Rosacea Type 3

By: Vivacare - Dr. Mark Becker

Rosacea subtype 3, also called “phymatous rosacea”, is a more severe form of rosacea that results in enlarged skin pores and areas of thickened skin with irregular nodules. The thickened skin usually appears on the nose and forehead.

In more severe cases, the nose can become enlarged. This is a condition called rhinophyma and occurs primarily in men.

The earlier a patient starts rosacea treatment, the more likely he or she is to avoid the more advanced signs of rosacea subtype 3.

Rosacea Rhinophyma

Images: a. mild rhinophyma, b. moderate rhinophyma, c. severe rhinophyma

Treatment of rosacea subtype 3

Treatment options are generally used to remove the thick skin resculpt the affected areas. Multiple treatments may be requires to see adequate results.

Treatment options include:

  • Lasers and other light therapies. Some lasers remove the top layers of the skin, while others, such as fractional lasers, smooth the skin without removing a significant portion of dermis layer. Other light therapies, such as intense pulsed light (IPL), may require more treatment sessions to see positive results.
  • 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. The recommended treatment depends on a number of factors including the severity and location of skin thickening and skin type.Initial treatment may be followed by long-term use of topical or oral rosacea medications to keep symptoms under control.
Subtype 3 rosacea before
Subtype 3 rosacea after

Images: Before and After Treatment


Rhinophyma images courtesy of the National Rosacea Society. Treatment images courtesy of Gerald Goldberg, M.D.