Lumps or nodules
Raised areas that appear where the filler was injected.
Dr. Gustavo Suárez · Aesthetic medicine
Hyaluronidaseto dissolve a filler.
Hyaluronidase is an enzyme that breaks down hyaluronic acid. Its most common use is dissolving a hyaluronic acid filler that has caused problems or has produced an unsatisfactory result. It does not work on fillers made from other materials.
Request a consultation What is hyaluronidase?The treatment
An enzyme
that breaks down hyaluronic acid.
Hyaluronidase is an enzyme that breaks down hyaluronic acid. It is injected into the area containing the filler, and the body then eliminates the dissolved material. It can act on all of the filler or only part of it, such as a lump.
As the use of hyaluronic acid fillers has increased, so has its use to correct complications or unsatisfactory results. The AEMPS stresses that, when injected, it must be a medicinal product and must be administered by a qualified doctor.
The limitation
Hyaluronidase only dissolves hyaluronic acid. It does not dissolve a silicone filler or one made from another material.
The first step is therefore to establish what was injected. Removing a filler made from another material may require other procedures, and some materials are difficult or impossible to remove.
When it is considered
When reversing
a filler is considered.
Examination of the area helps assess whether all or only part of the filler should be dissolved in these situations.
Asymmetry or excess volume
An uneven result between the two sides or an unnatural-looking volume.
An unsatisfactory result
When the size, shape or appearance of the treated area is not satisfactory.
Infection
This is another situation in which its use is described.
A vascular complication
If the filler compromises circulation in a blood vessel, hyaluronidase forms part of the urgent response. This is why the AEMPS requires centres working with hyaluronic acid fillers to have it available.
The assessment
Before
dissolving.
The consultation reviews the previous filler: which product was used, where it was injected and what is unsatisfactory. Objectives and limitations are clarified, including when there have been previous treatments.
Allergies are reviewed, including previous reactions to hyaluronidase and bee or wasp stings. This history may require an allergy assessment before treatment. You should also mention smoking and medicines or supplements that increase bleeding, such as aspirin or fish oil.
Preparing for the initial consultationWhat the AEMPS requires
A medicine,
not a cosmetic.
Hyaluronidase is sold as both a cosmetic and a medicine, in very similar vials or ampoules. The AEMPS has detected cases in which the cosmetic product was injected, and published these recommendations in May 2025.
Only the medicinal product is injected
Cosmetic hyaluronidase may only be applied to the skin. Injecting it is not permitted and poses a serious health risk.
It is administered by a doctor
Hyaluronic acid fillers and injectable hyaluronidase must be administered by qualified doctors with specific training.
How it is obtained in Spain
No medicine containing hyaluronidase is registered in Spain. Centres can obtain it as a foreign medicine through the AEMPS; it should not be prepared as an individually compounded medicine.
Available wherever fillers are administered
A centre that uses hyaluronic acid fillers must have hyaluronidase available as a medicinal product to act immediately in the event of a complication.
Ask about the product
Always ask for information about the product that will be used.
Afterwards
Care and
risks.
After the injection
Swelling, bruising and tenderness may occur in the area and usually resolve on their own. With a large amount of filler or nodules, more than one session may be needed.
Reported risks
Allergic reactions, itching, pain, rash, skin colour changes and swelling may occur.
The enzyme also dissolves the area's own hyaluronic acid. This means the area may look thinner for a time, with fine lines or small indentations, until the body replenishes it.
During the consultation, after the medical assessment, these are explained individually according to each patient's characteristics.
When to seek urgent care
If there are signs of a severe allergic reaction: difficulty breathing or swallowing, wheezing, coughing, swelling of the eyelids, lips or tongue, nausea or abdominal pain.
Before deciding
Frequently asked
questions.
Questions from people who already have a filler and are considering dissolving it.
What is hyaluronidase and what is it used for?
It is an enzyme that breaks down hyaluronic acid. In aesthetic medicine, it is mainly used to dissolve a hyaluronic acid filler that has caused a complication or whose result is unsatisfactory.
What happens when hyaluronidase is administered?
The hyaluronic acid filler in the area breaks down and the body clears it. Swelling, bruising or tenderness may occur afterwards and usually resolve on their own. The enzyme also acts on the body's own hyaluronic acid, so the area may look thinner for a time.
Is hyaluronidase dangerous?
It can cause allergic reactions, sometimes severe. A previous reaction to hyaluronidase or bee or wasp stings must be reported before treatment. Suitability and precautions are assessed individually. AEMPS warns that cosmetic hyaluronidase must not be injected.
How is hyaluronidase injected?
It is injected with a fine needle into the area containing the filler; sometimes an anaesthetic cream is applied beforehand. The amount and method of administration depend on the filler and the area, and are decided by the doctor.
Can any filler be dissolved?
No. Only hyaluronic acid fillers. Silicone fillers and fillers made from other materials cannot be dissolved with hyaluronidase, and some are difficult or impossible to remove.
How long does hyaluronidase take to work?
Some of the effect may be noticeable soon, but the full result takes a little longer to become visible, and with a large amount of filler or nodules, more than one session may be needed. Specific timeframes are explained during the consultation.
Related procedures
Other treatments
in aesthetic medicine.
Dermal fillers
Injectable products that add volume and soften lines and folds. Most, such as hyaluronic acid, are temporary.
Botulinum toxin
A medicine that temporarily relaxes specific facial muscles to soften lines caused by facial expressions. It does not add volume.
Polynucleotides
Purified DNA fragments injected to improve skin quality. They are not used to correct volume.