La ialuronidasi è un enzima idrolitico presente costituzionalmente nel nostro corpo che serve a degradare l’acido ialuronico. Questo enzima viene riprodotto a livello industriale (da derivazione animale o batterica) e utilizzato come farmaco “per la degradazione controllata dell’acido ialuronico” con molteplici scopi medici. In ambito medico estetico, il suo utilizzo controllato serve per sciogliere i filler cross – linkati di acido ialuronico ad uso dermo estetico.

Hyaluronidase is a hydrolytic enzyme constitutionally present in our body that serves to degrade hyaluronic acid. This enzyme is reproduced on an industrial level (from animal or bacterial derivation) and used as a drug “for the controlled degradation of hyaluronic acid” with multiple medical purposes. In the aesthetic medical field, its controlled use is used to dissolve the cross-linked hyaluronic acid fillers for dermal aesthetic use.

In the specific aesthetic medical field, it is used to degrade the cross-linked hyaluronic acid filler. This treatment is performed on an outpatient basis and requires the infiltration of hyaluronidase into the areas to be treated. The quantities are predefined and established by protocols.

VASCULAR OCCLUSION

Due to the accidental injection of hyaluronic acid filler into an artery. Such an event should be treated immediately (refer to Expert Panel on Aesthetic Complications, Necrosis Guidelines). Signs of imminent necrosis include sharp severe pain, prolonged blanching of the skin, and a bruised appearance of surrounding areas. Hyaluronidase should be given as soon as these complications occur.

EXCESSIVE AMOUNT or DISPLACEMENT of the filler

Often caused by poor injection technique or poor product choice for a particular area.

NODULES, GRANULOMAS

Subcutaneous accumulations of hyaluronic acid which may appear up to several months after initial treatment (see Guide to Examination of Delayed Onset Nodules, Aesthetic Complications Expert Panel).

TYNDALL EFFECT

It refers to the bluish discoloration that can be observed in some patients after the injection of hyaluronic acid (refer to Expert on Aesthetic Complications, Tyndall Effect Guide). It is caused by too superficial placement of the hyaluronic acid gel or by using an inappropriate product for the treated area.

The effect is practically immediate: the hyaluronidase immediately degrades the hyaluronic acid filler and eliminates itself as the dosage ends: all within about a minute. Since, like all enzymes, it interrupts itself by itself, it is NOT possible that it will continue to act in the following days. Since the cross-linked hyaluronic acid fillers are never completely absorbed but are integrated into the tissues, the use of hyaluronidase can also be carried out after some time (we have had cases of patients treated 5 years after the infiltration of fillers).

It is therefore an extremely effective solution for dissolving the cross-linked hyaluronic acid from the lips, cheekbones, nasolabial folds and the periocular area, to bring them back to their original situation. Therefore, if the filler treatment was not successful, the problem can be solved, returning exactly to the way it was before the hyaluronic acid filler.

When used in the aesthetic medical field, the required dosage depends on various factors (related to the particular hyaluronic acid filler): quantity of gel, degree of cross-linking, concentration of hyaluronic acid, treated area. There are international recommendations and national protocols which indicate the dosages in the various areas of the face. These dosages must necessarily be respected, despite the fact that it is an off-label use.