Alcoholic Nose: Is This Really a Thing?

This informal term of alcoholic nose is used to refer to rhinophyma, which is a subtype of severe rosacea. This chronic skin condition predominantly impacts facial areas, frequently the nose.

Rhinophyma tends to occur with untreated or severe cases of rosacea.[1]

What Is Rhinophyma (Alcoholic Nose)? 

Rhinophyma is a form of rosacea that makes the nose appear puffy and inflamed.[1] Although commonly associated with alcohol consumption, the condition does not stem directly from drinking habits alone.[2]

Rhinophyma may also be known by several slang terms or nicknames associated with the appearance of alcohol use. These are some of the most common terms for rhinophyma:[2–4]

• Whiskey nose
• Potato nose
• Drinker’s nose
• Alcoholic’s nose
• Bourbon nose
• Rummy nose

These terms are not medically accurate. Though people often use them to refer to someone who drinks heavily, the truth is that there is no known evidentiary link between rhinophyma and alcohol misuse or alcohol use disorder (AUD). 

Does Alcohol Use Really Cause Rhinophyma? 

While alcohol consumption can exacerbate symptoms of rosacea, particularly flushing or redness of the face, it is not the primary cause of rhinophyma. Because people who drink heavily or daily may exhibit a permanent redness in their skin, the common assumption is that it is the drinking that is causing the issue. 

In fact, rhinophyma is primarily linked to untreated or inadequately managed rosacea, a chronic inflammatory skin condition that affects the blood vessels in the face, and other environmental factors. Some studies show that alcohol abuse can increase your risk of rosacea.[5]

Causes of Rhinophyma 

While there isn’t a known singular cause of rhinophyma, various genetic, environmental, and vascular factors may contribute to its development, such as these:[1,6-7] 

Rosacea

There is a strong link between rhinophyma and rosacea, which is a chronic skin condition that causes redness, flushing, and small, pus-filled bumps on the face. If rosacea is untreated or severe, it can sometimes progress to rhinophyma.

Chronic Inflammation

Persistent issues with skin inflammation, particularly in the nasal area, can contribute to the thickening and enlargement of the tissues. This can lead to the characteristic appearance of rhinophyma.

Vascular Abnormalities

Irregularities in blood vessels and vascular function in nasal skin may contribute to the condition.

Hormonal and Immune Factors

Hormonal fluctuations and an unbalanced immune system response to environmental triggers can potentially trigger or worsen rhinophyma.

Alcohol Consumption

While excessive alcohol consumption is not a direct cause of rhinophyma, it can exacerbate symptoms of rosacea and make the problem more difficult to treat. Some studies also link it more directly as a contributing factor to rhinophyma’s development.

Risk Factors for Developing Rhinophyma 

These are potential risk factors for rhinophyma:[1,6-9]

Sex & Age

Men are more likely to develop rhinophyma than women. Additionally, rhinophyma is more prevalent in middle-aged and older individuals than it is among younger adults, teens, or children. Most often, it presents in people who are between the ages of 30 and 60.

Genetic Predisposition

A family history of rosacea or rhinophyma — in parents, grandparents, or siblings — may increase an individual’s predisposition to developing rhinophyma.

Heavy Smoking or Drinking

Exposure to tobacco, tobacco smoke, and heavy alcohol consumption don’t cause rhinophyma. But it can worsen existing symptoms and increase your chances of developing the issue in the first place.

Presence of Acne Rosacea

Acne rosacea, an acne-like subtype of rosacea that manifests with skin lesions similar to acne breakouts, increases your risk for rhinophyma when left untreated or managed improperly.

Occupational Exposures 

Longer exposure to certain workplace irritants — such as chemicals, dust, or environmental elements — may aggravate rosacea symptoms. This can potentially trigger the development of rhinophyma.

Treatment Options for Alcoholic Nose

Treatment options aim to decrease both the size and appearance of affected nostrils while improving overall health outcomes for rhinophyma patients. 

Here are a few treatments options available for rhinophyma:[1,9-10]

Surgical Procedures

Surgical treatment for rhinophyma is usually successful and a relatively quick solution to the problem.

Laser Surgery

Laser resurfacing can be an effective method for eliminating excess tissue and improving the aesthetic appearance of the nose. Carbon dioxide (CO2) lasers or erbium lasers are often utilized for this purpose.

Electrosurgery

Electrosurgical techniques may be used to remove extra tissue and re-contour the nose.

Cryosurgery

Cryosurgery freezes any extraneous tissue using liquid nitrogen. This can help to reduce the size of the nose.

Excisional Surgery

For a more natural appearance, excess tissue can be surgically excised before reconstruction. This removes much of the appearance of puffiness associated with alcoholic nose.

Dermabrasion

With this procedure, the top layers of skin are smoothed via rotating brushes and other abrasive devices.

Medications

These are some of the commonly prescribed medications for rhinophyma:

Topical Medications

Topical creams or gels that contain active ingredients such as tretinoin or azelaic acid can decrease redness. 

Oral Antibiotics

Antibiotics, such as tetracycline or doxycycline, may be prescribed to manage inflammation and control the progression of the condition.

Intralesional Corticosteroid Injections

Injecting corticosteroids directly into the affected area can significantly reduce inflammation and shrink excess tissue.

Cauterization

Controlled cautery or electrocautery can be used to remove excess tissue and reshape the nose.

Lifestyle Changes

If you smoke and drink, you are contributing to inflammation in your body. Because inflammation can cause rosacea to flare up, limiting substance use can help. 

Additionally, limiting sun exposure can help to further manage rosacea and help the issue. Wear sunscreen and protective sun gear, like sunglasses and sun hats.