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Alopecia Induced by Poly-L-Lactic Acid Injection.

Gabriel Lazzeri Cortez1, Karime Marques Hassun1, Luciana Ribeiro Patrício Linhares1

  • 1Drs. Cortez, Hassun, Linhares, Pinheiro, Florenço, Michalany, Bagatin, and Nascimento are from the Federal University of São Paulo, Brazil. Drs. Cortez, Hassun, Linhares, Pinheiro, Florenço, Bagatin, and Nascimento are from the Department of Dermatology, and Dr. Michalany is from the Department of Dermatopathology. Drs. Cortez de Almeida and Melo are from Department of Dermatology, Rio de Janeiro State University, Brazil.

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Summary

Facial cosmetic procedures using poly-L-lactic acid (PLLA) can cause alopecia, a rare adverse event. Early recognition via trichoscopy and histopathology aids in managing this complication.

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Area of Science:

  • Dermatology
  • Aesthetic Medicine
  • Pathology

Background:

  • Cosmetic procedures, including facial aesthetic treatments, carry risks of adverse events.
  • Alopecia, hair loss, is a rare but potential complication of such procedures, ranging from transient to permanent.
  • Poly-L-lactic acid (PLLA) is a dermal filler used for facial rejuvenation.

Observation:

  • A case report details a 35-year-old woman experiencing pain, erythema, and edema with nonscarring alopecia after facial PLLA application.
  • The alopecia affected the frontal hairline, indicating a localized reaction to the aesthetic treatment.
  • The patient's symptoms were observed following the PLLA injections for cosmetic purposes.

Findings:

  • Trichoscopy and histopathologic analysis confirmed the diagnosis of alopecia.
  • The findings suggest a link between PLLA application and the development of hair loss.
  • The specific mechanism may involve embolization or inflammatory responses affecting hair follicles.

Implications:

  • Dermatologists must be aware of alopecia as a potential adverse event associated with PLLA treatments.
  • The report highlights the risk of embolization and retinal ischemia secondary to PLLA use.
  • Combining trichoscopy with histopathology is crucial for the early diagnosis and effective management of PLLA-induced alopecia.