Lipoatrophy

Lipoatrophy is the loss of subcutaneous fat. It appears as large “dents” or depressions in the skin.

This condition in multiple sclerosis is usually related to the use of Copaxone (glatiramer acetate), one of the disease-modifying therapies for MS. Copaxone is injected daily subcutaneously (or into the fat layer under the skin). Some patients on Copaxone develop lipoatrophy at injection sites. One study showed that 45% of people on Copaxone developed lipoatrophy. All the people who developed lipoatrophy in this study were female.

The exact mechanism that causes lipoatrophy is unknown, with theories that it could be due to: local immune reaction, mechanical injury over time or a delayed inflammatory response. While it does happen most often in areas that are repeatedly injected (which is why rotation of injection sites is so important), it has also been observed in people who have diligently rotated injection sites.

Lipoatrophy is permanent, although it has been occasionally reported by some patients to lessen over time. Once lipoatrophy occurs in an area, patients are instructed to no longer inject in that area.