Hyaluronidase use in aesthetic medicine: a review

Abstract

Background: Demand for hyaluronic acid (HA) dermal filler procedures is rapidly growing, and several adverse events are recognised with these procedures. Since the use of hyaluronidase as a dissolving agent in HA dermal filler complications, dermal filler-related outcomes have improved. Aims: This integrative literature review will aim to present the current evidence for the safety of hyaluronidase use in the aesthetic field. Methods: CINAHL and OVID databases and the author's university search platform were searched for primary studies that support the use of hyaluronidase for HA dermal filler adverse events or primary studies descriptive of adverse outcomes with the use of hyaluronidase. Findings: A total of 17 studies were located: four cohort studies and 13 case studies. Two themes were identified throughout the captured literature: ‘hyaluronidase reactions and treatment’ and ‘intradermal skin testing’. Conclusion: Adverse reactions to hyaluronidase are rare, and most reactions can be safely mitigated with conservative management or antihistamine and corticosteroid treatment. The small risk of adverse reactions to hyaluronidase needs to be weighed against the risk of not treating HA dermal filler complications, both physically and psychologically. In most HA dermal filler complications, hyaluronidase treatment remains beneficial, despite the rare risk of sensitivity.