There are different hyaluronidases and this makes a difference. Allergy to hyaluronidase is not common and is estimated to occur in 0.1% of patients receiving hyaluronidase. Certainly if you have past history of reacting to hyaluronidase, you should be skin tested to determine if your allergy is a general one or limited to a specific type of hyaluronidsase. Some clinicians are concerned about the potential fro cross reacting when there is a history of bee sting allergy. You should know the literature on this subject is weak. If this is your concern, again skin testing can resolve this question. Vitrase is a hyaluronidase product that is derived from sheep , scientifically described as ovine. Again allergy is quite rare but some are sensitive to sheep proteins. In contrast Hylenex is a hyaluronidase that is genetically engineered from human hyaluronidase, It is believed the incidence of reactions to this product are much less likely. Without the use of hyaluronidase to breakdown hyaluronic acid filler, these products likely persist for decades . There really is no alternative for the use of hyaluronidase.
