Hyaluronic Acid Filler Injections Under the Metatarsal Heads Provide a Significant and Long-Lasting Improvement in Metatarsalgia From Wearing High-Heeled Shoes

BACKGROUND Metatarsalgia is a common overuse injury that may be caused by wearing high-heeled shoes. OBJECTIVE To evaluate the decrease in metatarsalgia using a hyaluronic acid dermal filler. METHODS A 6-month, open study was conducted in 15 subjects with metatarsalgia because of regularly wearing high-heeled shoes. Hyaluronic acid (20 mg/mL) with lidocaine hydrochloride (3 mg/mL) was injected under the metatarsal heads at baseline. Pain (on a 0–10 scale) under the metatarsal heads when walking in high heels was recorded in a weekly subject diary. RESULTS At 6 months after injections, 5 subjects (33.3%) reported no metatarsalgia pain. For subjects with pain, they were able to wear high heels for significantly longer than before the injections (7.2 hours at 6 months vs 3.4 hours at baseline). Significant improvements from baseline were observed at Month 6 for time to onset of pain (3.5 hours longer), time between onset of pain and intolerable pain (1.9 hours longer), and pain sensation (−2.2 grades at onset and −3.8 grades at shoe removal). No adverse events were reported. CONCLUSION Injection of hyaluronic acid filler to the forefeet provided a significant effective, long-lasting, and well-tolerated improvement in metatarsalgia because of wearing high-heeled shoes. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Address correspondence and reprint requests to: Jean Paul Foumenteze, MD, Private Practice, 19 rue des Serbes, 06400 Cannes, France, or e-mail: drjpfoumenteze@hotmail.fr Supported by Galderma R&D. J.P. Foumenteze received a grant for conducting the study. N. Kerrouche and H. Simpson are employees of Galderma R&D. © 2018 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.

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