Alopecia Following Deoxycholic Acid Treatment for Submental Adiposity

Sebaratnam, Deshan F; Wong, Xin Lin; Kim, Leo A.; Cheung, Karen

doi:10.1001/jamafacial.2019.0640

Cited by 18 publications

(13 citation statements)

References 5 publications

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“…Still, its approval by control agencies is relatively recent. Even with the confirmation of reduction of submental fat, the DCA presents several limitations due to a variety of adverse events such as edema, pain, local induration, hematomas, numbness, and, less frequently, mandibular nerve paresthesia, ulcerations, skin necrosis, alopecia, and vascular events 2,20,23–27,29–31 . The occurrence of alopecia was inserted in the medicine leaflet after the sales started since it was discovered later, as most of the DCA patients were female 31 .…”

Section: Discussionmentioning

confidence: 99%

“…It is not yet known because in some cases this adverse reaction is transient while in other cases it is a permanent phenomenon. Sebaratnam et al 24 Inadvertent intra-arterial injection of DCA, with consequent skin necrosis, is a severe complications that have also been described in literature. [25][26][27] The mechanism of damage from in- Ulceration and skin necrosis are important adverse effects and may also be due to superficial injection (intradermal) of the substance.…”

Section: Appli C Ati On Me Thods and Adver S E Re Ac Tionsmentioning

confidence: 93%

“…It is not yet known because in some cases this adverse reaction is transient while in other cases it is a permanent phenomenon. Sebaratnam et al 24 performed a biopsy of lesional skin from the anterior neck in a patient with alopecia. Overall, the histological changes were consistent with a nonscarring alopecia with an increased telogen‐catagen count of 75%.…”

Section: Application Methods and Adverse Reactionsmentioning

confidence: 99%

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Deoxycholic acid in the submental fat reduction: A review of properties, adverse effects, and complications

Farina

Cherubini

Figueiredo

et al. 2020

J of Cosmetic Dermatology

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Background Deoxycholic acid (DCA) was developed by the pharmaceutical industry for aesthetical use in submental fat reduction. It represents the first lipolytic substance approved by the Food and Drug Administration (FDA) for fat reduction in that area. Aims This study presents an update of properties and the use of DCA, as well as adverse events and possible complications. Methods A search in MEDLINE/PubMed, Cochrane, and Bireme/LILACS databases was performed using the terms: “deoxycholic acid” OR “ATX‐101” AND “injection” NOT “amphotericin” NOT “biliary” NOT “bile.” Experimental studies developed in animals, clinical trials, literature reviews, case reports, and letters to the editor that included the DCA mechanism of action, dose, manner of use, adverse effects, and complications were selected. Results The most frequent adverse events are edema, local pain, bruise, and numbness, which usually spontaneously regress. However, complications, including, skin necrosis, nerve injury, alopecia, and vascular events, can occur, demanding complex management without specific protocols. Conclusion Although DCA is beneficial for lysis of adipose tissue, clinicians should be aware about the adverse effects and risks involved with the use of this substance. The knowledge of local anatomy, properties, and adverse effects are fundamental to treatment with DCA.

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Section: Discussionmentioning

confidence: 99%

Section: Appli C Ati On Me Thods and Adver S E Re Ac Tionsmentioning

confidence: 93%

Section: Application Methods and Adverse Reactionsmentioning

confidence: 99%

See 1 more Smart Citation

Deoxycholic acid in the submental fat reduction: A review of properties, adverse effects, and complications

Farina

Cherubini

Figueiredo

et al. 2020

J of Cosmetic Dermatology

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“…A total of 5 cases within 4 articles experienced alopecia following deoxycholic acid injection. [12][13][14][15] Grady et al reported alopecia in 2 male patients. 12 The first was a 38-year-old Caucasian male who received 21 injections at a dose of 0.2 mL per site within the submental area.…”

Section: Localized Alopeciamentioning

confidence: 99%

“…Both Wambier and Sebaratnam et al reported a case of nonscarring alopecia in the beard area of a male patient. 14,15 To further define the cause of alopecia, Sebaratnam et al biopsied the area to show that a localized telogen effluvium was the likely responsible mechanism leading to alopecia. 15…”

Section: Localized Alopeciamentioning

confidence: 99%

Uncommon Adverse Effects of Deoxycholic Acid Injection for Submental Fullness: Beyond the Clinical Trials

et al. 2020

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Deoxycholic acid (BELKYRATM, Allergan, Markham, ON, Canada) is a minimally invasive injectable treatment approved by Health Canada for the nonsurgical reduction of submental fullness. Multiple phase III clinical trials have proven the efficacy and safety of deoxycholic acid. In the clinical trials, the most common adverse events (AEs) reported, such as injection site pain, numbness, swelling, bruising and induration, were transient and mild-to-moderate in severity. Additional postmarketing AEs have been reported in the literature. In this study, we reviewed the uncommon reported events and aimed to increase clinician awareness of the potential adverse effects for patient counselling of risks and benefits, identify AEs of procedures that may be performed outside of the medical environment, and identify factors that increase the risk of an adverse event. Beyond the clinical trials, real-world case reports and case series have been reported for the AEs of alopecia, transient neuropraxia, vascular occlusive events/vascular injury, and skin necrosis. Dermatologists need to be aware of these risks, for the treatment and management of their own patients and for those patients who may be treated outside the medical clinic environment that present for medical management of these AEs.

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A Practical Precaution Relevant to Facial Injections

Widgerow

2019

JAMA Facial Plast Surg

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Alopecia Following Deoxycholic Acid Treatment for Submental Adiposity

Cited by 18 publications

References 5 publications

Deoxycholic acid in the submental fat reduction: A review of properties, adverse effects, and complications

Deoxycholic acid in the submental fat reduction: A review of properties, adverse effects, and complications

Uncommon Adverse Effects of Deoxycholic Acid Injection for Submental Fullness: Beyond the Clinical Trials

A Practical Precaution Relevant to Facial Injections

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