What Causes Acne After Rhinoplasty, and Can I Squeeze the Spots?

Key points

• Acne on the nasal bridge after rhinoplasty is usually caused by oil and dirt building up under the nasal splint, and it can happen in the first period after surgery.
• Do not pick, scratch or squeeze spots on your nose, to lower the chance of an infection that could affect your rhinoplasty implant or new nose shape.
• Cleaning your face as your doctor advises helps your skin recover and reduces blocked pores.
• If you get severe inflamed spots or unusual redness and swelling around the surgical area, consult the doctor looking after your case for a check-up.

Acne on the nasal bridge is a condition that can happen after rhinoplasty, and it can cause worry about infection. It is mostly caused by oil and dirt building up under the nasal splint, where air cannot circulate, together with not being able to wash your face normally in the first period after surgery. As a result, the oil glands in the healing skin become blocked and show up as small red bumps or small pus-filled spots.

In this article, S45 explains what causes acne after surgery, how to tell ordinary spots apart from a nose infection that can be dangerous, and how to clean your face around the wound to lower the chance of further inflammation.

What Can Cause Acne on the Nasal Bridge After Rhinoplasty?

Acne on the nose is a condition that can happen in the early recovery period after rhinoplasty. It comes from how the skin reacts and how the body heals, together with changes in the conditions around the surgical wound, depending on each person’s skin. In particular, wearing a splint or tape to support the nose for several days in a row stops air reaching the skin in that area and lets oil build up under the skin.

You also cannot wash the skin around the surgical wound with water or cleanser as usual, so dirt and dead skin cells build up. Physical stress and some medicines taken during recovery may also make the oil glands produce more oil for a while, which can lead to blocked pores or small inflamed spots.

Wearing a Nasal Splint and Tape for a Long Time

Wearing a nasal splint and surgical tape for several days after rhinoplasty is the main trigger for acne on the nasal bridge. They cover the skin and raise the temperature underneath, so the oil glands produce more oil than usual and the oil cannot escape. The doctor usually books an appointment to remove the splint 7 days after surgery.

When this oil mixes with sweat and dirt under the nasal splint, the pores become blocked. This is especially true in the first period after surgery, when you cannot wash the skin normally. You can then get small blocked spots on the nasal bridge, or pus-filled spots from bacteria building up under the medical tape.

Skin Irritation and Incomplete Cleaning

Acne on the nasal bridge after rhinoplasty happens because you cannot clean the skin on your nose as usual in the first period after surgery. A wound that is not yet fully dry means you need to avoid washing your face with water and soap, so the oil glands produce oil that builds up with sweat and dead skin and blocks the pores.

Also, wiping around the nose too lightly because you are worried about disturbing the silicone implant often leaves residue behind, which irritates the skin and turns into acne.

Hormones and Side Effects of Anti-Inflammatory Medicines

Acne on the nasal bridge after surgery may be caused by built-up physical stress, which triggers the release of the hormone cortisol, together with side effects of antibiotics and anti-inflammatory medicines.

When stress hormone levels are high, the body produces more oil through the pores than usual, which can easily block them. Some medicines can also affect the oil glands and bowel function, so the already delicate skin on the nasal bridge becomes more sensitive to dirt, and you can get small inflamed spots.

How to Tell Ordinary Acne From Signs of Inflammation After Rhinoplasty

Getting acne on your nose after rhinoplasty can happen, and it often causes worry about infection. Checking your early symptoms the right way can help you tell what kind of problem you have and see a doctor for a check-up.

You can tell the 2 apart by how the spots are spread, how painful they are and any changes in the skin around the nasal bridge. The table below shows the differences.

