What are the risks of hyaluronidase?

Hyaluronidase is officially approved by the FDA to improve the dispersion and absorption of other drugs, such as anesthetic agents. The use of hyaluronidase to reverse hyaluronic acid fillers such as Restylane, Juvederm, or Perlane, while safe and effective, is not officially approved by the FDA and thus is considered an off-labelled indication. Ideally, allergy testing should be performed along an inner forearm area and observed for 24-48 hours to minimize risk of very unlikely chance of allergic reaction.

The use of hyaluronidase to dissolve hyaluronic acid dermal fillers is very effective and safe. Although its use in this manner is not FDA-approved, this off-label use is very acceptable and beneficial. In fact, using HA dermal fillers anywhere besides the laugh lines (nasolabial folds) is also considered off-label but considered a standard of practice. We know of no adverse events as those suggested in the question.

Hyaluronidase is great at smoothing down bumps from Juvederm or Restylane but may take a few weekly injections and doesn't affect the normal skin at all so it has no permanent problems with regular use.