Aesthetic and Cosmetic Procedures in Patients with Rheumatic Diseases: Utilization and Patient-Reported Outcomes

Background and Objectives: Evidence on aesthetic and cosmetic procedures in patients with rheumatic diseases is limited. This study assessed procedure use after rheumatic disease diagnosis, associated factors, peri-procedural practices, and patient-reported outcomes. Materials and Methods: This multicenter cross-sectional survey included adults attending four Saudi rheumatology clinics between April and June 2026. Participants completed a structured questionnaire. Multivariable logistic regression was used to identify factors associated with procedure use. Results: Of 503 patients, 100 (19.9%) reported undergoing procedures after diagnosis; 69 underwent only non-surgical procedures, and 31 underwent at least one cosmetic surgical procedure. Fillers (60%), laser (58%), and botulinum toxin injections (56%) were most common. Among users, 88% reported inactive or mildly active disease, and 45% were receiving corticosteroids, immunosuppressants, biologics, or Janus kinase inhibitors at the time of a procedure. Rheumatology consultation and risk discussion were reported by 29% and 32%, respectively. Thirteen users (13%) reported disease activity after a procedure (9%) or local inflammatory reactions within 2 weeks (6%), with two reporting both. Outcomes were self-reported and not linked to specific procedures. Procedure use was associated with female sex, higher education, employment, and longer disease duration; Saudi nationality was associated with lower odds of use. Personal preference or no perceived need was the most common reason for non-use (52.6%). Conclusions: One in five patients reported procedure use, and 13% of users reported disease activity or local reactions after a procedure. Infrequent rheumatology consultation and risk discussion highlight counseling needs. These findings cannot establish causality; prospective studies are needed.