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Thread: Nose Swelling, big pores, phymous tissue--please post!

  1. #1
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    Default Nose Swelling, big pores, phymous tissue--please post!

    Hi. I've had phymous rosacea for the last two years. It really sucked at first, but now it's going better. I really wish there were more people talking about it when I got it. The information was quite sparse. Can everybody with the aforementioned symptoms please post? It would help many people, including us. I'll post a bit on what helped and hurt me and my symptoms.

    Symptoms: Large pores, scar tissue bulidup around pores, swelling on and around nose, pain and numbness of nose. Not much redness, and no pimples.

    What helps me: retinoids (Differin) once or twice per week, minocycline, low-dose accutane, anti-histamines (allegra and QuerCelain), diet and exercise with herbal supplements (white willow bark, boswellia), GoodSkin lotion and other thin serums, exfoliators.

    What hurts me: Hyaluronic acid, glycerin, shea butter, thick creams, Epidermal Growth Factor.

    As you can see it's basically the opposite of what most rosacea suffers deal with: an epidermis that's too thick, not too thin.
    That's about it for me. I'm very curious to hear what helped/hurt the rest of you.

  2. #2
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    Tmon12,

    Thanks for posting. I was diagnosed with early stage Rhinophyma over the Summer. Our symptons sound very similar. I
    have never heard of phymous rosacea, are you sure it isn't Rhinophyma ?

    Symptons: Top half of nose has large pores, scarring, 3 ice pick scars, scar tissue buildup, swelling, increased sebum production.
    I dont have any pain or numbness. I do get inflamed capillaries from time to time.

    Triggers: I have histamine response to certain foods (Sugar, canned fish, some oils, citrus, others), Excessive sun .
    Food is the worst trigger ! Nose becomes inflamed, oily, bulbous, pimply

    Treatments (laser): CO2 Laser for reshaping and trimming extra tissue build up. Diolite laser for capillaries.

    Treatments (creams): Low dose Retin A has been the best (every other night). Also use Finacea on spot basis every other night.

    Treatments (other): antihistamines help, I take an otc every other day.

    These didn't work: Metrogel, Antibiotics, Cleansers, Clenia (worked for 7-8 weeks only)


    Note: CO2 Laser was awesome, but the recovery was brutal (a solid 2 months).



    Tmon, have you tried any laser treatments ??

  3. #3
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    Default Thanks for the post!

    Quote Originally Posted by gobutkus View Post
    Tmon12,

    Thanks for posting. I was diagnosed with early stage Rhinophyma over the Summer. Our symptons sound very similar. I
    have never heard of phymous rosacea, are you sure it isn't Rhinophyma ?

    Symptons: Top half of nose has large pores, scarring, 3 ice pick scars, scar tissue buildup, swelling, increased sebum production.
    I dont have any pain or numbness. I do get inflamed capillaries from time to time.

    Triggers: I have histamine response to certain foods (Sugar, canned fish, some oils, citrus, others), Excessive sun .
    Food is the worst trigger ! Nose becomes inflamed, oily, bulbous, pimply

    Treatments (laser): CO2 Laser for reshaping and trimming extra tissue build up. Diolite laser for capillaries.

    Treatments (creams): Low dose Retin A has been the best (every other night). Also use Finacea on spot basis every other night.

    Treatments (other): antihistamines help, I take an otc every other day.

    These didn't work: Metrogel, Antibiotics, Cleansers, Clenia (worked for 7-8 weeks only)


    Note: CO2 Laser was awesome, but the recovery was brutal (a solid 2 months).



    Tmon, have you tried any laser treatments ??
    First of all, thanks for your awesome post! Second, no I haven't tried laser treatments. I have thought of rhinoplasty/surgery/laser, though. It's so cool to hear what you said about what works best because I was totally thinking about alternating between my homemade "finacea" and Differin at night. I also take an antihistamine, but I take it every day. It's basically allegra 180, but the generic kind (why waste money).

    Metrogel also didn't work for me...it made me breakout at first, worse than the Differen...much worse. It was too much to bear so I stopped after a few nights and put it into the trashbin. And the antibiotics helped only with the swelling and pain, not the phymous tissue. But they did help with something, at least.

