Vascular Injury After Deoxycholic Acid Injection

McKay, Cather; Price, Cynthia; Pruett, Lisa

doi:10.1097/00042728-900000000-98738

Cited by 2 publications

(6 citation statements)

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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%

“…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][24][25][26][27][29][30][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 As deoxycholic acid is a relatively new drug for cosmetic submental fat, case reports are useful in the qualitative detection of new reactions which may be caused by the substance and, therefore, be monitored in subsequent studies.…”

Section: Discussionmentioning

confidence: 99%

“…Inadvertent intra‐arterial injection of DCA, with consequent skin necrosis, is a severe complications that have also been described in literature 25–27 . The mechanism of damage from intravascular injection of DCA is unknown; however, DCA has vasoconstrictive properties and cause disruption of the cell membrane with cell lysis, cell death, and tissue inflammation 26 .…”

Section: Application Methods and Adverse Reactionsmentioning

confidence: 96%

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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: Discussionmentioning

confidence: 99%

Section: Application Methods and Adverse Reactionsmentioning

confidence: 96%

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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“…Vascular injuries or skin necrosis have been reported after deoxycholic acid treatment in 4 case reports. [17][18][19][20] Riswold and Flynn reported a 37-year-old woman who received 2 deoxycholic acid treatments 3 months apart. 17 During her second visit, a deoxycholic acid injection caused pain and a white blanch, which ran lateral and upward from the injection site.…”

Section: Vascular Injury and Skin Necrosismentioning

confidence: 99%

“…McKay et al reported 2 patients who experienced a vascular injury following treatment. 18 The first patient was a woman in her 20s who received a number of 0.2 mL injections. The procedure was well tolerated until an injection inserted at the midline caused her to experience immediate pain and to develop immediate blanching extending from the neck to the lower mucosal lip.…”

Section: Vascular Injury and Skin Necrosismentioning

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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Vascular Injury After Deoxycholic Acid Injection

Cited by 2 publications

References 0 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

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