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Lydase is the Russian bovine testicular hyaluronidase preparation, injected to break down hyaluronic acid in scars and contractures and, off label, to dissolve dermal filler.
- Nothing else reverses a filler occlusion before tissue dies
- Breaks down hyaluronic acid in scars and contractures
- Spreads injected fluid through resistant tissue
- An important drug in a properly equipped clinic
- The Russian Lydase preparation, bovine testicular hyaluronidase
- Also used off label to dissolve dermal filler
- Hyaluronidase degrades hyaluronan, the glycosaminoglycan responsible for resistance to bulk fluid flow in the subcutaneous space, which is what limits large-volume subcutaneous delivery [1].
- Recombinant human PH20 (rHuPH20, Hylenex) is FDA-approved as a dispersion and absorption adjuvant and is co-formulated in subcutaneous trastuzumab and rituximab and dosed sequentially with immunoglobulin in HyQvia [1].
- The therapeutic window is short: enzyme activity in tissue diminishes within about 30 minutes, so timing matters more than total dose in emergencies [3].
- Biphasic fillers dissolve at lower concentrations than monophasic fillers, and direct injection into the filler mass beats surface application [3].
- Non-emergent complications take low or moderate doses, whereas vascular occlusion and blindness require immediate high-dose treatment, with retrobulbar versus supraorbital route still contested [2].
Mechanism
Hyaluronidase cleaves the glycosidic bonds of hyaluronic acid into glucosamine and glucuronic acid fragments, collapsing the viscosity of the ground substance so that fluid and injected drugs can spread through tissue that would otherwise hold them in place. The effect on intradermal administration lasts up to about two days.
receptor fingerprint
Hyaluronan (hyaluronic acid) in the extracellular matrixHydrolyses the beta-1,4 bond between N-acetylglucosamine and glucuronic acid, depolymerising the polymer and lowering interstitial viscosity
Interstitial resistance to bulk fluid flowDegrading hyaluronan removes the principal barrier limiting large-volume subcutaneous delivery
Cross-linked hyaluronic acid dermal filler gelDegrades injected filler; biphasic gels dissolve faster and at lower enzyme concentration than monophasic gels
IgE-mediated hypersensitivity (hymenoptera venom cross-reactivity)Hyaluronidase is a major allergen in bee and wasp venom, so venom-allergic patients face increased risk from ovine or bovine preparations
Safetyrisks and cautions, not medical advice
an injectable animal derived enzyme with documented anaphylaxis, and its popular off label use for dissolving dermal filler is a procedure that fails in ways a buyer cannot manage at home
Subjective profileweighing the evidence above
Nothing else reverses a filler occlusion before the tissue dies, which is both the entire case for hyaluronidase and the entire case against keeping it in a bathroom cupboard. It is an animal derived injectable enzyme with documented anaphylaxis, and a filler emergency is judged by how the skin looks over the following hour by somebody who has seen it before. In a clinic equipped to treat anaphylaxis this is an important drug; bought online for self-treatment it is the worst idea in aesthetics.
Where to buy
Suppliers
Vendors carrying Hyaluronidase, with live product details and codes. Links are affiliate links that support the wiki at no cost to you.
RUPharma🌐
Hyaluronidase
Research
- 2017first citedQuantitative Correlation Between Hyaluronic Acid Filler and Hyaluronidase.
- 2025most recentHow Should We Use Hyaluronidase for Dissolving Hyaluronic Acid Fillers?
- 1.ENHANZE drug delivery technology: a novel approach to subcutaneous administration using recombinant human hyaluronidase PH20.
- 2.Hyaluronidase for Dermal Filler Complications: Review of Applications and Dosage Recommendations.
- 3.How Should We Use Hyaluronidase for Dissolving Hyaluronic Acid Fillers?
- 4.Quantitative Correlation Between Hyaluronic Acid Filler and Hyaluronidase.
- 5.Guideline for the Safe Use of Hyaluronidase in Aesthetic Medicine, Including Modified High-dose Protocol.
5 listed here; entry last updated August 2026
Reviews
My notesprivate to this device
Notes and cautions
- The principal hazard is hypersensitivity: most products are ovine or bovine testicular extracts, and hyaluronidase is a major allergen in bee and wasp venom, so venom-allergic patients carry elevated risk and skin testing is reasonable in that group [5].
- Because it removes the diffusion barrier for co-injected drugs it accelerates their systemic absorption and toxicity, and it must never be injected into or around an infected or acutely inflamed site because it spreads infection.
- It also digests the patient's own dermal hyaluronan, so over-dosing an aesthetic correction produces visible volume loss taking months to recover.