Facial lipoatrophy (also known as lipodystrophy) is part of a redistribution of body fat, most commonly occurring in people living with HIV. This is due to both the HIV infection as well as its antiviral treatment. Lipoatrophy can also occur with hepatomegaly, hyperglycemia, insulin resistance, hyperlipidemia and hypermetabolism.
Lipoatrophy is part of the wide range of changes in body metabolism that can occur with HIV and its treatment. The main features of this skin condition are fat loss affecting the face, limbs and buttocks, accompanied by central fat accumulation in the abdomen and breasts and over the dorsocervical spine (the ‘buffalo hump’). However, facial lipoatrophy is the most visible element of this disorder.
The main areas affected on the face tend to be the cheek and temples. The cheeks can become sunken and the temples may also appear hollow. This loss of fat also increases facial lines and highlight changes seen with age. It also makes an individual look tired and older than their years. The loss of facial fat can be asymmetrical, made worse on one side by dental abscesses or other dental problems.
