Combination of rhinoshave and fractional ablative CO2 laser therapy for fine contouring of pronounced rhinophyma - A monocentric retrospective study with long-term follow-up.

Abstract

Background: Currently, there are no effective drug therapy options that lead to the regression of rhinophyma. Many surgical procedures for treating rhinophyma have been published; however, there are limited data on their effectiveness. In addition, these treatment options often lead to persistent hypopigmented scarring if excessive ablation or heat is applied.

Patients and methods: To prevent excessively deep ablation and enable precise nasal contouring, a combination therapy was developed, integrating classic rhinoshave for coarse ablation followed by laser fine contouring. Fractional ablation was performed to minimize heat accumulation. Here, we report on 45 patients with pronounced rhinophyma who underwent this treatment at the Dermatology Clinic of Leipzig University between 2016 and 2024. The median follow-up period was 51 months (range: 6-96 months).

Results: The majority of the patients were either very satisfied or satisfied with the postoperative outcome (n = 26; 92.3%). One case of postoperative hemorrhage was reported (2.2%). There was no wound infection observed, and the recurrence rate was 17.9%.

Conclusions: The combination of rhinoshave and fractional ablative CO₂ laser treatment is a feasible and safe therapeutic procedure and ensures high patient satisfaction with a low recurrence rate.