    The reason I call it phymous rosacea is because it can affect more than the nose. I've got it on my left cheek too, and I've heard about others who have it on their forehead, ears, etc.

    Questions:
    Can you recommend surgery, like how you picked the doc, the results, downsides, etc?
    Did the sulfer (Clenia) make you more puffy? That happened to me...but it worked great at first.

  4. #4
    Senior Member queta's Avatar
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    Hi:
    I have struggled with phymatous rosacea for years. I have swelling on my nose, cheeks, chin, eyelids, and forehead. The worst thing I can do for my face is to eat products containing gluten. I also react badly to spicy foods, smoked foods, and tomatoes. The things that work best for me are: an over the counter antihistamine twice per day and a quercetin/bromelain supplement with meals. If I am careful about what I eat and take the aforementioned remedies, my face looks pretty good. I will probably get IPL some day on the end of my nose because I have some permanent veins that show there. I take after my paternal grandpa in that respect, he had a lot of visible veins on his face as he got older.
    Regards
    Queta
    "Do not go where the path may lead, go instead where there is no path and leave a trail."
    Ralph Waldo Emerson

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    Tmon12,
    This clinical research piece convinced me that the way to go for Rhinophyma is Classical CO2 Laser:
    http://www.ncbi.nlm.nih.gov/pubmed/1...?dopt=Abstract
    So I had it done 8/30/2011. Previous to my decision I was very pleased with my Dermatologist and he has conducted
    several hundred of these CO2 Laser surgeries. Here are positive/negative of results:
    Positive: Nose was reshaped providing a more natural smooth appearance, a slight overall reduction in size, some of
    the scarring (not the ice picks) was reduced,
    Negative: Bloody/scabby recovery for 2 weeks (needs to be covered)- then redness for another 5-6 weeks. This is the
    old classical laser first introduced in the 1990's. It is not a common procedure so most doctors have discontinued moving
    onto the more modern lasers.
    Yes/No: If you are able to withstand the recovery period I highly recommend. Cost $300

    Queta: I use Diolite Laser (in office, no downtime) for the capillaries. Very successful--they disappear. Need follow up 1x-2x
    per year. Cost $100

    tmon/Queta: Interesting that all of us have histamine responses to food and react positive to antihistamine drugs !! I have the quercetin
    but haven't tried yet (I will this week)

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    Hey, Queta! Nice to hear from you again. I also have a problem with gluten, sugar, etc. Also heat is a big problem for me. Oddly, antihistamines seem to help with that. Does that make any sense? I also eat something close to the "ph-diet" (although, I'm skeptical of its claims) and that works for some reason. I guess that we react to the same triggers as most with rosacea and some of the same things help...but ours is still special in many ways. Do you have any scar tissue or just swelling? I would love to know what you do for the scar tissue if you have any.

    Gobutkus, thanks for the response. I definitely recommend upping the antihistamines too. My derm scratched my arm and it puffed up and got white and apparently that's some kind of histamine test. Ever since then I've taken large amounts of antihistamine per day and the swelling went down like 80%. About the laser, did you have any tissue grow back, or did the retinoids/azelaic acid keep it down? I have a tiny amount of tissue to remove but I'm afraid that it grows back faster after...was that true for you?

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    tmon912. Thanks for the post. Have been looking for a thread like this for some time.
    Have been considering the laser surgery since mid last year and have had two
    consultations with two separate clinics. Was not happy with the explanation of
    recovery. If possible could you give more detail. Were you able to go to work etc.
    How many trips to clinic for dressings, medications etc.

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    Quote Originally Posted by maidenrod View Post
    tmon912. Thanks for the post. Have been looking for a thread like this for some time.
    Have been considering the laser surgery since mid last year and have had two
    consultations with two separate clinics. Was not happy with the explanation of
    recovery. If possible could you give more detail. Were you able to go to work etc.
    How many trips to clinic for dressings, medications etc.
    Ah yes, I'm looking for some information of that sort too. I'm sure our friend Gobutkus will help us out with those answers when he's back online. BTW, would you mind elaborating on your symptoms, experience, etc?

