# Xanthelasma‐Like Reaction Following Poly‐L‐Lactic Acid Intradermal Injection Managed With Fractional Non‐Ablative Lasers and Stem Cell‐Derived Conditioned Media: A Case Report

## TL;DR

A rare skin reaction after a collagen stimulator injection was successfully treated with lasers and stem cell media.

## Contribution

A staged treatment using non-ablative lasers and stem cell-derived media for a rare xanthelasma-like reaction is presented.

## Key findings

- Partial improvement was observed after initial fractional laser treatment.
- Combination laser therapy with stem cell media led to marked lesion flattening and reduced redness.
- Improvement was sustained at four-month follow-up.

## Abstract

Xanthelasma‐like periocular plaques are rare adverse reactions following injectable collagen stimulators and may be challenging to manage in cosmetically sensitive areas.

To describe a rare xanthelasma‐like reaction after polymer‐based collagen stimulator (poly‐L‐lactic acid or poly‐D,L‐lactic acid) intradermal injection and its management using fractional non‐ablative lasers and stem cell‐derived conditioned media.

A 49‐year‐old woman with Fitzpatrick skin type IV developed bilateral infraorbital yellowish plaques (~1 × 2 cm) approximately two weeks after a collagen stimulator injection and presented four months later with persistent lesions, after showing minimal response to a prior 577‐nm yellow laser treatment performed at another clinic. Our first treatment approach consisted of a fractional 1550‐nm erbium glass laser combined with intralesional 0.9% sodium chloride and a short course of oral corticosteroids. A subsequent session incorporated combined fractional 1550‐nm erbium glass and 1450‐nm diode lasers, followed by intradermal stem cell‐derived conditioned media.

Partial improvement was observed after the initial treatment. Further improvement was achieved following combination laser therapy with adjunctive stem cell‐derived conditioned media, with marked lesion flattening and reduced erythema within two months and sustained improvement at four‐month follow‐up.

This case highlights a rare xanthelasma‐like reaction following polymer‐based collagen stimulator injection and demonstrates that a staged, non‐ablative fractional laser approach with adjunctive stem cell‐derived conditioned media may be an effective and minimally invasive management option.