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Facial hemiatrophy: causes, symptoms, diagnosis, treatment
Last reviewed: 07.07.2025
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Hemiatrophy of the face (synonyms: Paris-Ramberg hemiatrophy, Ramberg trophoneurosis).
The causes and pathogenesis of facial hemiatrophy have not been established. Facial hemiatrophy often develops with damage to the trigeminal nerve and disorders of autonomic innervation, which may be genetically determined; progressive hemiatrophy may be a symptom of banded scleroderma.
Symptoms of facial hemiatrophy. Facial hemiatrophy is characterized by unilateral atrophy of the skin, subcutaneous tissue and muscles of the face. The development of atrophic changes is rarely preceded by neuralgic pain. The skin of the affected part of the face is thin, dry, stretched, dyschromia, graying and hair loss are observed, sweating and sebum secretion are often reduced. The face noticeably decreases in size, asymmetrically. Endo- or exophthalmos occurs. Later, trophic changes spread to the masticatory muscles, and in severe cases - to the zygomatic bone, lower jaw. Facial expressions change. Atrophic changes can spread to the skin of the forehead, in rare cases - the neck, shoulders, trunk and even to the opposite side of the face and body (crossed hemiatrophy). After slow progression over many years, spontaneous stabilization may occur. Sometimes the first symptom may be the appearance of pigmented spots on the face. Progressive hemiatrophy is sometimes associated with localized scleroderma, which may develop in the atrophic zone. The tongue and larynx are involved in the process.
Histopathology: Histologically, thinning of all layers of the skin and subcutaneous tissue is detected.
Differential diagnosis. The disease should be distinguished from limited scleroderma, Melkersson-Rosenthal syndrome.
Treatment of facial hemiatrophy. There are no specific treatment methods. At an early stage, penicillin is prescribed at 1,000,000-2,000,000 IU per day for 3-4 weeks. Trophic-improving agents (vitamins PP, group B, theonikol), analgesics, and massage are indicated. Softening and vitaminized creams are applied externally. Cosmetic plastic surgery is performed upon stabilization.
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