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    Senior Member Brady Barrows's Avatar
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    Might consider this post.
    Brady Barrows
    Blog - Join the RRDi



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    Ok guys (and gals) here is what I wrote on another forum regarding the recovery from CO2 Laser :

    Procedure : 30 minutes--nose is 100% numb, no pain, covered in a bandage (looks like a broken nose)
    I had procedure done on Friday morning . Off from work until following 2nd Monday. 10 full days.
    No medication (retin a ) on nose for 30 days.

    Today is day #3.
    My nose is red, oozing and scabbing--no swelling, no pain . All expected.
    I am using ice compression(water + vinegar) every 2 hours--ice for the swelling, vinegar to kill any bacteria .
    I can see little bits of pink skin around the edges coming thru already...this is very encouraging
    Doctor visit, Day #5
    Nose appearance: still scabbing and oozing, but reducing each day. Pinkish new skin coming in more and
    more each day. Painless, although some itchiness.Its sort of similar to have a "scabbed" knee as a kid ---
    but on the nose....
    Doctor visit, Day #10
    Nose appearance: All scabbing has cleared. Mostly just a mix of new pink skin coming in + still healing red skin.
    Today is my first public appearance day (without a bandage on nose) and also my first exercise day. Overall
    appearance is amazing----nose looks skinnier, smoother/rounded, and scars have less depth. The areas where
    there was 'thickening of the skin' , now looks more thinner.
    2 Week update:
    I am now fully integrated into regular life cycle: work, exercise, lunches out, etc...
    Redness remains but goes down a tad each day---some dry spots.Still looks a little rough.
    3- 3.5 weeks post procedure Update:
    *Still noticeably red on nose , some dryness and slight crusting.
    *Blackheads came back with a flurry ---amazing to see how quickly they developed and spread. I was allowed to
    start back up on Finacea and Retin A which virtually 'wiped out' the blackheads in 3-4 days.This confirms my April
    suggestion that Finacea works particularly well on blackheads.
    * I have lost some of my early enthusiasm , but I still see greatly improved 'depth' of scarring and a more
    streamlined and even appearance of nose......just waiting for the redness to fade away.
    Time will tell folks, recovery on this procedure moves at a snails pace (this was the biggest complaint on the forums).

    Final analysis and 'rating'
    Classical CO2 Laser surgery

    Purpose of surgery: To remove layers of 'skin thickening' found on the top half of nose (early stage Rhinophyma) , reduce appearance of acne scarring,and smooth out uneven surface.
    Why CO2 ? : The use of the 'classical' CO2 Laser has an effective and proven track record (several clinical studies) of treating Rhinophyma. A majority of the studies I found showed a very low risk of side effects and high patient satisfaction after 12 months post surgery. CO2 Laser is considered to be among the first lasers to be used successfully on patients. Outside of Rhinophyma patients, most Doctors have ceased the use of the classical CO2 laser. Patients seem to favor today's modern lasers, primarily because they require 1/3 the recovery time.

    Procedure: In office under 30 minutes.No pain, no inconvenience. Cost $300

    Recovery: Versus today's modern laser (I had Pixel earlier in the year), recovery moves at a snails pace. Scabbing, oozing, bleeding thru 3-4 days.

    Scabbing and more recovery thru 9 days. Makeup (for women) starting at day 10. I wore nose bandage for 3 weeks telling most people who asked that I was elbowed' playing basketball. Redness has begun to really fade 5+ weeks, but it is still there. They say full recovery by 6 weeks, with some mild redness. I agree.

    Outcome: Nose is more streamlined and surface is smoother. Skin thickening was reduced. Surprisingly decent job on the acne scarring (which were pretty deep). Unfortunately no help for the enlarged skin pores which seemed to have return to there old form (this is not a surprise).

    Overall rating: 10 out of 10 for anybody with skin thickening. It works. The downside is recovery time needed as mentioned and it could be difficult to find Doctor who still has this 'classical' laser.

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