Therapeutic hyaluronidase to provide optimal aesthetic outcomes: A case report and call to action

With hyaluronic acid injectable treatments becoming increasingly popular, more patients are presenting with pre-existing hyaluronic acid creating a poor cosmetic effect, requiring subsequent dissolving with hyaluronidase. We sought to characterize the clinical features and demographics of patients receiving therapeutic hyaluronidase electively and not in the context of an adverse event. We retrospectively reviewed the charts of patients receiving therapeutic hyaluronidase in two aesthetic dermatology practices from 2020 to 2024. There were 35 patients, ranging in age from 23 to 74 years. Fifty-seven percent of patients sought consultation for further injectable treatments and were unaware of the negative impact of their prior hyaluronic acid. Our data highlight the necessity of considering therapeutic hyaluronidase during an aesthetic consultation. Practitioners who seek to provide patients with the most optimal, natural, and balanced cosmetic outcomes must both recognize the signs of excess or poorly placed hyaluronic acid and be comfortable in administering treatment with hyaluronidase.