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Deoxycholic Acid

Deoxycholic acid is a bile acid which emulsifies and solubilizes fats. When injected subcutaneously, it disrupts cell membranes in adipocytes and destroys fat cells in that tissue. Deoxycholic acid is approved by the FDA for the treatment submental (under the chin) fat to improve aesthetic appearance and reduce facial fullness or convexity.

Deoxycholic acid has been commonly used in injectable treatments like mesotherapy for many years.

Mesotherapy, or Lipodissolve, is a technique that employs localized micro-injections of phosphatidylcholine (PC) with deoxycholic acid (DC) to remove subcutaneous fat from targeted areas by targeting receptors on fat cell surfaces which cause lipogenesis (fat production) and lipolysis (fat breakdown). Thousands of physicians utilize these treatments for reduction of cellulite, localized fat spot reduction, and skin rejuvenation.

Around 2004 a standard formula of phosphatidylcholine (PC) with deoxycholate (DC) emerged and has been adopted by the American Society of Aesthetic LipoDissolve in the United States. Since then, several hundred physicians in the United States have treated thousands of patients. Fat reduction and smooth skin retraction are dual goals of treatment.

Deoxycholic acid is also the primary ingredient of Kybella, an FDA-approved injectable treatment for dissolving fat under the chin.

These injectable treatments are very effective however aren’t without their costs. Injections must be spaced out by 4-8 weeks and patients are usually left with bruises at the site of the injection. Studies have found that 5-11% of patients discontinue treatment because of adverse side effects.

For these reasons, patients may prefer a topical form of deoxycholic acid which utilizes a liposomal delivery system for optimal dermal penetration.

References:
Logan, I. (2017). Deoxycholic acid in the treatment of submental fat. DermNet NZ. Retrieved from: https://www.dermnetnz.org/topic/deoxycholic-acid-in-the-treatment-of-submental-fat/
Shridharani S. M. (2017). Early Experience in 100 Consecutive Patients With Injection Adipocytolysis for Neck Contouring With ATX-101 (Deoxycholic Acid). Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]43(7), 950–958. https://doi.org/10.1097/DSS.0000000000001133
Wollina, U., & Goldman, A. (2015). ATX-101 for reduction of submental fat. Expert opinion on pharmacotherapy16(5), 755–762. https://doi.org/10.1517/14656566.2015.1019465
Ascher, B., Hoffmann, K., Walker, P., Lippert, S., Wollina, U., & Havlickova, B. (2014). Efficacy, patient-reported outcomes and safety profile of ATX-101 (deoxycholic acid), an injectable drug for the reduction of unwanted submental fat: results from a phase III, randomized, placebo-controlled study. Journal of the European Academy of Dermatology and Venereology : JEADV28(12), 1707–1715. https://doi.org/10.1111/jdv.12377

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