Symptom	Ordinary acne after surgery	Infection
Type of spot	Small, with a whitehead or blackhead	Widespread red swelling with no head
Level of pain	Painful only when you press the spot	Constant dull ache that spreads across the nose
Surrounding skin	Normal, or possibly oilier than usual	Red, bruised or tight, or a change in skin colour
Other symptoms	No other unusual symptoms	Mild fever, or fluid or pus coming from the wound

Signs of Ordinary Blocked Pores or Small Inflamed Spots

Ordinary blocked pores or small inflamed spots after rhinoplasty come from oil and dirt building up under the nasal splint. They look like whiteheads, blackheads or small red bumps that appear only on the outer layer of skin, for example around the alae (the sides of the nostrils) or the nasal bridge. This type of acne does not affect the inner structure of the nose, and there is no fluid or blood coming from the surgical wound.

To care for them at first, clean the area with a cotton bud dipped in sterile saline (Normal Saline 0.9%) to reduce oil. If you have an inflamed spot, you can dab on an acne product as advised by your doctor or pharmacist. Never squeeze or pop spots yourself, because the pressure can move the silicone implant or spread irritation to the surgical wound inside.

Warning Signs of Thin Nasal Skin and a Chance of Implant Extrusion

Nasal skin that is getting thinner with a chance of the implant pushing through can be noticed when the skin on the nasal bridge turns unusually red or pale when exposed to sun or heat. This often comes with a feeling of tightness at the nasal tip, or a sharp pain when something lightly touches the tip. If left untreated, the skin in that area may keep getting thinner until the edge of the silicone implant clearly shows through.

If you start to see the white outline of the silicone implant through the skin, or a large, tight, bright red lump like a big spot that does not go down for more than 14 days, this is a sign of implant extrusion. Do not touch or rub your nose, because pressure from your fingertips can push the silicone implant through the skin more easily. Gently applying a cold compress around the nose can ease the tightness at first, before you see the doctor to plan removing the implant for a while or reshaping the nose.

Signs of Wound Infection That Need Prompt Medical Attention

Signs of infection after rhinoplasty include warmth, very red skin and pain that keeps getting worse. This is different from ordinary acne on the nasal bridge, which usually goes down by itself within a few days.

See a doctor straight away if you have a large pus-filled spot on the nasal bridge together with widespread red swelling, if the skin on the nasal tip or bridge becomes so tight and see-through that the edge of the silicone implant clearly shows and catches the light, or if you have a fever above 38°C with chills in the first 1 to 2 weeks after surgery. These may be signs of nasal tissue damage.

Why Not to Pick or Squeeze Spots on the Nasal Bridge Soon After Surgery

Picking or squeezing spots on the nasal bridge in the first period after surgery may affect how the skin heals, because the skin there is still healing and settling over the silicone implant. Pressing on the area may disturb the position of the nose and the healing skin, and can affect the surrounding skin in these ways:

• bacteria from under your nails getting into the surgical wound and causing pus that spreads to the implant
• bruised, red skin and deep pitted acne scars on the skin of the nose
• more swelling and tightness in the surrounding skin, so recovery takes longer

Avoid touching, picking or scratching your nose in the early recovery period, and let the spots settle down by themselves while you keep the area clean as your doctor advises.

How to Care for Your Skin If You Get Acne on Your Nose After Surgery

When caring for your skin after surgery with acne on the nasal bridge, focus on reducing excess oil and bacteria build-up without disturbing the skin or the surgical wound.

In the early recovery period, avoid rich creams and all kinds of facial oils, to lower the chance of oil building up and blocking your pores.

Also avoid scrubbing, rubbing, exfoliating or face masks made with plant extracts that may irritate the healing skin. Consider gentle, water-based skin care products, and clean and care for your skin as your doctor advises.

Cleaning Your Face Without Disturbing the Nose Wound

When washing your face in the first period after rhinoplasty, avoid getting water directly on your face, so the surgical wound stays dry while it heals, until your nose stitch removal appointment. The right way to care for your skin during this time is to clean it section by section, leaving out the nose and the area around the eyes to avoid disturbing the wound and the silicone implant:

1. Put a few drops of gentle cleansing water on a cotton pad and gently wipe other areas of your face, such as your forehead, cheeks and chin.
2. Wipe again with a cotton pad dipped in clean water and squeezed out, instead of rinsing your face with water, so no water seeps into the nasal splint.
3. Pat your face completely dry straight away with lint-free facial tissue to reduce bacteria build-up.

