Progressive hypothyroidism associated with this disease causes an increased accumulation of sugar derivatives called glycosaminoglycans in the skin. These compounds, including hyaluronic acid, attract water. Over time, excess fluid can accumulate in the skin, leading to swelling, a condition known as myxedema. This swelling is called myxedema, and one of the most common places where it appears is on our faces.
In advanced Hashimoto's disease, people with hypothyroidism experience swelling of the face, especially around the eyes. The skin can also become dry and scaly. The complexion can also become pale or even take on a yellowish hue due to the development of hypercarotenaemia — excessive accumulation of carotene derivatives in the skin. Additionally, proptosis, or bulging eyes, can also occur.
Furthermore, individuals with severe hypothyroidism associated with advanced Hashimoto's disease may exhibit a widened nose, thickened lips, and an enlarged tongue. They may also experience hair loss, including hair loss in the outer part of the eyebrows. Facial swelling typically occurs in the advanced stages of Hashimoto's disease. However, it can also happen in patients who have stopped taking their thyroid medication. Moreover, in cases of facial swelling, it is essential to consider other possible causes for such skin changes, including allergic reactions, cellulitis (a bacterial skin infection), or sinusitis (a viral or bacterial infection of the paranasal sinuses), among others.
