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Hyaluronidase (Filler Dissolver)2 items

Hyaluronidase

Hyaluronidase is an enzyme that breaks down hyaluronic acid, which is why a doctor can inject it to dissolve hyaluronic acid filler. This category covers 1,500 IU vials such as Liporase and Hyalase, for clinics that want to know the product before choosing. Because the enzyme acts on hyaluronic acid, it is mainly relevant to filler of that type.

Start with what the enzyme does, which fillers it relates to, when doctors use it and the allergy cautions, then look at the box name, strength and storage on the label. Those details tell products apart; the plan for using one belongs to the doctor.

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Brands in Hyaluronidase
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What does it mean to dissolve filler, and what should you check before choosing a product?

Dissolving filler means a doctor injects the enzyme hyaluronidase to break down hyaluronic acid filler in the tissue. In many countries the enzyme is a prescription medicine. Before choosing a product, read the box name, strength per vial, the source of the enzyme, the manufacturer, the expiry date and the storage conditions on the label. Fillers that are not hyaluronic acid are not what this enzyme acts on, and the FDA notes they can be harder to remove. Assessment and the plan for use stay with the doctor.

References

  1. Dermal Fillers (Soft Tissue Fillers)(opens in a new tab) U.S. FDA
  2. Hyaluronidase for Dermal Filler Complications: Review of Applications and Dosage Recommendations(opens in a new tab) JMIR Dermatology (Kroumpouzos & Treacy, 2024)
  3. Hydase (hyaluronidase injection, bovine) prescribing information(opens in a new tab) U.S. FDA (Drugs@FDA)
  4. Hyaluronidase(opens in a new tab) Wikipedia

What is hyaluronidase, and how does it dissolve filler?

Hyaluronidase is a family of enzymes that cleave hyaluronic acid, a component of tissue. Once hyaluronic acid is broken down, the material becomes less viscous and the tissue more permeable, which is why the enzyme can be injected to dissolve hyaluronic acid filler. A review in JMIR Dermatology describes it as an enzyme that depolymerises hyaluronic acid and can reverse complications of this type of filler.

The same enzyme has other medical uses: it helps other injected drugs spread and absorb, and it is combined with local anaesthetics in eye surgery. The Hydase label published by the FDA lists it as an adjuvant for drug absorption, for subcutaneous fluids and for contrast agents in urography. Dissolving filler is not among the indications on that label.

Which fillers does hyaluronidase relate to?

Hyaluronidase relates to hyaluronic acid fillers, the group most often used in filler treatment. The FDA notes that removal can be harder with fillers that are not hyaluronic acid, especially so-called permanent ones. Knowing which filler was used before therefore matters to the doctor, and the box name or earlier records can help identify it.

Hyaluronic acid fillers do not all break down at the same rate. The review notes that a filler's physical properties influence how the enzyme degrades it, so a brand or category name alone does not settle the question. The doctor assesses what is in the tissue and whether the enzyme is appropriate.

When do doctors use an enzyme to dissolve filler?

The JMIR Dermatology review lists non-inflamed nodules, caused by overcorrection, misplaced filler or migration, among the common complications, and describes hyaluronidase as a tool doctors use for them. The enzyme is a corrective instrument for clinicians, not a product for self-treatment.

Another situation is filler entering a blood vessel, which the FDA calls the most concerning risk, with possible tissue death, vision problems or stroke. The review states that vascular occlusion and blindness need immediate enzyme treatment. Skin that turns white, grey or blue near the injection site, or any change in vision, calls for immediate medical care.

What names and forms does hyaluronidase come in here?

This category holds 1,500 IU vials such as Liporase and Hyalase. As the review summarises, the hyaluronidase available worldwide is either animal-derived or a human recombinant, so read each label for the source of the enzyme rather than judging from the brand name.

The box name, strength per vial, manufacturer, batch number and expiry date are what tell products apart. The IU figure is the strength the maker assigns; it does not compare formulas between brands. Two items with the same strength can still differ in other ingredients and in enzyme source, which only their own documents show.

What allergy risks and cautions apply to hyaluronidase?

