# The Prevalence and Effect of Cosmetic Procedures on Patients with Rheumatic Diseases: A Cross-Sectional Survey

## TL;DR

This study explores how many patients with rheumatic diseases consider or undergo cosmetic procedures and what factors influence their decisions.

## Contribution

The study identifies key predictors of cosmetic procedure use among patients with rheumatic diseases.

## Key findings

- 92 out of 212 participants considered or underwent cosmetic procedures.
- Female sex, higher education, and income were significant predictors of undergoing cosmetic procedures.
- Fear of disease flare-ups was a common reason for avoiding cosmetic procedures.

## Abstract

Objective: Due to the increasing prevalence of rheumatological conditions worldwide, especially among women, and their known negative impact on body image, there is a growing demand for cosmetic procedures. Therefore, it is imperative to develop an evidence-based understanding of the safety of these procedures and their potential effects on the disease course to prevent undesirable exacerbations. Methods: An observational cross-sectional survey was conducted among adult patients diagnosed with rheumatic diseases. Data were collected using an electronic questionnaire that addressed demographics, disease characteristics, comorbidities, and perceptions of cosmetic procedures. Ethical approval was obtained from the Institutional Review Board of King Saud University and King Saud University Medical City. Appropriate descriptive and inferential statistical analyses were performed. Results: A total of 212 participants were included; among them, 92 participants considered or underwent cosmetic procedures, while 120 did not. A significant difference was observed between groups regarding disease-related impact on self-confidence (p = 0.01). Factors associated with undergoing cosmetic procedures included gender (female sex) (OR 12.02; 95% CI: 1.55–93.17; p = 0.017), higher educational level (OR 14.00; 95% CI: 1.32–147.42; p = 0.028), a monthly income of SAR 1000–5000 (OR 2.39; 95% CI: 1.03–5.53; p = 0.041) or SAR 5000–10,000 (OR 2.75; 95% CI: 1.19–6.33; p = 0.017), and employment status (OR 1.81; 95% CI: 1.03–3.18; p = 0.038). Conclusions: A substantial proportion of patients with rheumatic diseases considered or had undergone cosmetic procedures, primarily driven by appearance-related concerns and reduced self-confidence. Female sex, higher education, higher income, and employment status were significant predictors. Fear of disease flare-ups and potential side effects were the most common reasons for avoiding cosmetic procedures.