Outcomes of Electrosurgery Combined With 50% TCA Application in Patients With Rhinophyma.

Introduction: Rhinophyma causes significant cosmetic problems and social stigmatization. This study aimed to evaluate outcomes of electrosurgery combined with 50% trichloroacetic acid (TCA) treatment. Methods: The medical files and photographs of six patients who underwent rhinophyma electrosurgery combined with 50% TCA application were retrospectively analyzed. Demographic and clinical features of the patients, rhinophyma severity, posttreatment wound care, and treatment outcomes were reviewed. The cosmetic outcomes were evaluated with the physician's cosmetic evaluation scale and the patient's cosmetic satisfaction scale. Results: All six patients were male, with a mean age of 66.5 ± 3.5 years and a disease duration ranging from 3 to 21 years. The RHISI scores were 4 in two patients and 5 in four patients. All patients tolerated the whole process well. After electrosurgery, bismuth subgallate (BS) powder was poured for wound care. The BS coat remained until it dried and detached spontaneously from the skin after approximately 10 days. Subsequently, collagen gel was applied twice daily for 7-17 days. The mean time from the procedure day to the day of complete re-epithelialization was 24.0 ± 4.7 days. Only one patient had marked scarring on alar regions, one had no complications, and the remaining four had only minimal, nondisturbing skin changes in limited areas. Patients' cosmetic satisfaction scores ranged from 7 (satisfied) to 10 (extremely satisfied). Conclusion: Electrosurgery combined with 50% TCA application may provide a practical, well-tolerated, and low-cost treatment option in selected patients with rhinophyma. Postoperative wound care with topical BS powder and collagen gel serves a postoperative healing period of approximately three to 4 weeks.