Changes to Your Face (Facial Lipoatrophy) : What is facial lipoatrophy?

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Changes to Your Face (Facial Lipoatrophy)

What is facial lipoatrophy?

Facial lipoatrophy, also known as facial wasting, occurs when individuals lose volume in the fat that normally pads the face. Typically, fat is lost from the cheeks, the smile lines (nasolabial folds), and the temples. Lipoatrophy can also affect the eye sockets. This can give the face a skeletal, sunken, or hollow look, often with deep smile-line furrows.

Dealing with facial lipoatrophy can be particularly difficult for HIV-positive individuals. The condition can lead to depression, anxiety and social isolation, as well as to poor adherence to HIV treatment. Not only do many find the physical changes unattractive, but they feel that HIV is, in effect, written on their faces. This can ultimately accentuate the effects of HIV stigma. Other people who recognize the condition on the face of someone experiencing lipoatrophy may know that it is a sign of HIV, while others may think that it indicates some sort of illness.

What causes facial lipoatrophy?

The causes of lipodystrophy, including lipoatrophy (abnormal fat loss) and lipohypertrophy (abnormal fat gain) are not very well understood. However, what is known is that three older antiretrovirals (rarely used today) are associated with fat loss in the face, including:

  • Retrovir (AZT, or zidovudine)
    Retrovir is a component of Combivir (zidovudine/lamivudine) and Trizivir (abacavir/zidovudine/lamivudine).
  • Zerit (d4T, or stavudine)
  • Videx (ddI, or didanosine)
An estimated 40 to 50 percent of people who were treated with these antiretrovirals experienced some form of lipodystrophy as a result. Since these drugs have been replaced by newer, less toxic medications, new cases of facial lipoatrophy have become far less common among people living with HIV.

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Last Revised: November 10, 2015

This content is written by the POZ and AIDSmeds editorial team. For more information, please visit our "About Us" page.

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