Against wrinkles, dark circles… Injections of hyaluronic acid for aesthetic purposes can be risky, warns the Medicines Agency. Since the beginning of 2022, around forty reports of adverse effects have been reported to it.
To fill in wrinkles on the face, give volume to the lips, remove dark circles… Injections of hyaluronic acid for aesthetic purposes are appealing. But beware ! In a communicated of July 2022, the Medicines Agency (ANSM) reports about forty reports of adverse effects since the beginning of 2022, following injections ofhyaluronic acid made by people – when their profession is known – not allowed. Who really has the right to perform these injections? In which circumstances ? What are the possible side effects?
What are the effects of hyaluronic acid injections?
Thehyaluronic acid was discovered in 1934. He is used since 1996-1997 in the form of injections for aesthetic purposes. These injections help fight the signs of facial aging. The injected product fills or adds volume to a specific area: nasolabial folds, frown lines (between the eyebrows), crow’s feet (corner of the eyes), cheeks, chin, around the mouth, lip contour, dark circles, cheekbones… The injection of hyaluronic acid is performed in women and men in the dermis or deep dermis.
Who has the right to inject hyaluronic acid?
The realization of injection is forbidden to beauticians and a fortiori to all non-professionals. This prohibition is valid regardless of the aesthetic purpose of the act (eg pigmentation, filling, tattoo removal or semi-permanent makeup). Thereby, only doctors are authorized to perform hyaluronic acid injections for aesthetic purposes. “Their training and their knowledge of the anatomy of the face and body mean that they are the only ones authorized and competent to guarantee the safety of injections” reminds the ANSM. The safety of these injections is based on good control:
- hygiene conditions (change of syringe, bottle, disinfection of premises, etc.),
- of the injectable product according to the areas to be injected.
Moreover, the injection of hyaluronic acid requires the realization of a clinical interrogation, to check in particular the medical background of the patient (allergies, autoimmune diseases, etc.) and choose products suitable for the injection area. Know that the traceability of the injected product (type, brand, batch number) must be kept by the practitioner. “Doctors know how to deal with immediate side effects such as an allergy to the injected product (anaphylactic shock), necrosis / ischemia (clogged blood vessel), by appropriate medical treatment (antibiotic, anti-inflammatory, hyaluronidase, etc.) and will set up appropriate monitoring if necessary in the event of long-term side effect” adds the health agency. In addition, they master the rules of hygiene relating to operating waste (dirty syringe) which prevents the risk of contamination of HIV transmissible diseases, hepatitis C etc.
To know : in a therapeutic setting such as to treat an oral pathology, dental surgeons can use injectable fillers at the level of the lips and the nasolabial fold.
What are the side effects of hyaluronic acid injections?
Erythema may occur just after the injection, it generally disappears after a few hours or even a few days. Bruises, hematomas may appear in the following days and disappear within a week. Redness, edema, erythema may be associated with itching or pain on pressure. An outbreak of cold sores is possible, especially in people who have already had it. It should be reported to the doctor.
The most common short-term side effects related to improper use of these productsare :
► if the injection of the product does not respect the rules of asepsis:
- local infection of the area where the product was injected, which can become generalized (sepsis) if the localized infection is not treated quickly;
- viral contamination (including HIV) or bacterial if the material used is shared.
► if the product is injected into a blood vessel:
- necrosis which can lead to tissue amputation if the product is injected into a blood vessel,
- loss of sight (blindness) if it is a vessel that supplies blood to the eye.
In the long term, the risks are the bad position of the injected product due to its migration and the inflammation of the injected tissues.
What precautions should be taken before and after an injection of hyaluronic acid?
- Avoid taking aspirin, nonsteroidal anti-inflammatory drugs and vitamin C for the previous 3 days.
- In the event of an outbreak of nasolabial herpes before the injection, report it to the doctor.
- After the injection, avoid taking alcohol and anti-inflammatories.
- Remain calm for 3 hours following the injections, avoiding moving the face.
- Sauna, sun exposure, violent sport, dental care, skin cleaning are to be avoided during the 3 days following the injection.
- Makeup can be resumed the next day
Sources:
Injections of hyaluronic acid for aesthetic purposes: only doctors can perform them. ANSM. July 11, 2022
Injections and other skin piercing practices, Ministry of HealthJanuary 19, 2022
French Society of Dermatology