Scleroderma on the face can cause symptoms that may affect your appearance, including the texture, discoloration, and elasticity of your skin. Medications, facial exercises, and dermatological procedures may help.
Scleroderma affects connective tissues like your skin, blood vessels, muscles, and tendons. It’s an autoimmune condition that occurs when your body’s immune system attacks its own cells, resulting in inflammation that triggers an overproduction of collagen and other proteins.
Collagen is a protein that provides structure, strength, and elasticity to your connective tissues. But when you produce too much collagen, it may cause tissue to thicken or harden.
Scleroderma symptoms may be localized, primarily affecting the skin and underlying tissues. It may also be systemic, affecting your skin as well as the blood vessels and tissues of major organ systems. Both types of scleroderma can cause changes to the tissues of your face.
Changes to your facial tissue from scleroderma can contribute to a variety of cosmetic and functional effects.
As skin tightens and hardens, depending on its location, it may alter the shape or symmetry of your face. Scleroderma may also prevent you from effectively using your mouth or jaw, and it may cause wrinkles and dimpling as it pulls on sections of your skin.
How scleroderma presents on the face may vary depending on the type of scleroderma and its severity.
Localized scleroderma on the face typically develops in
- Morphea: Isolated, oval-shaped areas of thickened or hardened skin with a waxy or yellow appearance and a discolored outline.
- Linear: Lines of discolored, thickened, or hardened skin, primarily seen on the forehead or scalp.
Systemic scleroderma involves more widespread areas of tissue change but may begin as patches of hardened or tightened skin, especially in cutaneous systemic sclerosis, a subtype of systemic scleroderma.
Scleroderma face symptoms primarily seen in systemic scleroderma include:
- skin tightening and hardening that creates a waxy, mask-like appearance
- the appearance of telangiectasias, small blood vessels visible through the skin
- Raynaud’s phenomenon, a condition of impaired circulation that causes the nose and lips to turn pale or blueish when cold
- difficulty opening or moving the mouth (microstomia)
- diminished ability to make facial expressions
- skin discoloration
- formation of calcium deposits on the skin (calcinosis)
In both local and systemic scleroderma, you may also notice:
- changes in facial symmetry
- dry skin
- a shiny, waxy skin appearance
- visible blood vessels
- impaired facial muscles
The development of calcium deposits, functional impairment, and the appearance of blood vessels are more common in forms of systemic scleroderma.
Facial scleroderma can feel differently to each person, depending on individual sensitivities, the extent of the affected area, and the severity of symptoms.
You may notice:
- a constant sensation of skin pulling or tightness
- severe skin dryness, itching, or burning
- numbness or tingling in some areas or the whole face
- discomfort or pain from overly tight skin
- sensitivity to temperature or touch
- skin that feels hard and waxy to the touch
- hard nodules or lumps under the skin from calcium deposits
Scleroderma on the face can be painful. Not only can tight, hardened skin pull on sensitive areas around your eyes and mouth, but changes in circulation, like in Raynaud’s phenomenon, can heighten skin sensitivity to touch, temperature, and blood flow.
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There’s no cure for scleroderma yet, but treatment may slow the condition’s progression and help you manage symptoms. Your treatment plan may be based on individual diagnosis and symptoms.
Common components in a scleroderma treatment plan include:
Specific facial care
Hydrating facial lotions and creams help combat skin dryness and itching. A doctor may also recommend switching to gentle, fragrance-free products and using daily sun protection to help reduce irritation overall.
Medications
Topical medications can help reduce inflammation and autoimmune processes in localized areas.
For more widespread symptoms, a doctor may prescribe oral immunosuppressants, antifibrotic medications to limit collagen production, or targeted medications such as vasodilators and calcium channel blockers for Raynaud’s phenomenon.
Facial exercises
Stretching, massage, and facial exercises may help improve function when scleroderma face symptoms affect movement in your mouth or jaw.
Dermatological procedures and surgery
Laser therapy, dermabrasion, and microneedling are examples of procedures that may help improve skin texture and discoloration, though they are not indicated for everyone with scleroderma.
No treatment is available for calcinosis yet. Surgery is a rare option if the mobility of your mouth or jaw is severely limited or in severe cases of calcinosis.
Psychotherapy
Working with a mental health professional may help you manage challenges like depression or anxiety, which are a common experience due to scleroderma’s chronic nature and effects on appearance and self-esteem.
The type of scleroderma impacts the likelihood of specific facial symptoms, but all forms can cause tight, hard areas of skin, texture changes, discoloration, the appearance of blood vessels, and feature asymmetry.
Medications, facial exercises, daily skin care, and dermatological procedures can help manage the symptoms associated with scleroderma on the face.