Carbon dioxide laser treatment of rhinophyma: a review of 124 patients.

摘要

BACKGROUND: Rhinophyma is a progressive, localized or generalized nasal deformity resulting from hypertrophy of sebaceous and connective tissue. The CO(2) laser has been used for treatment of rhinophyma, but the long-term efficacy of the treatment is unknown. OBJECTIVES: To review the outcome of 124 patients with rhinophyma treated with the CO(2) laser between 1996 and 2008 in our centre. PATIENTS AND METHODS: Exuberant sebaceous tissue was ablated using the Sharplan 40C CO(2) laser (Sharplan Lasers UK Ltd, London, U.K.) under local anaesthesia. The technique varied with the severity of rhinophyma; the laser was used in a continuous mode to debulk the larger rhinophymas, and in a resurfacing mode (Silk Touch scanner; Sharplan, 4-7-mm spot at 20-40 W) or continuous mode (10-20 W using a defocused 2-3-mm beam) to reshape the nasal contours. Outcomes were determined by case notes, clinical review and questionnaire. RESULTS: Laser treatment was completed in a single session in 115 of 124 patients. All patients were reviewed 3 months post-treatment. Results were classified as good to excellent in 118 and poor in six patients. All patients were sent a satisfaction questionnaire in 2008 and 52 patients replied. Patients reported high levels of satisfaction following treatment. The post-treatment response at 3-month review was maintained long term. The main complications were pain associated with injection of local anaesthetic, scarring and hypopigmentation (four patients) and open pores (two patients). CONCLUSIONS: The CO(2) laser is an effective and durable treatment for rhinophyma. Treatment carries a low risk of side-effects and is associated with high patient acceptability and satisfaction.