Hypersensitivity Caused by Cosmetic Injection: Systematic Review and Case Report.

[OBJECTIVE] Botulinum toxin injection, micro-needling injection, and filler injection are the most widely used non-surgical facial cosmetic treatments. Hypersensitivity reactions associated with injections have not received sufficient attention due to their low incidence rates. The authors tried to summarize the characteristics of the hypersensitivity caused by cosmetic injections and helped to improve the diagnosis and treatment.

[METHODS] A comprehensive search of the PubMed database to September 2019 was performed. Articles were screened using predetermined inclusion and exclusion criteria. Data collected included patient characteristics, injection information (injected material, trade name, location of injection, symptoms of allergy, time of onset), diagnostic examination, treatment, and prognosis.

[RESULTS] A total of 14 articles (57 patients) were included. There were 3 patients receiving botulinum toxin injection, 3 patients receiving micro-needling injection, and 46 patients receiving hyaluronic acid injection. Five patients were injected with collagen, polyacrylamide, paraffin, alkyl-imide or hyaluronidase, separately. The symptoms were redness, swelling, itching or induration at the injection site. The diagnosis and treatment methods vary greatly depending on the injection fillers. Removing the injected filler is the primary treatment.

[CONCLUSION] Although hypersensitivity reaction is a relatively uncommon adverse event, more practice guidelines and research on diagnosis and treatment are demanded to help improve the outcomes.

[LEVEL OF EVIDENCE III] This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the table of contents or the online instructions to authors www.springer.com/00266 .