Understanding Late-Onset Reactions to Hyaluronic Acid Dermal Fillers

In the pursuit of advancing medical excellence and safety in the field of aesthetic medicine, Teoxane has published a scientific study in the Dermatology and Therapy Journal. This publication delves into the causes, risk factors, and management of late-onset reactions to hyaluronic acid dermal fillers. 

Dermal fillers, especially those made from hyaluronic acid (HA), have become incredibly popular in cosmetic procedures. They are widely regarded as safe and effective for enhancing facial features and reducing wrinkles. However, like any medical treatment, they can sometimes cause unexpected reactions. Recently, experts have been studying a specific type of reaction known as late-onset reactions (LORs), which can occur months after the injection.

LORs are adverse effects that show up between three to four months after receiving an HA filler injection. In rare cases, they can appear as early as 24 hours after the procedure. These reactions can include symptoms like swelling, inflammation, lumps under the skin, and even infections.

The Complication Assessment and Risk Evaluation (CARE) board, a group of specialists in aesthetic medicine carefully curated by Teoxane, has been investigating the causes of these reactions. They have identified three main reasons: 

• First, the structure of the filler itself can be a factor. Some HA fillers, especially those with low molecular weight, might trigger the body's immune response. 
• Second, infections can be introduced during the injection process or reactivated from dormant states. 
• Third, issues with the immune system, such as autoimmune diseases or viral infections, can make the body react more strongly to the filler.

To minimize the risk of LORs, it's crucial to select patients carefully. This involves taking a detailed medical history and ensuring patients understand the procedure and its risks. Practitioners should use high-quality products and maintain strict hygiene standards during injections. After the procedure, patients should be educated on how to care for the treated area.

If a patient develops an LOR, the treatment approach will depend on the suspected cause. Non-inflammatory reactions may be treated with hyaluronidase, an enzyme that breaks down HA fillers. Inflammatory reactions might be managed with a watchful waiting approach and/or oral steroids. Infections, however, need to be treated with antibiotics, and sometimes the infected area must be drained.

The CARE board has created guidelines to help practitioners prevent and manage LORs effectively. This includes a risk assessment questionnaire to determine patient eligibility for HA fillers and a treatment algorithm to guide practitioners in handling these reactions.

In summary, while HA fillers are generally safe, it's important for both patients and practitioners to be aware of the potential for LORs. With careful patient selection, proper technique, and appropriate management, the risks can be minimized, ensuring a safer experience for all.

You can read the full article by clicking here: https://pubmed.ncbi.nlm.nih.gov/38907876/