The pinhole method as a novel approach to remove residual hyaluronidase powder: a case report

Abstract

With the increasing use of hyaluronic acid (HA) fillers in aesthetic medicine, hyaluronidase has been widely used for the correction of HA fillers and the treatment of related complications. A 24-year-old female presented with a whitish papule beneath her right eye. She had previously undergone triamcinolone and HA filler injections with subsequent hyaluronidase treatment. Despite an initial suspicion of triamcinolone residue, observation revealed the persistence of the lesion. A single session of treatment with the pinhole method using a carbon dioxide laser successfully removed the residual hyaluronidase powder, without complications, and the lesion completely resolved after 7 months. By creating microscopic holes and inducing dermal remodeling, the pinhole method is effective in treating various skin lesions. This case highlights the importance of thorough mixing of hyaluronidase solutions and demonstrates the utility of the pinhole method in treating such cases, suggesting its broader applicability in dermatological interventions.