The review says allergic reactions to hyaluronidase are uncommon in aesthetic use and that the recombinant type is thought to cause fewer, though long-term data are limited. Known hypersensitivity to the enzyme or any ingredient is a contraindication on the Hydase label. The review also highlights cross-reactivity in people allergic to bee or wasp stings.

The Hydase label adds that the enzyme should not be injected into or around an infected or acutely inflamed area, because it could spread a localised infection. Allergy history, infections and current medicines should be shared with the doctor. Pre-testing is the doctor's call; the review says it is not warranted in emergencies.

How should you read the label and storage conditions?

The Hydase label published by the FDA says to store the vials in a refrigerator at 2 to 8 degrees Celsius and not to freeze them. That is an example for the same type of enzyme; the conditions for Liporase, Hyalase or any other brand must come from the label and documents of that exact item, including the directions on preparation and how long a prepared dose may be kept.

Check the expiry date, batch number, vial condition and the appearance of the powder or solution as the documents describe. If packaging looks abnormal or directions are incomplete, the clinic's responsible person should review it before use. Storing to the label is a product matter; deciding whether to use it is a doctor's matter.

Who uses hyaluronidase, and who plans the treatment?

The FDA says filler injection should be treated as a medical procedure and carried out by a licensed, experienced provider. Hyaluronidase is prescription-only in the United States, the United Kingdom and Australia, as Wikipedia summarises, so it is a product for doctors and clinics.

Amount and technique are decided case by case. The review notes that recommendations on dose differ between authors and that too much enzyme can remove all of the filler. This category therefore describes the product only. Tell the doctor which filler was used, where, and what concerns you.

Frequently asked questions

Which fillers can hyaluronidase dissolve?
The enzyme breaks down hyaluronic acid, so it relates to hyaluronic acid fillers. The FDA notes that fillers that are not hyaluronic acid, especially permanent ones, can be harder to remove. Each hyaluronic acid filler breaks down differently according to its physical properties, so tell the doctor which filler you had and bring any records from the earlier treatment.
How much does dissolving filler cost?
The doctor assesses the earlier filler, the area and the tissue before explaining a plan and its costs. Ask what the quoted cost covers: assessment, the medicine, the injection and follow-up, since clinics group these differently. Prices of the products themselves, for clinics, are shown on each product page.
How many hyaluronidase injections are needed?
The doctor sets the plan after examining you. The review notes that opinions on use vary and that a filler's properties affect how it breaks down, so someone else's experience cannot set yours. Say which filler you had and where, and ask what the follow-up will review.
Does hyaluronidase also break down natural hyaluronic acid in the skin?
The enzyme breaks down hyaluronic acid where it is injected, natural hyaluronic acid included. The review says the body replaces it and reports no detrimental long-term effects on skin quality, but a high enzyme dose can remove all of the filler. The doctor judges case by case how much is appropriate.
Is an allergy test needed before dissolving filler?
That is for the doctor to decide. The review says no pre-test is warranted in emergencies such as vascular occlusion, that it is optional in non-urgent cases and not required for recombinant products. People allergic to bee or wasp stings should say so, because cross-reactivity is a risk. The label lists hypersensitivity to the enzyme or its ingredients as a contraindication.
How much hyaluronidase is used to dissolve filler?
The doctor decides after examining the earlier filler and the area. The review notes that dose recommendations differ between authors and that filler properties influence breakdown. The IU number on a vial states strength per vial, not how much to use. Tell the doctor which filler was used and which area concerns you.
Are Liporase and Hyalase different?
Both items in this category are 1,500 IU hyaluronidase vials. The source of the enzyme, other ingredients, manufacturer and storage conditions must be read from each item's label and documents, not inferred from the brand name. The review notes that both animal-derived and recombinant enzymes are on the market.
How should hyaluronidase be stored?
Follow the label and documents of that exact product. The Hydase label published by the FDA says to refrigerate at 2 to 8 degrees Celsius and not to freeze, as an example of the same type of enzyme. Check expiry, batch number and vial condition on the box you will use, and have the clinic's responsible person review any missing directions first.