• Chenyu Wang, Tianyu Sun, Nanze Yu, and Xiaojun Wang.
• Department of Plastic surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100730, China.
• Medicine (Baltimore). 2020 Jun 12; 99 (24): e20394.

IntroductionHyaluronic acid injections is relatively safe with little risk of complications. Although herpes reactivation after the injection of hyaluronic acid is rare, it produces quite a huge pressure and panic on patients. Quite a lot cosmetic practitioners have no awareness of preventing, diagnosing, and giving correct treatment in time due to lack of experience.Patient ConcernsA 24-year-old woman presented with erythema, crusted papules, pain and swelling on the nose after receiving the injection of hyaluronic acid. A swab of the discharge fluid was obtained for bacterial and viral culture, showing positive for herpes simplex virus.DiagnosisThe patient was diagnosed as herpes reactivation after the injection of hyaluronic acid.InterventionsThe patient underwent antiviral therapy with acyclovir 400 mg, 3 times daily for seven days.OutcomesAfter a week of antiviral treatment, the clinical signs improved.ConclusionHerpes reactivation after the injection of hyaluronic acid is quite rare but needed sufficient attention of cosmetic practitioners to make the proper diagnosis, prevention and treatment.

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