What is Alcoholic Nose?
An alcoholic nose is also referred to as a drinker’s nose. It typically manifests as a noticeably red, bumpy, or bulbous nose or swollen cheeks. While the firming and thickening of skin and discoloration are most commonly seen on the nose, these symptoms may appear elsewhere, including the chin, forehead, cheeks, ears, and eyelids.
This is a skin disorder called rhinophyma, which is a side effect of another type of skin condition called rosacea. For years, it was widely believed that this condition (Rhinophyma) was caused by alcohol use disorder or alcoholism. However, new research released in 2015 proved otherwise.
According to the report, rhinophyma (the medical name for the alcoholic nose) actually has nothing to do with how much or how little a person drinks. With very little connection between rhinophyma and alcoholism, how did the myth of alcoholic nose start and why is it still perpetuated today?
Historically, rhinophyma has been mistakenly linked to alcohol consumption, but there has been no substantiated evidence that excessive alcohol use, is in any way related to rhinophyma. Instead, this incorrect association has created a stigma for individuals with rhinophyma as well as a host of inconsiderate colloquial terms, including:
- Alcoholic nose
- Gin blossom
- Potato nose
- Drinker’s nose
- Whiskey nose
What is Rhinophyma?
Rhinophyma is a skin disorder characterized by a large, red, bumpy, or bulbous nose. It can occur as part of phymatous rosacea. The exact cause of rhinophyma is unknown, but it’s considered a subtype of severe rosacea. This condition is significantly more common in men, especially between the ages of 50 to 70 years.
Overall, rosacea is a common, chronic inflammatory skin condition. It causes irregular redness or flushing of your face, particularly in the cheeks or nasal areas. Small, red bumps filled with pus, called pustules, may appear on your face as part of this condition. According to the National Rosacea Society (NRS), more than 16 million Americans are affected by rosacea.
Rhinophyma has been classified as part of subtype 3 rosacea. It forms gradually over several years and is believed to be the result of poorly treated or untreated rosacea. The outcome is usually a large mass on the lower half of your nose.
Historically, rhinophyma was erroneously considered to be linked with alcohol consumption because substances such as alcohol and caffeine can cause local vasodilation, which worsens the symptoms. This alleged association with alcohol has caused much social stigma and loss of self-esteem in patients suffering from the disease, with several nicknames for the condition such as “whiskey nose” and “rum nose.
The diagnosis of rhinophyma is clinical and can be identified by the nose’s bulbous shape, skin pitting/scarring, and telangiectasia . The thicker and more sebaceous nasal tip and alae are usually preferentially enlarged, but involvement can spread to the thinner nasal dorsum and sidewalls to a lesser degree.
With progression, the aesthetic subunits of the nose merge and become obliterated. While the underlying frameworks are usually unaffected, patients often suffer from secondary nasal airway obstruction at the external nasal valves.
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Symptoms of Rhinophyma
Rhinophyma (alcoholic nose) usually occurs in more severe cases of rosacea. You may see some of the following symptoms in the less severe stages of rosacea or notice other subtypes that include:
- Random facial flushing
- Red, blotchy areas in the center of your face
- Recurrent bumps and pimples, often mistaken for acne
- Telangiectasia, which is a swelling of tiny blood vessels on your nose and cheeks
- Very sensitive skin
- Ocular rosacea, which is characterized by a burning or gritty feeling in your eyes, often along with conjunctivitis, characterized by redness and inflammation of your eye, and blepharitis, an inflammation or your eyelid
Symptoms can get worse as your rosacea progresses. More symptoms arise with the onset of rhinophyma. For example, the connective tissue and oil glands on your nose may increase. You also may notice the following changes to your nose:
- Gradual growth into a swollen, bulbous shape
- Numerous oil glands
- Enlarged skin pores
- Reddish skin tone
- Thickening of the outer layers of skin
- Waxy, rough, yellowish appearance
Can Alcoholism Cause Alcoholic Nose?
It was previously thought that excessive alcohol consumption was the cause of rhinophyma – hence the nickname alcoholic nose or drinkers nose. Alcohol use can cause vessels to enlarge in the face and neck creating redness or flushed skin. Due to this, the idea that alcoholism could cause rhinophyma held up for many years.
However, a study published by the University of South Florida Morsani College of Medicine in 2015 disproved this theory. Many of the patients that participated in this study were clinically diagnosed with rhinophyma but did not suffer from alcoholism or even drink regularly.
