Allergic Complications of Hyaluronidase Injection: Risk Factors, Treatment Strategies, and Recommendations for...

Area of Science:

• Dermatology
• Allergology
• Plastic Surgery

Background:

• Hyaluronidase is a key agent for reversing hyaluronic acid fillers and enhancing medication diffusion.
• Allergic reactions to hyaluronidase, documented since 1984, remain frequently misdiagnosed.
• Understanding hyaluronidase allergy is crucial for patient safety in aesthetic procedures.

Purpose of the Study:

• To review the clinical presentation of hyaluronidase allergy.
• To identify risk factors contributing to hyaluronidase allergy development.
• To provide management recommendations for plastic surgery settings.

Main Methods:

• Systematic literature search of PubMed, Scopus, and Embase databases.
• Adherence to PRISMA guidelines for study selection.
• Analysis of 37 eligible articles involving 106 patients.

Main Results:

• Patients often reported a history of allergies to other substances and allergic diseases.
• A significant number of patients experienced symptoms upon their second exposure to hyaluronidase.
• Treatment with steroids and/or antihistamines led to rapid symptom resolution.

Conclusions:

• Prior exposure or sensitization to insect/wasp venom appears to be a primary risk factor for hyaluronidase allergy.
• The interval between hyaluronidase injections does not significantly influence allergy development.
• Prompt treatment with corticosteroids and antihistamines is effective for hyaluronidase allergy.