Hyaluronic acid lip fillers are safe and effective for patients with systemic sclerosis or scleroderma, researchers write in JAAD Case Reports (July 2024; 49:79–81).
In the paper, the authors note that orofacial symptoms, such as lip thinning, are common in patients with systemic sclerosis (SSc), and thin lips can impact an individual’s ability to eat and sleep. While hyaluronic acid (HA) fillers are used for lip volume restoration, data on their efficacy and safety in patients with SSc are limited due to concerns about the injections worsening the autoimmune condition.
To explore the safety and efficacy of these dermal fillers in patients with SSc, researchers in Yale University’s Department of Dermatology and Internal Medicine’s Section of Rheumatology, Allergy and Immunology conducted a prospective study of seven patients with systemic sclerosis and perioral involvement. All participants were female, with a mean age of 60 years and a mean duration of disease of 13 years. Four of the patients were immunosuppressed.
The team chose Restylane® Silk (Galderma) as the hyaluronic acid filler to test, hypothesizing its low cross-linking may result in lower immunogenicity.
Investigators evaluated the patients’ baseline and post-treatment lip fullness based on photographs before and immediately following filler treatment. Dermatologists and patients also completed the Investigator Global Aesthetic Improvement Scale and Subject Global Aesthetic Improvement Scale, respectively, in which one indicated “very much improved,” and five indicated “worse than the original condition.”
The authors found a statistically significant increase in the difference between pre- and post-injection fullness in both upper and lower lips across the study population. Additionally, the mean post-treatment score fell between “much improved” (2) and “improved” (3) on both the Investigator Global Aesthetic Improvement Scale and the Subject Global Aesthetic Improvement Scale.
There were no cases of delayed nodules or any reported flares of SSc.
The researchers concluded that their findings indicated that hyaluronic acid fillers were safe and effective for patients with scleroderma, demonstrating improved appearance of thin lips and high patient satisfaction. The authors also observed anecdotally that more frequent treatment may be needed for scleroderma patients due to more quickly diminishing filler.
They also note that ongoing work will assess changes in chewing ability and sleep quality.
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