Phymatous Rosacea

Phymatous rosacea is a subtype of rosacea, a skin condition that causes redness and visible blood vessels on the face, often accompanied by pimple-like bumps or thick, bumpy skin. Phymatous rosacea is characterized by the skin becoming thick and bumpy, often leading to an enlargement of the nose (rhinophyma) or the development of lumps or growths on the eyelids, chin, forehead, or ears. Treatment options for phymatous rosacea include topical creams, oral antibiotics, laser therapy, and in severe cases, surgical removal of the affected skin.


  1. Genetics: There may be a genetic predisposition to developing phymatous rosacea, which is more common in people with fair skin and a family history of the condition.
  2. Hormonal changes: Hormonal changes, such as menopause, pregnancy, or the use of hormonal medications, may trigger the development of phymatous rosacea.
  3. Chronic sun exposure: Prolonged exposure to UV rays from the sun can increase the likelihood of developing phymatous rosacea.
  4. Alcohol consumption: Excessive alcohol consumption can worsen the symptoms of rosacea, including phymatous changes.
  5. Stress: Chronic stress can cause the skin to become more sensitive and trigger rosacea symptoms, including phymatous changes.
  6. Bacterial infection: Certain bacteria, such as Demodex, can trigger rosacea symptoms and exacerbate phymatous changes.
  7. Environmental factors: Exposure to wind, cold, heat, or humidity can trigger rosacea symptoms and make phymatous changes more severe.
  8. Certain medications: Certain medications, such as steroids and some blood pressure medications, can trigger rosacea symptoms and worsen phymatous changes.


  1. Enlarged nose: The skin on the nose becomes thick and bumpy, leading to a condition called rhinophyma.
  2. Bumpy skin: People with phymatous rosacea may experience raised, thick patches of skin on the cheeks, chin, or forehead.
  3. Pimple-like bumps: The skin may appear red and swollen, with pimple-like bumps or red, swollen bumps.
  4. Skin discoloration: The skin may also become discolored, with areas of red or brownish-red patches appearing.
  5. Sensitivity: The skin may be sensitive and tender to the touch, with burning or stinging sensations.
  6. Eye irritation: Some people with phymatous rosacea may experience eye irritation and dryness.
  7. Itching: The skin may become itchy and irritated, causing discomfort and even pain.


Rosaceous lymphedema is a condition that affects the skin and lymphatic vessels in individuals with rosacea. The main diagnosis of this condition is made through physical examination and a patient’s medical history. Additional tests that may be performed to confirm the diagnosis include:

  1. Lymphoscintigraphy: A radiology test that uses a radioactive tracer to visualize the lymphatic system and identify any blockages or abnormalities.
  2. Duplex Ultrasound: An imaging test that uses high-frequency sound waves to create images of blood flow and identify any blockages in the lymphatic vessels.
  3. Biopsy: A small sample of tissue is taken from the affected area and examined under a microscope to determine the presence of inflammation or other characteristic signs of rosaceous lymphedema.

It is important to consult a doctor for proper diagnosis and management of rosaceous lymphedema.


Treatment: Phymatous rosacea can be treated through a combination of medical and cosmetic treatments. Medical treatments include:

  • Antibiotics: to control the underlying inflammation and reduce the growth of bacteria.
  • Isotretinoin: to control sebum production and reduce the thickness of the skin.
  • Corticosteroids: to reduce inflammation and swelling.

Cosmetic treatments include:

  • Electrocautery: to remove excess tissue and reshape the nose.
  • Laser therapy: to reduce the size of blood vessels and improve the appearance of the skin.
  • Microdermabrasion: to remove dead skin cells and improve the texture and tone of the skin.