying structures.

It is most common in older white males above the age of 50, though rosacea can affect people of any age including children.

It is considered to be a progressive and chronic skin condition, meaning that a person’s skin changes and worsens gradually over time. This is why early diagnosis and treatment are essential.

By impacting a person’s blood vessels and skin texture, rhinophyma results in a nose that appears swollen, red, enlarged, and bulbous in appearance – a condition that will only worsen if left untreated.

While alcohol consumption does not cause rosacea, rosacea is an inflammatory skin disease that is affected by alcohol use, causing facial redness, flushing, and visible blood vessels.

This means that in someone who already has rosacea, heavy drinking may cause the rosacea to become more severe and they may then develop symptoms like rhinophyma.

For this reason, drinking alcohol is often misunderstood as a cause for rhinophyma, when in fact a person would already have to have rosacea in order for alcohol use to cause rhinophyma to develop.

It is because of this misunderstanding of rhinophyma and the effects of alcohol that it has been given nicknames like “whiskey nose” and “drinker’s nose”.

The exact cause of rhinophyma is unknown beyond the fact that it is related to rosacea, and for some people who develop it, it can be a mystery as to why.

And while it can happen to both drinkers and non-drinkers, it is more likely to occur in people who consume alcohol regularly.

This is because alcohol is what is known as a vasodilator, which means it causes blood vessels to expand and blood to flow to the surface of the skin. This is especially true and noticeable for the skin on a person’s face.

In people who already have rosacea and rhinophyma, this can mean an increase in inflammation, flushing, and the further progression of these conditions.

One study by the University of Strasbourg in France that examined 52 rhinophyma patients found that there was a direct correlation between the severity of a person’s alcohol use and the severity of their rhinophyma.

While drinkers and non-drinkers were equally as likely to develop rhinophyma in the first place, moderate drinkers were at a heightened risk for more severe rhinophyma, with heavy drinkers having the most severe cases of rhinophyma.

Not all cases of rhinophyma are simple to recognize, as it can present differently depending on how far along the condition has progressed.

Signs and symptoms of rhinophyma include:

• Red and bumpy skin on or around the nose (called “gin blossoms”)
• A bulbous nose
• Broken blood vessels
• Thickening of the skin on the face
• Oily skin
• Enlarged pores
• Flushed appearance
• Swollen appearance

Once the signs of an alcoholic nose are present, it is difficult to make them go away without the use of certain treatments.

How is alcohol nose diagnosed?

Rhinophyma can often be diagnosed through a visual exam, as long as a patient is presenting multiple physical features of the condition.

In rare instances, a doctor may perform a biopsy to test the rhinophyma, but this is typically only done in cases of rhinophyma that have not responded to treatments.

It is important to note that rhinophyma can be harder to recognize and diagnose on darker skin, so dermatologists may need to look for other signs like swelling and facial pain as opposed to the more typical signs of redness and visible blood vessels.

Rhinophyma may also be easier to diagnose in people who present risk factors such as:

• Male gender
• Age between 50 and 70 years old
• Fair skin
• Family history of rosacea or rhinophyma
• Excessive alcohol consumption

Rhinophyma can be difficult on a person’s self-esteem, as it can be difficult to hide and can inspire a lot of judgment and social stigma.

This can lead to further mental health issues, such as depression or anxiety, as well as an overall loss of pleasure in life.

It is important to address any mental health issues that arise from rhinophyma – otherwise, further complications can develop:

• Unhappiness and poor quality of life
• Relationship difficulties
• Unemployment and financial problems
• Problems with substance abuse
• Increased physical health problems
• Increased risk of suicide

While there is no cure for rhinophyma or rosacea, there are several treatments that can help reduce the symptoms and appearance of both conditions.

Treatment for alcoholic nose usually involves visits to both dermatologists and plastic surgeons, who then may work together in treating your rhinophyma.

Surgical Treatments

Surgical treatments for rhinophyma can greatly reduce its appearance and make it less likely that the condition returns, as long as the person sticks to their treatment plan.

Surgical treatments for rhinophyma include:

• Dermabrasion – this procedure uses a special tool to essentially “sand” off the top layer of a person’s skin
• Dermaplaning – this procedure is a form of exfoliation that can be done with or without chemicals, and is a way of removing raised tissue without cutting it surgically yet
• Debulking – with this procedure, the surgeon uses special scissors to cut away the raised tissue and thickened skin
• Electrocautery – a type of electrosurgery during which tissue is cut away using an electric current and heat, it can be used as a stand-alone treatment or combined with other surgeries
• Laser therapy – this procedure, which uses lasers as opposed to surgical instruments, can be used to further contour the nose and seal other types of tissue removal

Prescription Medications

Some studies have also indicated that certain medications can be helpful for treating rhinophyma. These include:

• Isotretinoin – a medication that is taken by pill or capsule that works by shrinking the sebaceous glands
• Metronidazole – a topical cream that can be applied to rhinophyma and helps in reducing skin inflammation

Please note, however, that medications will not make rhinophyma go away once it is already present, but can reduce its appearance and prevent infections.

Rhinophyma can also be addressed by making certain lifestyle changes or taking action to prevent its occurrence, such as avoiding triggers, maintaining a healthy lifestyle, and seeking help for mental or behavioral health problems that arise.

It is important to remember that rhinophyma cannot be reversed with lifestyle changes alone once it has developed, but it can be improved and symptoms of rosacea can be reduced.

One of the biggest lifestyle change options that people have for improvement or prevention is to stop consuming alcohol.

Depending on the severity of a person’s addiction, this can require professional intervention and help in the form of drug and alcohol rehab.

Addiction treatment options for alcohol abuse include:

• Medical detox
• Medication-assisted treatment (MAT)
• Inpatient treatment
• Outpatient treatment
• Behavioral therapy
• Case management
• Medication management
• Sober living homes
• Aftercare

Both alcohol addiction and rhinophyma can be difficult to treat and manage by yourself, and professional help is typically recommended when treating both, especially at the same time.

When looking at treatment programs for substance use, make sure to find an addiction recovery program that is accredited and which is in-network with your health care insurance.

There are numerous cases of individuals who have treated and continued to manage their rhinophyma successfully.

One example is that of Eric, a 57-year-old man who felt extremely self-conscious about his rhinophyma and was happy during the COVID-19 pandemic when it became commonplace to wear face masks.

He was, however, able to finally achieve the appearance of his pre-rhinophyma nose after being prescribed doxycycline, followed by an electrocautery treatment, and then finally treated with laser resurfacing surgery.

Another successful story of a rhinophyma patient is that of Pamela, whose rhinophyma seemed to be triggered by severe acne along with multiple pregnancies and emotional distress.

Pamela was successfully treated first with Ultherapy and a debulking procedure, along with a CO2 resurfacing with laser surgery. Her long-term treatment plan then included a prescription for Accutane.

Both Eric and Pamela were able to return to their former appearance, feel like themselves again, and feel more confident in public and around loved ones.

It is highly possible for others to achieve these types of results, however, it is important to remember that early intervention is key as well as adhering to a given treatment plan.

An alcoholic nose, or rhinophyma, is a type of rosacea that can be worsened by alcohol use but can often be successfully treated through a combination of surgeries, medications, and lifestyle changes.

If you or a loved one is living with rhinophyma, please know that you are not alone and that there are actions you can take to feel better and start to heal from this condition.

Not only can you make your skin health a priority and seek medical advice for any problems or concerns that you have, but you can also start to make informed decisions about your alcohol consumption and seek help if you think your alcohol use is a problem.

Contact RehabNet.com today on our free and confidential helpline to find out more about how you can get started in addiction recovery right away.