Clinical, Cosmetic and Investigational Dermatology (May 2021)
Immediate nor Delayed Type Hypersensitivity Plays a Role in Late Inflammatory Reactions After Hyaluronic Acid Filler Injections
Abstract
Tom Decates,1,* Jonathan Kadouch,1,* Peter Velthuis,1 Thomas Rustemeyer2 1Department of Dermatology, Erasmus Medical Center, Rotterdam, The Netherlands; 2Department of Dermatology, Amsterdam University Medical Center, Amsterdam, The Netherlands*These authors contributed equally to this workCorrespondence: Thomas RustemeyerAmsterdam University Medical Center, Dermatology of Department, Postbus 7057, 1007 MB Amsterdam, Amsterdam, The NetherlandsEmail [email protected]: The exact etiology of late inflammatory reactions (LIRs) to hyaluronic acid (HA) fillers is currently unknown. Some argue that these result from a hypersensitivity reaction, although evidence to support this is very scarce. Most reports on such reactions are not substantiated by positive skin tests. The purpose of our study was to determine whether immediate or delayed type hypersensitivity reaction follows hyaluronic acid (HA) filler injections.Patients and Methods: Twelve patients were referred for general allergic screening (patch tests), as well as specific intradermal testing (injection of 0.1cc boluses) on the medial upper arm with a selection of several currently available hyaluronic acid (HA) fillers on the market. A positive allergic reaction was defined as erythema, firmness or swelling.Results: During the 4 month follow-up, no reactions to any of the tested HA fillers were reported. No correlation was found between results from the general allergic screening and a history with LIRs to HA fillers.Conclusion: The results suggest that neither type I nor type IV hypersensitivity plays a role in late inflammatory reactions (LIRs) to hyaluronic acid (HA) fillers.Keywords: cosmetic dermatology, allergy, cosmetic, complications
