I have a history of anaphylaxis to bee stings. Does this mean I can never have any dermal fillers?

Thank you for your question. An allergy to bee stings should not have any cross over to dermal fillers.  If there is concern, a very small test dose can be reasonable.  

The concern about using fillers if one is allergic to bee stings is whether it is safe to use  hyaluronidase.  The most common fillers (for example, Juvederm and Restylane) consist of hyaluronic acid.  These fillers can be dissolved, if needed, by injecting hyaluronidase into the area of the filler.  This makes these fillers safer, because they can be reversed in the event of a side effect or if there is a poor cosmetic result.  People who are allergic to bee stings may be allergic to hyaluronidase.  In clinical practice, the vast majority of people injected with fillers do not require hyaluronidase, because most people are happy with the results and side effects are rare.  If I were injecting fillers in a patient with a known allergy to bee stings, I would be conservative, with careful injection technique and using low volumes to begin with.  I would try to avoid hyaluronidase if at all possible and I would have epinephrine or an Epi-pen on hand if use of hyaluronidase was absolutely necessary.The other question is how severe is the bee sting allergy?  If there is a history of severe reaction or anaphylaxis, the risk is obviously higher.

i am not aware of a reason why someone sensitive to bees should  assume they would have a problem with juvederm injections. allergy to hyaluronic acid products is quite unusual.