Progressive Hemifacial Atrophy (Linear Scleroerma)

Q: Dr. Eppley,I am a 32 year-old male and seem to be dealing with progressive hemifacial atrophy on the right side of my face. While signs of the disease first appeared seven year ago, I have seen more significant atrophy over the past 12-24 months. To this point, the disease seems to only be affecting soft tissue with no impact on bone or nerves. I understand your primary treatment option for this is fat injections, and I am interested in understanding more about this treatment as well as other options. 

A: It sounds like you have linear scleroderma as your source of facial atrophy. No one understands why this occurs and there are no known proven or preventative treatments for it. The standard therapy is to wait until the disease has burnt itself out and then fat graft it. Fat injection therapy remains as a front line treatment for a stable disease condition. Whether one should attempt to treat it in its active phase is a matter of debate. But given it is one’s own natural tissue, there is little harm in doing so. Whether it can cease the disease and prevent further progression of it is unknown but theoretically possible.

Dr. Barry Eppley

Indianapolis, Indiana