Chinese hyaluronic acid: it's an alarm

Counterfeit hyaluronic acid: it's an alarm.  The Ministry of Health warns su un filler fabbricato in Cina. Che potrebbe già essere stato immesso sul mercato. Tutelarsi però è possibile. Ecco i consigli del Prof. Antonino di Pietro, dermatologo e Direttore dell’Istituto Dermoclinico Vita Cutis di Milano

by Antonella Rossi – o6/01/15 Vanity Fair.it

The crisis slows down consumption, but the world of beauty knows no downturn. Many have sensed the deal, offering cheap aesthetic medicine treatments, which often hide pitfalls.

The latest alarm comes directly from the Ministry of Health, which warns against the probable counterfeiting of a hyaluronic acid-based filler. The offending product is Juvederm Ultra 4. On some lots, manufactured in China, the words Science of Erjuvenation are reported, instead of the original Science of Rejuvenation (Allergan).

Non è un caso che si tratti proprio di un filler. I trattamenti a base di acido ialuronico sono i più praticati in Italia. Secondo alcuni dati diffusi dall’Aicpe, Associazione Italiana di Chirurgia Plastica ed Estetica, nel 2013 sono stati eseguiti 290mila trattamenti, una media di 800 al giorno. Ne abbiamo parlato con il Prof. Antonino di Pietro, dermatologo e Direttore dell’Istituto Dermoclinico Vita Cutis di Milano.

The alarm raised by the Ministry of Health is worrying. What is the offending filler used for?

«It is a resorbable hyauronic acid, used to fill wrinkles and create volume. It is also called cross-linked, because compared to natural hyaluronic acid it has the addition of chemical substances, the BDDEs, which thicken the acid molecules and slow down their absorption by the skin. This is why it lasts longer than natural acid».

And the pure one instead?

“This is also injected. It is more fluid and absorbs quickly, therefore not very effective for volumizing. However, it is ideal for regenerating purposes».

Hyaluronic acid is also present in many cosmetic creams. Is there anything to worry about?

«No, also because it is a less pure substance. It doesn't have the ability to stimulate collagen production like the acid it injects, because it stops at the surface. However, it is a good moisturizer, it retains a lot of water and releases it gradually ».

How is it possible that substances of this type are able to pass the controls that are on drugs?

"These are medical devices, they do not follow the same process as medicines, and therefore unfortunately it can happen".

What can the patient do to protect himself?

«Always ask for the coupon of the injected product. Contains serial number, lot, date, manufacturing location, and expiration date.

It is also important to have a record of your medical history.

«Certainly, also because when treatments of this type are carried out, it is good practice to always use the same acid in the future as well. Then it is essential to know what has been injected in case there should be reactions ».

What kind of consequences can a non-compliant product have?

“Infections and granulomas, abnormal swellings with pus. Once healed, they can leave unsightly scars.

How long does it usually take before you have a reaction like this?

"Depends. It can happen after a few hours or after a few weeks ».

What should be done in these cases?

«Ci si rivolge al proprio medico, che poi inoltrerà la denuncia alla Als o all’AIFA, l’Agenzia Italiana del Farmaco. È però difficile che una donna denunci».

Why?

“Often we don't feel like a victim but an accomplice. Guilt prevails, prompting the patient to keep it hidden until it passes. The cases that emerge are always too few.