'Wrinkle fillers 'can give you arthritis' warn doctors', reads the headline in the Daily Mail today. It says that injections of polyalkylimide (PAI) a 'facial filler' used to 'improve the appearance of facial features such as lips, cheeks, forehead and lower facial lines between the nose and mouth' can be associated with severe allergic reactions, even months later. These PAI fillers provide a long-lasting change to facial lines and are injected deeply under the skin. Temporary fillers, such as hyaluronic acid, which are injected just below the skin surface, are more widely used in the UK.
The findings come from a Spanish study which looked at 25 patients who had side effects more than a year after having PAI injections; only one patient reported arthritis, most people had skin reactions near to the injection site. Although more severe side effects such as arthritis will be relatively rare, people thinking about having filler injections should be aware that there may be side effects and should discuss these with their doctor before deciding whether to have the procedure.
Where did the story come from?
Dr Jaume Alijotas-Reig and colleagues from Vall d Hebron University Hospital and research centres in Spain carried out this research. The study was funded partly by the Spanish Society of Cosmetic Medicine and Surgery. It was published in the peer-reviewed medical journal: Archives of Dermatology.
What kind of scientific study was this?
This was a prospective case series looking at people who had delayed adverse reactions to injections of a particular type of gel 'filler' polyalkylimide (PAI). This filler is mostly used in the face to reduce wrinkles (e.g. folds between the edges of the nose and mouth, lips, cheeks, between the eyebrows, jaw), but it can also be used elsewhere (e.g. thighs and buttocks). The researchers report that it is the one of the most commonly used fillers in Europe. Immune reactions have been described with other types of filler, but they have not yet been described with PAI.
Between January 2001 and December 2006, the researchers asked members of the Spanish Society of Cosmetic Medicine and Surgery to refer all patients who had intermediate or delayed adverse effects associated with cosmetic implant fillers. Patients had to show at least one of the following reactions: swelling, welts under the skin, hardening of the skin, nodules under the skin with or without seepage of pus or filler material, fever, pain in the joints, arthritis, dry eyes or mouth, skin lesions or other clinical complaints. Intermediate effects occurred between one and 12 months after the implant and delayed effects occurred after a year. Of the 136 patients who met the inclusion criteria, the researchers selected the 25 patients with delayed adverse effects related to PAI.
