After the treatment of hyaluronidase, one should avoid physical pressure, strenuous exercise, alcohol, anti-inflammatory drugs, sun and heat exposure, and other cosmetic treatments for smooth skin recovery and to get the maximum effect of the treatment.
Avoid Physical Pressure
For some time following the administration of this enzyme, one should avoid applying any kind of physical pressure on the site of treatment. Patients should avoid rubbing, massaging, or squeezing the site of treatment, especially the face, following injections, since this may interfere with the even breakdown of hyaluronic acid. This could result in uneven outcomes such as depressions or irregular skin texture.
From a biological point of view, the mechanism of action of hyaluronidase is to dissolve the hyaluronic acid injected into the skin. This process takes time, and the skin in the few days following the injection is in a sensitive state and thus highly susceptible to any pressure from outside. For the first 48 hours after the treatment, the patient should not do any activity that might put pressure on the treated area of the face, including sleeping positions that would allow the face to press against the pillow. Washing of the face is to be done with care and only with mild cleansers, avoiding the use of aggressive cleaning materials or manipulations.
Avoid Strenuous Exercise
Another thing to avoid is participation in strenuous workouts during the first 24 to 48 hours after the administration of hyaluronidase. This is essentially because heavy exercise increases the flow of blood, which may result in swelling and bruising at the site of treatment. When blood circulates at a faster rate, there is dilation of the vessels, thereby possibly increasing bruising, swelling, and discomfort at the site of treatment. Clinical studies have indicated that patients who undertook heavy exercise within 24 hours following the procedure tend to present skin redness and localized bruising more significantly than those who did not exercise.
Sweating during exercise can also affect the healing of the treated area. Salt from the sweat can cause skin irritations and create a possibility for infection. For the first two days after the injection, high-level exercises such as running, weightlifting, and high-intensity aerobic workouts should be avoided. If light physical activities like walking are necessary, they should be performed at a moderate pace, and excessive sweating should be avoided.
Avoid Alcohol and Anti-Inflammatory Drugs
Alcohol and anti-inflammatory drugs are also to be considered with caution within 48 hours after the injection of hyaluronidase. Alcohol dilates the blood vessels and may increase swelling and bruising at the treated area, delaying skin healing. Besides this, alcohol dehydrates the body, which would affect the skin cells’ ability for self-repair and may interfere with the effectiveness of hyaluronic acid breakdown.
Anti-inflammatory medications, such as aspirin and ibuprofen among other nonsteroidal anti-inflammatory medications, reduce inflammation, but minor inflammation at the injection site is part of the normal skin healing process after hyaluronidase administration. Taking anti-inflammatory medications too soon after treatment could impede that process, delaying a patient’s recovery time or perhaps even affecting the final result of the treatment. Various clinical studies have shown that patients who take anti-inflammatory drugs after the procedure are more likely to develop bruises and take longer to recover than those who do not use such drugs.
After the treatment, it is vital to avoid alcohol and anti-inflammatory drugs unless prescribed by a doctor. For pain relief, one can take acetaminophen; this drug has minimal negative effects on skin tissue.
Avoid Sun and Heat Exposure
Following the administration of hyaluronidase, the skin is very sensitive and tender, particularly to UV radiation and heat. In the days following treatment, try to minimize sun exposure, particularly around noon when UV radiation is highest. Ultraviolet rays can promote inflammation and may, in turn, lead to hyperpigmentation, especially in individuals prone to pigmentary changes.
It is also advisable to avoid heat exposure, as well as the sun. This includes saunas and steam baths, where the skin may be exposed to high temperatures and could lead to vasodilation, which increases swelling and discomfort. High temperatures can accelerate the metabolic breakdown of hyaluronic acid and thus could undermine the durability and efficacy of the treatment. Patients should ideally avoid such high-temperature environments for at least a week after treatment and keep the skin clean and cool.
It is worth noting that the skin, subsequent to hyaluronidase treatment, should be well-protected against the sun. Apart from physical protection—which involves the use of wide-brimmed hats and sunglasses—the application of broad-spectrum sunscreen will be quite essential too. Application of sunscreen acts as a protective agent for the skin against damage by UV radiation, and at the same time, it contributes to minimizing the risk of hyperpigmentation following the treatment.
Avoid Other Cosmetic Treatments
Other aesthetic treatments are avoided for two weeks following the hyaluronidase treatment; this includes those that might further cause irritation to the skin, like microneedling, laser treatments, or radiofrequency therapy. The breakdown of hyaluronic acid takes time, and intervention with other aesthetic treatments may interfere with this breakdown process, resulting in an adverse reaction or complication.
Microneedling works by creating a series of micro-lesions in the skin, which then stimulate an increase in the production of collagen. Microneedling used on freshly hyaluronidase-treated skin may induce secondary injury. Inflammation, redness, or even infection can be expected. Other heat-based treatments, such as laser and radiofrequency, act through heat transfer to deeper tissues of the skin. However, high temperatures would also influence hyaluronidase metabolism and rapidly degrade the drug at the site of treatment, reducing the effectiveness of such treatments.
For other cosmetic treatments that may be necessary for patients, at least two weeks should be given to ensure the skin is fully recovered before starting any other care or treatment. Patients needing further treatment should consult a professional doctor who will assess the skin condition and develop a proper treatment plan.
