Albargawi Salma, Nagshabandi Khalid Nabil, Shadid Asem
Department of Dermatology, College of Medicine, Imam Mohammad Bin Saud Islamic University, Riyadh, Saudi Arabia.
Department of Dermatology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
J Cosmet Dermatol. 2025 Feb;24(2):e16684. doi: 10.1111/jocd.16684. Epub 2024 Nov 20.
Dermal filler-induced alopecia is a rare yet significant complication of aesthetic procedures primarily associated with vascular occlusion and subsequent tissue ischemia. Hyaluronic acid (HA) fillers, though widely used for facial rejuvenation, can lead to adverse outcomes such as skin necrosis and hair loss, particularly in high-risk areas like the temples and glabella.
This case report aims to highlight the clinical presentation, diagnostic approach, and multidisciplinary management of filler-induced alopecia, contributing to the existing literature with a comprehensive review of previously reported cases.
A 21-year-old female presented with localized skin necrosis and alopecia four days after receiving 7 mL of HA filler injections in the temples, tear trough, and eyebrow glabella regions. Trichoscopy revealed follicular dropout and white dots, consistent with ischemic hair loss. Treatment included hyaluronidase injections (1500 units), intralesional corticosteroids, topical minoxidil, and CO laser therapy. Over 1 year of follow-up, the patient achieved complete hair regrowth and resolution of facial scarring.
Only 16 cases of filler-induced alopecia have been documented, predominantly involving HA fillers. This case underscores the importance of early recognition and intervention with hyaluronidase to mitigate ischemic damage. The multidisciplinary management approach employed here demonstrates the potential for full cosmetic recovery.
Filler-induced alopecia, though rare, necessitates heightened awareness among dermatologists and aesthetic practitioners. Adhering to recommended injection techniques and dosages, alongside the judicious use of ultrasound guidance, can minimize risks and improve patient safety.
真皮填充剂所致脱发是美容手术中一种罕见但严重的并发症，主要与血管闭塞及随后的组织缺血有关。透明质酸（HA）填充剂虽广泛用于面部年轻化，但可导致皮肤坏死和脱发等不良后果，尤其是在颞部和眉间等高风险区域。
本病例报告旨在突出填充剂所致脱发的临床表现、诊断方法及多学科管理，通过对既往报道病例的全面回顾为现有文献做出贡献。
一名21岁女性在颞部、泪沟和眉间区域注射7毫升HA填充剂4天后出现局部皮肤坏死和脱发。毛发镜检查显示毛囊缺失和白点，符合缺血性脱发。治疗包括注射透明质酸酶（1500单位）、皮损内注射皮质类固醇、外用米诺地尔和CO2激光治疗。经过1年多的随访，患者头发完全再生，面部瘢痕消退。
仅记录到16例填充剂所致脱发病例，主要涉及HA填充剂。本病例强调了早期识别并用透明质酸酶干预以减轻缺血性损伤的重要性。此处采用的多学科管理方法显示了完全美容恢复的潜力。
填充剂所致脱发虽罕见，但皮肤科医生和美容从业者仍需提高认识。遵循推荐的注射技术和剂量，同时明智地使用超声引导，可将风险降至最低并提高患者安全性。
