Hyperbaric oxygen therapy in the reconstruction of giant rhinophyma: a case series

Rhinophyma is a progressive, disfiguring form of rosacea that affects the nasal soft tissues and leads to functional and cosmetic challenges. Surgical excision is the primary treatment, but healing can be complicated by scarring, infection, and graft failure, especially in extensive lesions. Hyperbaric oxygen therapy (HBOT) has been suggested as an adjunctive treatment to enhance healing, reduce inflammation, and improve skin-graft survival. This case series presents three patients with giant rhinophyma who underwent surgical excision, with one requiring a split-thickness skin graft (STSG). Postoperatively, HBOT sessions (90 minutes at 2.4 atmospheres absolute [ATA]) were administered for 5-10 days, depending on the lesion severity. All patients demonstrated excellent healing with complete epithelialization and no evidence of hypertrophic scarring or short-term recurrence. HBOT contributed to faster recovery, improved skin-graft survival, and enhanced cosmetic outcomes. These findings suggest that HBOT is a promising adjunct in the surgical management of rhinophyma, although larger studies are required to validate its efficacy.