Hyaluronic Acid Dermal Filler

How it works

The cross-linked hyaluronic acid is hydrophilic and integrates into the dermis, providing volume and water-binding support, and is gradually degraded by tissue hyaluronidase over months.

Prescribing in practice

• Inadvertent intravascular injection can cause vascular occlusion leading to skin necrosis or, near the glabella and nose, visual loss — an emergency requiring immediate recognition and hyaluronidase availability.
• Avoid injecting into infected, inflamed or compromised skin, and delay around active infection or recent dental procedures because of seeding risk.
• Delayed inflammatory nodules and hypersensitivity reactions can occur, sometimes precipitated by later illness or other injections.

Monitoring

Monitor for early signs of vascular compromise (disproportionate pain, blanching, dusky discolouration) immediately after injection and review for delayed nodules at follow-up.

Counselling the patient

• Bruising, swelling and tenderness at injection sites are common and usually settle over days.
• Seek urgent review for severe pain, skin colour change, or any vision disturbance after treatment, as these need prompt action.

Evidence & guidelines

Vascular occlusion with skin necrosis or visual loss is the most serious recognised complication of dermal fillers and is reflected in regulatory and specialty safety guidance.