Thermal degradation of hyaluronic acid dermal fillers

Abstract

Hyaluronic acid (HA) dermal fillers are extensively used for facial volume enhancement. Despite their widespread use, HA fillers are prone to degradation due to various factors, including enzymatic activity, pH changes, ultrasound exposure, temperature variations, oxidative stress, and ultraviolet (UV) radiation. To mitigate these issues, manufacturers have developed cross-linking techniques to improve the stability of HA fillers. Energy-based devices (EBDs) are increasingly utilized for purposes such as skin tightening, collagen stimulation, and fat reduction. However, the interaction between EBDs and HA fillers is complex and requires further investigation. Recent research has examined the effects of EBDs on HA fillers, yielding mixed results. Some studies suggest that early EBD treatment may lead to the degradation of HA fillers, while others find no significant impact. The timing between filler injection and EBD treatment appears to be crucial, with delayed treatment potentially reducing the risk of degradation. Histological examinations have demonstrated that the interactions between EBDs and HA fillers are intricate, influenced by factors such as the location of the filler and the timing of the treatment. The relationship between EBDs and HA fillers is multifaceted and affected by numerous variables, including the type of EBD, energy levels, filler characteristics, and the timing of the treatment. Further research involving diverse participant groups, various types of HA fillers, and different EBD technologies is necessary to develop comprehensive guidelines for optimal treatment intervals.

Keywords

Dermal fillers / hyaluronic acid / energy-based devices / multi-wavelength diode laser / high intensity focused ultrasound / radiofrequency

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