Hyaluronic Acid Fillers: A Promising Option for systemic sclerosis and Morphea: Study

A new study published in the journal of Autoimmunity Reviews that Hyaluronic acid (HA) fillers seem to be a safe, minimally invasive treatment for improving both functional and aesthetic concerns in patients with systemic sclerosis (SSc) or morphea. However, further randomized controlled trials are required to better define their indications, durability, and long-term safety profile.

Systemic sclerosis and morphea are chronic autoimmune disorders characterized by skin thickening, fibrosis, and atrophy. These changes can lead to disfiguring features such as tight facial skin, narrowed mouth opening (microstomia), thin lips, and depressed or hardened plaques. While physicians traditionally focus on immunosuppressive therapy to control disease progression, aesthetic and quality-of-life issues often remain under-addressed.

This study searched through major medical databases including PubMed and ClinicalTrials.gov from their inception through January 2025 and included systematic review of studies evaluating HA filler use in these patients.

A total of 19 studies met the inclusion criteria. These included 8 case reports, 7 case series, and 4 prospective interventional studies, one of which included a control group. Despite the total number of patients were relatively small, the findings showed consistent trends.

The most frequently treated facial regions were the forehead, chin, and perioral area, which are the sites commonly affected by sclerosis or atrophy. In several studies, HA fillers were combined with additional therapies like botulinum toxin injections or platelet-rich plasma to enhance results.

Patients generally reported high satisfaction with cosmetic outcomes. Improvements were noted not only in appearance but also in functional measures. In patients with systemic sclerosis, HA filler injections often increased mouth opening and helped relieve microstomia, which interferes with eating, speaking, and dental care.

One controlled study found that HA fillers did not significantly improve mouth opening when compared to autologous fat grafting, suggesting that different techniques may be more effective in certain cases.

The patients with morphea showed variable responses. Inactive lesions tended to respond better to HA filler treatment than actively inflamed areas, which indicated that disease stage may influence outcomes. The adverse events were generally mild and temporary, like localized swelling or bruising. And, none of the studies reported disease flares or worsening autoimmune activity following filler injections.

Overall, this research suggest that HA fillers represent a effective minimally invasive option for patients with systemic sclerosis or morphea who seek both cosmetic improvement and functional relief.

Source:

Gkouvi, A., Liapis, N.-M., Zafiriou, E., Bogdanos, D. P., Katsiari, C. G., & Simopoulou, T. (2026). Hyaluronic acid fillers in systemic sclerosis and localized scleroderma: A systematic review. Autoimmunity Reviews, 104009. https://doi.org/10.1016/j.autrev.2026.104009