What Is Alcoholic Nose?

Rhinophyma, commonly referred to as alcoholic nose, is a condition in which the nose takes on a red coloration and becomes enlarged in a bulbous shape.

While many people attribute this disfiguration to heavy alcohol use, it is only lightly associated since excessive alcohol use often results in facial flushing.

Drinker’s Nose

Drinker’s nose is one of many informal terms for the reddish bulbous changes that occur as rhinophyma develops. It has been culturally associated with people who drink too much, though professionals can clarify that it occurs just as frequently in people who don’t drink alcohol.

Some people react to drinking alcohol with an “alcohol flush,” which turns their face red alongside other symptoms. In these cases, people may develop a red nose from alcohol, but not the associated deformation. This association between a red face and alcohol use may have founded the belief of a connection between the red nose of rhinophyma and drinking. However, chronic facial flushing due to rosacea can be an early stage of rhinophyma development.

Other Names For Alcoholic Nose

Alcoholic nose is referred to by other names, both in layman’s terms and medically. Other names for alcoholic nose include:

  • Bulbous nose
  • Nose-bulbous
  • Phymatous rosacea
  • Drinker’s nose

  • Whiskey nose
  • Rum nose
  • Rum blossom
  • Alcohol nose

Causes Of Rhinophyma Or Alcoholic Nose

Rhinophyma is believed to be a rare but severe manifestation of inflammatory rosacea. Some healthcare personnel refer to the nose condition as “end-stage rosacea.” In these cases, the sebaceous tissue (part of the skin that produces oil) becomes overgrown and enlarged. Sebaceous glands are typically colonized with bacteria, which can contribute to inflammation when they become plugged.

Though rosacea is more common in women, end-stage rosacea with rhinophyma is more common in men. It is thought that the higher level of male hormones, such as testosterone, may contribute to the overgrowth of tissue. Sometimes, extensive cases of overgrowth may occur with cancerous tumors. It is unclear whether the rosaceous growth itself is carcinogenic or whether a predisposition for cancer may increase the likelihood of rosacea.

Who Is At Risk For Alcoholic Nose?

Though drinking alcohol may contribute to facial flushing, there is no definite connection between drinking alcohol and those with end-stage rosacea.

Factors that have been associated with the development of rhinophyma include:

  • Male sex
  • Middle age (40–60)
  • English or Irish descent
  • Extreme emotional states (including stress)
  • Extensive sun exposure
  • Cold weather exposure
  • Taking some medications (such as ACE inhibitors, simvastatins, and vasodilators)

What Does Alcoholic Nose Or Rhinophyma Look Like?

Rhinophyma develops over many years, making the nose appear tuberous or bulbous with red discoloration. The vessels on the nose enlarge, cysts and pustules may erupt, making the skin extra oily, and the tissues on the end of the nose appear as if they expand.

In severe cases, without intervention, the nose may appear completely enlarged and disfigured, mostly on the bottom two-thirds and tip. For some people, the condition can spread to the chin or the ear, causing extra tissue growth and disfigurement.

The condition does not cause much physical discomfort or danger.

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Signs of Rhinophyma

The signs of rhinophyma may begin to appear in adolescence or early adulthood. Rosacea often develops in the following stages, which increase in severity with age and continued aggravation.

The stages and identifiers of rosacea include:

  • Prerosacea: in which a person has frequent facial flushing.
  • Vascular rosacea: in which a person may experience thickened skin, spider-web appearance of blood vessels on their skin, and/or transient or persistent facial redness.
  • Inflammatory rosacea: in which red pustules and bumps appear on the face, nose, or forehead. In this stage, rhinophyma may become apparent.

Rhinophyma is further classified according to its severity and the amount of deformity:

  • Early vascular type (predominately overgrown blood vessels)
  • Diffuse enlargement (moderate)
  • Localized tumor (early stage)
  • Diffuse enlargement (extensive)
  • Diffuse enlargement (extensive and localized tumor)

If you are concerned you may be developing rhinophyma, speak to your doctor about available treatments and lifestyle changes that might help.

Treatments For Rhinophyma Or Alcoholic Nose

Rhinophyma can be an exceedingly distressing condition because of its dramatic appearance, but safe and reliable treatment is available.

Depending on the level of disfigurement and patient discomfort, treatment of rhinophyma can include medication with or without surgery. Before beginning treatment, a physician may take a biopsy to ensure the disfigurement is not due to cancerous growth instead of simple inflammation from rosacea.

Systemic, medical treatment of rosacea is critical for achieving control over the condition and to keep it from worsening. Topical medications and some oral antibiotics may adequately treat early rhinophyma, with stronger medications used in severe cases.

Only surgery can fix the deformity after rhinophyma has progressed to a certain level. ENT surgeons are versed in multiple techniques that can reduce the overgrowth of tissue while preserving the underlying cartilage. Sometimes, the enlargement can return after treatment, but surgical treatments can be repeated as needed.

Identifying Alcohol Misuse

If you often experience the facial flushing associated with alcoholic nose, it could be a sign that you are misusing alcohol or are at risk for health effects from heavy use.

The CDC defines excessive drinking as either binge drinking or heavy drinking. Either form of alcohol misuse can lead to serious health problems and other dangerous outcomes, including:

If a person frequently engages in excessive drinking, they may develop an alcohol use disorder (AUD). You may be at risk of developing an AUD if:

  • You frequently drink more than you intend to or for longer periods of time than you intend to.
  • You find yourself giving up things that were previously important to you in favor of obtaining, drinking, or recovering from alcohol.
  • You think that alcohol may be causing or worsening physical, social, or psychological problems.
  • You are not able to keep up with duties at school, home, or work due to alcohol use.

Mental health professionals use these and other signs of addiction to diagnose alcohol use disorder.

Once diagnosed, a person may receive evidence-based treatment methods with therapy, medication, and specialized programs that can help them overcome alcohol and the problems it causes.

Get Help For Alcohol Misuse

If you are experiencing negative emotions or having difficulty with vision, nasal obstruction, or sleep apnea due to rhinophyma, treatment can help significantly. Your primary doctor can help you or direct you to resources for medical, surgical, and emotional treatment as you heal.

Though rhinophyma is not caused by alcohol misuse, if you or a loved one are concerned about your drinking and other potential health effects, help is available. Take our alcohol assessment to assess your drinking habits or contact a treatment provider to explore your treatment options. It’s time to get the help you deserve.