Hyaluronic acid degradation with hyaluronidase

Hyaluronic fillers are sterile gels containing non-animal stabilized hyaluronic acid for injection into the skin. They are used to correct facial lines, wrinkles and folds, to increase lip volume and to contour the face. Sometimes fillers need to be broken down. Reasons may include that the aesthetic treatment has not produced the desired result, or there is a likelihood of vascular obstruction or impending necrosis (tissue death), with the risk of compromising healthy tissue.

Hyaluronidase is used in aesthetic medicine only in emergencies, and it is desirable to have the patient undergo a skin test at least twenty minutes before the procedure. The test is performed by injecting hyaluronidase into the subcutaneous tissue of the forearm and monitoring for signs of a reaction (urticaria). With a positive result, treatment with hyaluronidase should not be carried out, Hyaluronidase is a drug that is a tongue that breaks down hyaluronic fillers. As it is highly allergenic there is a risk of anaphylaxis on application. (a severe allergic reaction that is life-threatening in itself and requires immediate medical intervention).

Hyaluronidase can be applied in different areas: lips, cheekbones, around the mouth, forehead and chin, temples, around the eyes, lower jaw, neck, hands and others.

Patients who undergo this treatment receive a detailed consultation, during which they learn about the procedure and its possible side effects. Most commonly, such reactions include redness, swelling, pain, itching, bruising and soreness at the injection site. Usually, they do not require medical intervention and subside.


The safety and quality of the references applied must be guaranteed by your dermatologist. Esteline Dermatology Clinic works only with preparations that are officially registered for use in Bulgaria, clinically tested and with quality certificates.

The clinic’s dermatologist, trained and certified to work with the preparation, will prepare the patient for the procedure and strictly follow the established clinical protocol.

Injection of hyaluronidase does not require local anesthesia, but in case of particular sensitivity, a numbing cream is applied.

Hyaluronidase is injected with a needle at the site where the filter needs to be broken down. The result achieved in a few minutes, up to 48 hours.

Depending on the areas treated, the injection procedure takes between 15 – 20 minutes.

The amount of hyaluronidase injected depends on the amount of filter that needs to be broken down.

Therapy is not recommended for patients with a proven allergy to hyaluronidase.

When it is applied, it is possible to break down some of the body’s own hyaluronic acid, in addition to the filter.

Loss of volume and sagging of the skin are possible and it takes a minimum of 14 days to see the final result. Repeated administration may be necessary.

The most common reactions after the procedure include redness, swelling, pain, itching, bruising and soreness at the injection site. Usually, they do not require medical intervention and subside.

If you are taking medication or suffering from an illness, you should tell your doctor immediately.

The result achieved by the procedure is individual and depends on the physiological characteristics and habits of the individual. The degree of response can be reported after the traumatic reactions have subsided. If necessary, the procedure can be repeated.

We recommend that you have eaten a light meal about an hour before the procedure.

As a preventative measure and to reduce the likelihood of bruising as a result of the prick, it is advisable to take the nutritional supplement Arnica from the day before the procedure.

Up to 2-3 hours after the procedure should not be wet or dirty prick sites.

The treated areas should not be pressed or massaged, and cosmetic procedures, peels, massages and cleansing should not be performed during the next 2 weeks.

A follow-up examination is recommended 2 weeks after the procedure, when additional of the product can be placed if necessary.