How to Clean the Skin Around the Nasal Splint With Saline

Caring for the skin around the nasal splint correctly helps reduce the build-up of oil and dirt, which is one factor that can lead to blocked pores after surgery, especially in the early recovery period when the skin is delicate. To clean the skin around the nasal splint with saline:

1. Prepare thin cotton pads and small sterile cotton buds, along with sterile saline (Normal Saline).
2. Pour enough saline onto a cotton pad to moisten it, then gently press it onto the parts of your face not covered by the splint. Avoid rubbing hard.
3. Dip a cotton bud in saline so it is damp, then gently wipe oil and dirt from the edges of the nasal splint, especially in the creases beside the alae and between the eyebrows.
4. Pat your skin completely dry straight away with soft facial tissue, to stop moisture building up under the nasal splint, which can make the tape adhesive come off too early.

Clean your skin this way twice a day, morning and evening, to help control excess oil on your face and reduce blocked pores.

Why Choose S45 Clinic for Rhinoplasty

For rhinoplasty at S45 Clinic, we use post-surgery wound support materials that help air circulate and reduce the build-up of oil and bacteria, and we have a follow-up system for aftercare.

Nasal Splints Chosen to Reduce Trapped Moisture

Using a nasal splint with ventilation holes helps air flow and reduces moisture building up under the splint, which is one factor that can lead to blocked pores on the nasal bridge in the early recovery period.

This material can be shaped to fit closely along the nose while avoiding unnecessary pressure on the skin, so the skin under the splint gets better air flow throughout the time the splint supports your nose.

An Aftercare System to Follow Up After Your Procedure

S45 Clinic has a system of follow-up appointments after surgery to check the shape of your nose as well as the health of the surrounding skin, where the tape or the supporting splint may trap oil and block the pores. At your follow-up appointment, our experienced doctors will check the condition of your skin and how it is healing during recovery.

If we find blocked pores or oil build-up on your skin, our team will help clean the outer skin and recommend skin care products or spot treatments that suit you.

FAQ About Acne After Rhinoplasty

Can I Wear Make-Up Over Spots on My Nasal Bridge?

Avoid wearing make-up on your nasal bridge during recovery until the surgical wound is completely dry and your doctor has checked it, to lower the chance of blocked pores and avoid disturbing the skin. If you need to, wear make-up only on other areas, such as your eyes, eyebrows or lips, and leave your nose bare, to lower the chance of make-up building up around the wound.

How Should I Care for Very Oily Skin During Recovery?

If you have very oily skin, controlling excess oil around the nasal splint during recovery after surgery helps lower the chance of blocked pores on the nasal bridge, because oil that builds up under the splint can block the oil glands and lead to spots. To care for it at first, gently wipe other areas of your face with a cotton pad soaked in water-based cleanser to reduce oil build-up on the skin.

Can I Use Acne Cream If I Get Acne on My Nose After Rhinoplasty?

In the early recovery period, if you get spots on your nose, you can use a gentle spot treatment on the spot itself, but avoid applying it near the edges of the surgical wound so you do not disturb the skin. Also avoid products that contain alcohol, strong fruit acids, salicylic acid or vitamin A derivatives around the wound, because they can make the healing skin dry, flaky or irritated. If you want to use an anti-inflammatory cream, consult the doctor looking after you about which product suits your skin and your wound.

Summary

The main cause of acne on the nose after rhinoplasty is usually trapped moisture under the supporting splint, together with a build-up of excess oil because you cannot clean your face as usual. To care for it at first, wipe the skin around the surgical wound with a cotton pad soaked in sterile saline (Normal Saline 0.9%) to lower the chance of oil and dirt building up on the skin.

Knowing how to tell small ordinary blocked pores from infection with pain, tightness or red swelling during recovery also helps you assess your own symptoms and see a doctor for a check-up in good time.

Surgery and medical procedures carry risks. Find out about them and consult a doctor before you decide. Results depend on each person.