Delayed Inflammatory Reactions to Hyaluronic Acid Fillers: A Case Series of Novel Associations

Herein, we describe cases of delayed immunologic reactions (DIRs) following HA-soft tissue augmentation fillers precipitated by triggers not previously described in the literature.  Patients: Case 1 describes a 57-year-old female with DIR to HA-filler following a motor vehicle accident in the marionette lines and nasolabial folds. Case 2 is a 54-year-old female who had a filler-related DIR following an episode of contact dermatitis shortly after laser resurfacing. Finally, in Case 3, we diagnosed a 54-year-old female with DIR to HA-filler on the hands following prolonged gardening without gloves.  Conclusion: DIRs are an important filler-related complication. Practitioners need to be aware of the variable clinical presentations and a wide array of triggers. Given that these may not always be preventable, it is important for patients to understand the risk of DIRs, albeit low. J Drugs Dermatol. 2025;24(1):101-103.    doi:10.36849/JDD.8468.