Publication: Delayed inflammatory reactions to hyaluronic acid fillers: A literature review and proposed treatment algorithm
Issued Date
2020-01-01
Resource Type
ISSN
11787015
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2-s2.0-85085349655
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Mahidol University
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SCOPUS
Bibliographic Citation
Clinical, Cosmetic and Investigational Dermatology. Vol.13, (2020), 371-378
Suggested Citation
Ofir Artzi, Joel L. Cohen, Jeffrey S. Dover, Atchima Suwanchinda, Tatjana Pavicic, Marina Landau, Greg J. Goodman, Sahar Ghannam, Firas Al Niaimi, Jani A.J. van Loghem, Kate Goldie, Sonja Sattler, Daniel Cassuto, Ting Song Lim, Rungsima Wanitphakdeedecha, Ines Verner, Tanja C. Fischer, Vivian Bucay, Eli Sprecher, Dana Shalmon Delayed inflammatory reactions to hyaluronic acid fillers: A literature review and proposed treatment algorithm. Clinical, Cosmetic and Investigational Dermatology. Vol.13, (2020), 371-378. doi:10.2147/CCID.S247171 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/56332
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Title
Delayed inflammatory reactions to hyaluronic acid fillers: A literature review and proposed treatment algorithm
Author(s)
Ofir Artzi
Joel L. Cohen
Jeffrey S. Dover
Atchima Suwanchinda
Tatjana Pavicic
Marina Landau
Greg J. Goodman
Sahar Ghannam
Firas Al Niaimi
Jani A.J. van Loghem
Kate Goldie
Sonja Sattler
Daniel Cassuto
Ting Song Lim
Rungsima Wanitphakdeedecha
Ines Verner
Tanja C. Fischer
Vivian Bucay
Eli Sprecher
Dana Shalmon
Joel L. Cohen
Jeffrey S. Dover
Atchima Suwanchinda
Tatjana Pavicic
Marina Landau
Greg J. Goodman
Sahar Ghannam
Firas Al Niaimi
Jani A.J. van Loghem
Kate Goldie
Sonja Sattler
Daniel Cassuto
Ting Song Lim
Rungsima Wanitphakdeedecha
Ines Verner
Tanja C. Fischer
Vivian Bucay
Eli Sprecher
Dana Shalmon
Other Contributor(s)
Alexandria University
Università degli Studi di Roma La Sapienza
Mae Fah Luang University
Monash University
University of Texas Health Science Center at San Antonio
Yale School of Medicine
Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Faculty of Medicine, Siriraj Hospital, Mahidol University
The Warren Alpert Medical School
Tel Aviv Sourasky Medical Center
Goethe-Universität Frankfurt am Main
Tel Aviv University, Sackler Faculty of Medicine
Clique Clinic
UMA Institute
AboutSkin Dermatology and AboutSkin Research
Dermatology
Verner Clinic
Private Practice
European Medical Aesthetics Ltd
Private Practice for Dermatology and Aesthetics
SkinCare Physicians
Skin and Laser Center Potsdam
Rosenparkklinik
Università degli Studi di Roma La Sapienza
Mae Fah Luang University
Monash University
University of Texas Health Science Center at San Antonio
Yale School of Medicine
Faculty of Medicine, Ramathibodi Hospital, Mahidol University
Faculty of Medicine, Siriraj Hospital, Mahidol University
The Warren Alpert Medical School
Tel Aviv Sourasky Medical Center
Goethe-Universität Frankfurt am Main
Tel Aviv University, Sackler Faculty of Medicine
Clique Clinic
UMA Institute
AboutSkin Dermatology and AboutSkin Research
Dermatology
Verner Clinic
Private Practice
European Medical Aesthetics Ltd
Private Practice for Dermatology and Aesthetics
SkinCare Physicians
Skin and Laser Center Potsdam
Rosenparkklinik
Abstract
© 2020 Artzi et al. Background and Objectives: There is a wide diversity of opinions regarding the management of delayed inflammatory reactions (DIRs) secondary to hyaluronic acid (HA)-based fillers. The plethora of approaches has led the authors to conduct a review regarding management and treatment of DIRs as well as establish therapeutic guidelines for this purpose. Materials and Methods: A review of the literature was performed through databases such as PubMed using keywords including HA-fillers and complications, delayed HA filler sequelae and therapy, soft tissue and dermal filler reactions and management. Additionally, a survey comprised of questions regarding the management and treatment of DIRs was sent to 18 physicians highly experienced with soft-tissue filler injections in 10 countries. Their answers and recommendations were analyzed and debated amongst these panelists. Results: Sixteen panelists favored antibiotic therapy as first-line treatment for DIRs, specifically dual antibiotic therapy consisting of a fluoroquinolone along with a tetracycline or macrolide for a period of 3–6 weeks. The majority refrained from the use of intralesional (IL) or systemic steroids except in the case of disfiguring or recalcitrant reactions. IL hyaluronidase was recommended by 13 panelists; however, some preferred a watchful waiting approach for a period of 48 hours to 2 weeks prior to IL hyaluronidase, and in cases where antibiotics did not lead to improvement. Conclusion: A consensus was reached and summarized to propose a clear, easy-to-follow, stepwise algorithm for the treatment of DIRs.