Alternative treatment to injectable hyaluronidase for hyaluronic acid accumulation in periorbital region

Abstract

The filling technique using hyaluronic acid has been widely used for rejuvenation and facial remodeling. The increasing use of this technique brings the occurrence of undesirable results. In these situations, the most effective therapeutic option is the application of the enzyme hyaluronidase, capable of degrading hyaluronic acid. No studies were found that address the resolution of complications with the use of hyaluronic acid without parenteral application of the hyaluronidase. The aim of this study was to report an alternative treatment for the accumulation of hyaluronic acid. The use of ledtherapy associated with local massage and topical application of hyaluronidase ointment and betamethasone valerate was proposed. The use of hyaluronidase ointment was indicated for one week, associated with local massage; the enzyme acts by reducing the resistance of the tissue, changing the intercellular permeability, and aiding the dispersion of substances. The wavelength of 660 nanometers (corresponding to the spectrum of red light) was used for the ledtherapy; which has one of the highest tissue penetrations. The ledtherapy has anti-inflammatory action, photothermal effect and it is capable of inducing biostimulation. The final result was approved by the patient, since there was a reduction in the accumulation of product previously visible at the application site. The proposed therapy was resolutive and satisfactory, considering the small amount of hyaluronic acid applied.