While this study disproved the theory that alcohol use causes Rhinophyma (alcoholic nose), researchers were not able to uncover what did cause rhinophyma in their patients. However, there is evidence to suggest that ethnic and genetic predisposition may cause this disfiguring skin condition as it runs in families of English, Scottish, Scandinavian, or Eastern European descent. Despite these facts, the known cause of rhinophyma remains a mystery today.
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Is the Difference Between Rhinophyma (Alcoholic Nose) and Rosacea?
Rosacea, a common skin disease, tends to cause redness first on the cheeks and nose but may spread to the forehead, chin, neck, chest, and back. The symptoms tend to occur in stages and progress. This progression may include:
- Flushing or blushing easily
- Persistent redness
- Pus-filled bumps or pimples
- Visible broken blood vessels
- A burning or stinging sensation on the skin
- Plaques, or raised patches of skin
- Edema, or swelling due to the buildup of fluid, typically on the forehead, upper eyelids, nose, and cheeks
- Dry, scaly, or rough skin
- Oily skin
- Thickened skin
The exact cause of rosacea is unknown, but doctors say genetics and environmental factors likely make some individuals more susceptible to the condition.
There’s no cure for rosacea, but there are several ways individuals can prevent flare-ups, including knowing what triggers them. Factors that can make rosacea symptoms worse include:
- Drinking alcohol
- Eating spicy food, or hot (in temperature) food and drinks
- Experiencing stress or anxiety
- Using harsh facial cleaners and products
- Exposing your skin to extreme weather—hot or cold temperatures or strong winds, for example
- Participating in a strenuous activity or exercise
- Being in the sun
- Taking hot baths
Rhinophyma is the final and most severe stage of acne rosacea. It manifests as thickening skin on or around the nose. If left untreated, rhinophyma can cause medical problems, including respiratory issues that can make it difficult to breathe.
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How Alcohol Affects Rosacea
Although alcohol use does not cause rhinophyma or rosacea, it can aggravate the condition. As many as two out of three patients with rosacea experience flare-ups when they consume alcohol.
Alcohol aggravates symptoms of rosacea because drinking enlarges the body’s blood vessels. When the blood vessels are more open, they allow more blood to flow to the surface of the skin, creating a flushed look that is typically referred to as the ‘alcohol flush.’ The redness can spread anywhere on the body but is most noticeable on the face, shoulders, and chest. For those already suffering from redness due to rosacea, alcohol can make this symptom increasingly worse.
According to a survey of patients suffering from this skin condition, red wine is more likely to trigger flare-ups or worsen rosacea than other drinks. Doctors theorize it’s because of an additional chemical in red wine that also works to enlarge blood vessels, letting far more blood than usual flow to the skin’s surface.
In order to manage these symptoms of the alcoholic nose, doctors suggest that patients with this condition:
- Avoid red wine
- Don’t cook with alcohol
- Have a tall glass of water in between every alcoholic drink
- Drink in extreme moderation
- Dilute alcohol drinks with seltzer water
- Stop drinking alcohol
Rhinophyma can be treated with medicines or surgery. You and your doctor can decide which treatment option would be best for you.
Typically, once rhinophyma develops, it doesn’t respond well to medications. Medications may be successful in treating less severe cases and other subtypes of rosacea.
Surgery is the most common treatment of rhinophyma. Enlarged blood vessels and tissue overgrowth can cause disfigurement. This can be permanent if the affected area isn’t removed. Surgery is the preferred treatment for most cases. It’s considered the most effective option for long-term success.
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Treatment for Alcoholism
Individuals with an alcoholic nose should make healthy lifestyle changes to prevent the condition from getting worse or potentially leading to other diseases. People who may benefit from alcohol treatment programs may be deterred from taking initial steps in seeking treatment. They may be afraid they will feel shamed by other people’s judgments of alcohol abuse.
For some individuals with alcohol addiction, enrolling in a treatment program outside of their local community can be more effective. This way, they are not bombarded with social pressures and stigma close to home.
This helps eliminate some triggers and improves their odds of sticking with an alcohol rehab program.
Treatment plans for alcoholism may include detox, inpatient drug rehab, 12-step programs, aftercare and relapse prevention planning, and more. If you or a loved one are struggling with long-term alcohol abuse, contact one of our helpful alcohol treatment specialists today. We can provide information on rehab programs and detox programs that may fit your specific needs.
If you or a loved one are struggling with long-term alcohol abuse, contact one of our helpful alcohol treatment specialists today. We Level Up NJ can provide information on rehab programs and detox programs that may fit your specific needs.
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 NCBI – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4426765/