Hi AlexisMost hyaluronic acid products are developed by culturing the product in various strains of streptococcus, including streptococcus equi, which is a benign bacteria. Many modern day pharmaceuticals are made in this fashion in various bacteria, like insulin. The incidence of allergy to these products is low, and while most people have been exposed to various types of streptococcus bacteria and their proteins, the likelihood of prior infection predisposing to this allergy is very low. I have used Juvederm since it first came out around 2006 and I have only twice seen a hypersensitivity, and those happened all before 2008. The reactions were very mild and no therapy was needed.