Hyaluronidase helpful in complications after calcium hydroxyapatite and polylactic acid

Vascular adverse events (VAEs) following tissue filler injections pose a significant challenge to both patients and practitioners. Although hyaluronidase is an effective substance for dissolving hyaluronic acid (HA)-based fillers during VAEs, the lack of an effective "antidote" to non-HA fillers has been problematic to date.

A recent multicenter study* reported three cases of VAEs caused by non-HA fillers in which only ultrasound-guided hyaluronidase injections were used as part of the treatment.

Two cases involved calcium hydroxyapatite (CaHa) and one case involved polylactic acid (PLLA). All cases healed without tissue necrosis or scarring.

The authors of the study propose a hypothesis that the main cause of VAEs is long-term vasoconstriction, and in the case of CaHa, hyaluronidase probably increases tissue permeability and contributes to CaHa dispersion.

This innovative approach can significantly improve patient outcomes and minimize the risk of serious complications following non-HA filler injections.

*Kadouch, J., Schelke, L., Groh, O., Sokol, V. and Velthuis, P. (2024), Intralesional hyaluronidase injection to relieve non-hyaluronic acid filler-induced vascular adverse events. Int J Dermatol.