Hyalase in Dermatology: Applications Beyond Filler Management.

BACKGROUND

Hyaluronic acid (HA) is a key extracellular matrix component in the skin. Hyaluronidase is an enzyme that breaks down HA into monosaccharides. The FDA has approved this enzyme for hypodermoclysis, drug absorption enhancement, and subcutaneous urography. The most common application of this enzyme is the dissolution of HA fillers.

AIM: This study aimed to explore the various applications of hyaluronidase beyond its common medical uses. Moreover, we illustrate the mechanism by which this enzyme is helpful in conditions such as drug extravasation, scleroderma, scleromyxedema, and keloids.

METHODS

A comprehensive review of hyaluronidase applications in medicine, with a specific focus on dermatology, was conducted using PubMed/MEDLINE, the Cochrane Library, and Embase. The conditions under which hyaluronidase was applied are discussed, and the protocols used for each condition are evaluated and summarized.

RESULTS

Hyaluronidase improves tissue permeability and enhances drug delivery. Therefore, it is beneficial for treating keloids, managing pain, and enhancing the distribution of chemotherapeutic agents within tumors. It is also useful for reducing fibrosis in scleroderma, scleromyxedema, and chronic GVHD. Hyaluronidase is considered a safe drug, and its adverse effects are infrequent.

CONCLUSION

Hyaluronidase has the potential to be useful for various medical and dermatological conditions. Further research is required to fill existing gaps and establish standardized usage protocols.