Nearly half with SSc consider facial cosmetic therapy, survey finds
Cost and safety were leading barriers among those who did not proceed
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Nearly half of people with systemic sclerosis (SSc) surveyed in Australia had considered using facial cosmetic therapies, while nearly one in 4 had used at least one such treatment, a study found.
Treatments were mainly considered or used to address SSc-related facial changes, and patients reported perceived improvement with nearly three-quarters of them. While few serious adverse events were reported, researchers stressed that stronger evidence is needed to establish the safety and effectiveness of cosmetic therapies in people with SSc.
Cost and safety are key barriers to cosmetic treatment
Cost and safety concerns were the leading barriers among those who considered a cosmetic therapy but decided not to proceed. The findings highlight the need for clinicians to be aware of the treatments people with SSc may seek and to help patients make informed decisions about their potential risks and benefits.
The study, “Facial Cosmetic Therapy Use Among Patients With Systemic Sclerosis: An Australian Cohort Study,” was published in Arthritis Care & Research.
SSc, also known as systemic scleroderma, is a chronic autoimmune disease marked by inflammation, blood vessel abnormalities, and the excessive buildup of scar tissue, or fibrosis, in tissues throughout the body.
When SSc affects the face, skin may become tight and hardened, small, widened blood vessels called telangiectasias may become visible, and changes in pigmentation can occur. Some people also develop furrows around the mouth or microstomia, an abnormally small mouth opening that restricts normal function.
“These manifestations have been linked to poorer [quality of life] through reduced body image satisfaction, discomfort in social situations, and psychological distress,” the researchers wrote.
Yet SSc treatment often fails to address the substantial cosmetic and social impacts of the condition. A range of cosmetic therapies — from creams and serums to injectable treatments and laser-based procedures — are available to the general population and may help address SSc-related facial manifestations.
However, doctors have little evidence to guide patients interested in these treatments. There is no randomized controlled trial evidence supporting their use in SSc, leaving limited evidence about their effectiveness and safety.
Survey examines cosmetic therapy use in systemic sclerosis
To better understand how people with SSc use cosmetic therapies and what their experiences are like, a team of researchers surveyed participants enrolled in the Australian Scleroderma Cohort Study receiving care at specialized SSc clinics at three public hospitals and one private rheumatology practice.
Of 616 people invited, 241 completed the survey. It asked about satisfaction with their appearance, whether they had considered or used cosmetic therapies, why they sought treatment, perceived benefits and side effects, costs, and whether they had discussed treatment with a doctor.
Participants had a mean age of 62.6 years. Most (85.1%) were women, and they had been living with SSc symptoms for a mean of nearly 17 years.
Nearly half of respondents (49.4%) said they had considered or were currently considering a facial cosmetic therapy. More than 80% cited SSc-related manifestations as a reason, while aging and sun-related changes were also common reasons for considering treatment.
A total of 55 participants (22.8%) had used at least one cosmetic therapy. They reported 159 treatments in all — an average of nearly three per person.
Topical products were most common, making up 42.1% of treatments. These included creams and serums containing hyaluronic acid, vitamins, or retinoids. Injectables, including botulinum toxin and dermal fillers, accounted for 32.1%, while laser and other energy-based therapies made up 22.6%. Surgical procedures were uncommon, accounting for 2.5%.
Nearly two-thirds (64.2%) of treatments were used to address SSc-related facial changes. Telangiectasias were the most common SSc-related reason, followed by furrowing around the mouth, microstomia, and skin tightening.
Most treatments brought perceived improvement
Participants reported perceived improvement with 73% of treatments, but were satisfied with only 59.8% of them. Among those who were dissatisfied, nearly all said the treatment had not produced enough improvement, while a few cited short-lived effects or the need for repeated treatments.
Adverse events were reported with 25 treatments (15.7%), and most were mild. Pain was reported most often. Other problems included scarring, swelling, changes in pigmentation, and bruising. No infections were reported.
Among those who considered cosmetic therapy but ultimately decided against it, cost and safety were the leading barriers. Half cited cost concerns and 37.5% cited safety concerns. Others were unsure whether the treatments would work or were concerned about the lack of supporting evidence in SSc.
The researchers cautioned that the study could not determine whether these therapies are safe because outcomes and adverse events were self-reported rather than objectively assessed. They also noted that people already interested in cosmetic treatments may have been more likely to participate, which could have made interest in the therapies appear higher than it actually was.
“This study has demonstrated that among responders to the questionnaire a significant proportion of people living with SSc had reduced satisfaction with their appearance and had either considered or used topical, injectable, and/or energy-based cosmetic therapies,” the researchers wrote.
They added that “controlled studies assessing the efficacy and safety of cosmetic therapies in patients with SSc are needed to enable clinicians to educate and guide patients to make informed decisions about the risks and benefits of these therapies.”
Sj miller
I’d really like to know which treatments were effective and what dr or clinician was used. I’ve had a very hard time finding a dermatologist that has experience treating scleroderma pts. I went to a Bd Certif derm w experience treating patients w “autoimmune diseases”. A mild laser was used that left welts. She clearly did Not understand the difference in our dermal layers.
Patti Gilligan
At 69 yrs, I was diagnosed with limited sclerosis 10 years ago, although fibrosis from head to toe including painful lumps in my scalp. I have ridges from scalp to eyes, lumps and bumps on my nose and the whole perioral thing going on. There are no scleroderma dermatologists available to me and I fear trying even over the counter anti aging therapies. I would love to know if there are any products safe to use that would help the loss of velocity and elasticity. At this point I have had limited affected organ damage. My appearance at this point is the main reason for anxiety and limited social activity. I really wish there were more research in this area as I believe it is a source of isolation and mental health for many.