Topical Tacrolimus in the Treatment of Bovine Collagen Hypersensitivity

Abstract

Topical tacrolimus may be a useful first-line or adjuvant therapy in the management of bovine collagen allergic reactions. Further clinical experience with its use for bovine collagen hypersensitivity is required to determine its true efficacy in this condition.

Adverse reactions to injectable soft tissue fillers

“…14,15,28 Allergic reactions to bovine collagen may be treated with topical, intralesional, or a brief course of systemic corticosteroids, and there are also reports of patients who have been successfully treated with oral cyclosporine 33 or topical tacrolimus. 34,35 Zyderm I is used for correction of superficial wrinkles, whereas Zyderm II is more effective in moderate to deep wrinkles, and both of them should be injected in the superficial dermis. In contrast, Zyplast works best when placed at the mid-dermis and is more valuable in treating deeper lines, such as nasolabial folds, deep acne scars, and lip augmentation through injection in the vermillion border.…”

The Current State of Treatment of Adverse Reactions to Injectable Fillers

“…A medium‐dose pulse therapy (e.g., 240 mg (60/60/40/40/20/20 mg) of methylprednisolone weekly) was performed in most participants. The interval was extended by approximately 1 week after each treatment cycle 13 . Sustained success is usually achieved after six treatment cycles.…”

“…Cohen and colleagues 13,33 report beneficial effects for treatment of localized adverse reactions with tacrolimus (e.g., after collagen injection). Twice‐daily application for 3 to 6 weeks is recommended.…”

“…The physicians' options are the following: monitoring the participant without any treatment, conservative treatment (applied orally, intralesionally, or topically), surgical (incision, excision), or a combination of conservative and surgical therapy. As of March 16, 2009, there were no randomized controlled trials, only small case series and case reports (25 reports on 46 participants), in the Medline database 1–25 …”

Collagen fillers

“…Topical, intralesional, or a brief course of systemic corticosteroids may be used to treat these reactions. It has been reported that allergic reaction to bovine collagen may be treated with oral cyclosporine (22) or topical tacrolimus (23).…”