Hyaluronidase: efficacy and safety of use in cosmetology

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Abstract

With an increase in requests for the correction of aesthetic imperfections with dermal fillers based on hyaluronic acid, cases of adverse events and complications have become more frequent. Hyaluronic acid in the form of a dermal filler is one of the most popular procedures in aesthetic medicine and has a high safety profile. Despite the fact that hyaluronic acid is an integral part of the extracellular matrix, fillers based on it can also cause complications. The use of an antidote in the form of hyaluronidase allows you to correct possible adverse reactions such as hypercorrection, the Tyndall effect, the formation of granulomas, and the development of tissue ischemia. Hyaluronidase is widely used in all branches of medicine, including the treatment of adhesions in the body, is used in in vitro fertilization, improves the absorption of drugs into the lesion in the treatment of cancer patients, and is also successfully used in the treatment of dermatological patients. In cosmetology, the use of enzyme helps to cope with such severe phenomena as tissue ischemia due to intravascular occlusion by the drug. And the use of ultrasound diagnostics makes it possible to correct adverse events using the enzyme strictly in the focus of the filler, thereby improving the quality of the treatment.

About the authors

Evgeniya V. Ikonnikova

Central State Medical Academy General Management Department of the President of the Russian Federation; Institute of Plastic Surgery and Cosmetology

Author for correspondence.
Email: evikonnikova@bk.ru
ORCID iD: 0000-0002-8813-9132
SPIN-code: 9210-8396

MD, Cand. Sci. (Med.), Associate Professor

Russian Federation, Moscow; Moscow

Olga A. Golanova

Delite-Lancet, LLC, Lancet-Center Clinic

Email: evikonnikova@bk.ru
ORCID iD: 0000-0002-1770-0439
Russian Federation, Moscow

Larisa S. Kruglova

Central State Medical Academy General Management Department of the President of the Russian Federation; Institute of Plastic Surgery and Cosmetology

Email: kruglovals@mail.ru
ORCID iD: 0000-0002-5044-5265
SPIN-code: 1107-4372

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow; Moscow

References

  1. Girish KS, Kemparaju K, Nagaraju S, Vishwanath BS. Hyaluronidase inhibitors: a biological and therapeutic perspective. Curr Med Chem. 2009;16(18):2261–2288. doi: 10.2174/092986709788453078
  2. Cavallini M, Gazzola R, Metalla M, Vaienti L. The role of hyaluronidase in the treatment of complications from hyaluronic acid dermal fillers. Aesthet Surg J. 2013;33(8):1167–1174. doi: 10.1177/1090820X13511970
  3. Kaul A, Short WD, Wang X, Keswani SG. Hyaluronidases in Human Diseases. Int J Mol Sci. 2021;22(6):3204. doi: 10.3390/ijms22063204
  4. Lee A, Grummer SE, Kriegel D, Marmur E. Hyaluronidase. Dermatol Surg. 2010;36(7):1071–1077. doi: 10.1111/j.1524-4725.2010.01585.x
  5. Moharib MM, Mitra S. Alkalinized lidocaine and bupivacaine with hyaluronidase for sub-tenon’s ophthalmic block. Reg Anesth Pain Med. 2000;25(5):514–517. doi: 10.1053/rapm.2000.5664
  6. Bailey SH, Fagien S, Rohrich RJ. Changing role of hyaluronidase in plastic surgery. Plast Reconstr Surg. 2014;133(2):127e–132e. doi: 10.1097/PRS.0b013e3182a4c282
  7. Wohlrab J, Wohlrab D, Wohlrab L, et al. Use of hyaluronidase for pharmacokinetic increase in bioavailability of intracutaneously applied substances. Skin Pharmacol Physiol. 2014;27(5):276–282. doi: 10.1159/000360545
  8. Popkin RJ. The use of hyaluronidase by iontophoresis in the treatment of generalized scleroderma. J Invest Dermatol. 1951;16(2):97–102. doi: 10.1038/jid.1951.15
  9. Landau M. Hyaluronidase caveats in treating filler complications. Dermatol Surg. 2015;41(Suppl. 1):S347–353. doi: 10.1097/DSS.0000000000000555
  10. Brody HJ. Use of hyaluronidase in the treatment of granulomatous hyaluronic acid reactions or unwanted hyaluronic acid misplacement. Dermatol Surg. 2005;31(8 Pt 1):893–897. doi: 10.1097/00042728-200508000-00001. Erratum in: Dermatol Surg. 2008;34(1):135.
  11. DeLorenzi C. New high dose pulsed hyaluronidase protocol for hyaluronic acid filler vascular adverse events. Aesthet Surg J. 2017;37(7):814–825. doi: 10.1093/asj/sjw251
  12. Schelke LW, Decates TS, Velthuis PJ. Ultrasound to improve the safety of hyaluronic acid filler treatments. J Cosmet Dermatol. 2018;17(6):1019–1024. doi: 10.1111/jocd.12726
  13. Soparkar CN, Patrinely JR. Managing inflammatory reaction to restylane. Ophthalmic Plast Reconstr Surg. 2005;21(2):151–153. doi: 10.1097/01.iop.0000155853.68249.0b
  14. Bravo BSF, Bianco S, Bastos JT, Carvalho RM. Hyaluronidase: What is your fear? J Cosmet Dermatol. 2021;20(10):3169–3172. doi: 10.1111/jocd.14303
  15. Wu L, Liu X, Jian X, et al. Delayed allergic hypersensitivity to hyaluronidase during the treatment of granulomatous hyaluronic acid reactions. J Cosmet Dermatol. 2018;17(6):991–995. doi: 10.1111/jocd.12461
  16. Boone DC. Hyaluronidase iontophoresis. Phys Ther. 1969;49(2):139–145. doi: 10.1093/ptj/49.2.139
  17. Batheja P, Thakur R, Michniak B. Transdermal iontophoresis. Expert Opin Drug Deliv. 2006;3(1):127–138. doi: 10.1517/17425247.3.1.127. Erratum in: Expert Opin Drug Deliv. 2006;3(2):303.
  18. Sloan JB, Soltani K. Iontophoresis in dermatology. A review. J Am Acad Dermatol. 1986;15(4 Pt 1):671–684. doi: 10.1016/s0190-9622(86)70223-5
  19. Talybova AP, Kruglova LS, Stenko AG. Ultraphonophoresis of enzyme drugs in treatment of postacne scars. Russian Journal of Physiotherapy, Balneology and Rehabilitation. 2017;16(5):254–256. (In Russ). doi: 10.18821/1681-3456-2017-16-5-254-256
  20. Ikonnikova EV, Kruglova LS. Delayed immune-inflammatory response after hyaluronic acid filler application: a clinical case. Farmateka. 2019;(8):88–91. (In Russ). doi: 10.18565/pharmateca.2019.8.88-91

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Copyright (c) 2022 Ikonnikova E.V., Golanova O.A., Kruglova L.S.

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