How PDO Threads Break Down in the Skin

A 2019 case report looked at a woman who had problems after superficially placed PDO threads, along with a simple laboratory test of how a thread behaves when soaked in hyaluronic acid. The authors observed the thread loosening and fraying within three days in the lab and suggested hyaluronic acid might speed up thread breakdown. It is an early, single-case observation, not proof of a treatment, but it is a useful window into how these threads dissolve.

How PDO threads normally dissolve

Polydioxanone (PDO) is the same material used for some dissolvable surgical stitches. In the body, it breaks down mainly through a process called hydrolysis: water gradually works its way into the thread and splits the long chains that hold it together. Over a period of months the thread weakens, fragments and is cleared, while the body forms a thin layer of new collagen around it.

That slow breakdown is part of why threads give support for a while and then fade. It also means a thread placed too close to the surface can stay visible or palpable until it dissolves. Our article on PDO thread types explains how threads differ in thickness and design.

What the researchers did

The report followed a 36-year-old woman who developed swelling, bruising, a palpable thread, skin folds and dimpling about a day after barbed PDO threads were placed too superficially in her midface. The treating team injected a small amount of non-cross-linked hyaluronic acid along the affected area, repeated twice over the next six weeks, alongside a short course of anti-inflammatory medication.

Separately, they placed a 1 cm piece of PDO thread in undiluted hyaluronic acid at body temperature and examined it under a microscope at 24, 48 and 72 hours.

What they found

In the lab test, the thread began to take up fluid within a day. By 48 hours, gaps had opened between its layers and some fibres had broken. By 72 hours the core was largely hollowed out and the outer fibres frayed.

In the patient, the authors reported that swelling eased first, followed by fewer and shallower folds and irregularities. They did not use a scoring scale or measurements, and no tissue samples were taken.

The authors concluded that non-cross-linked hyaluronic acid may act as a catalyst for PDO breakdown, and that it might be worth considering for problems caused by threads placed too close to the surface. They also acknowledge there is no scientific evidence yet supporting this as a general practice.

What affects how fast threads dissolve?

Several factors are generally thought to influence how long a PDO thread lasts in the skin. Thicker threads and those with more barbs or a more complex design contain more material and tend to take longer to break down. The depth of placement matters too, since tissue with a richer blood supply and more fluid may speed up hydrolysis. Individual differences in metabolism, skin type and activity also play a part, which is one reason results and their duration vary from person to person. The thin collagen layer that forms around a thread is part of normal healing and can persist after the thread itself is gone.

How strong is this evidence?

This combines a single case report with a single laboratory sample, which is about as preliminary as evidence gets. Key limits include:

• One patient, no comparison. Swelling and dimpling after threads often improve on their own over weeks, so the improvement may not be due to the hyaluronic acid.
• Other treatment at the same time. The patient also took anti-inflammatory medication.
• No tissue findings. No biopsy was done, so changes inside the skin were not observed.
• Lab conditions differ from skin. A thread sitting in undiluted gel is not the same as a thread inside living tissue, and only one sample was tested.

The report is best read as a hypothesis for future research, not as a recommended fix.

What it means for you

For patients, the most practical takeaway is about the normal life of a thread rather than the experimental treatment. PDO threads are designed to dissolve gradually over months, and early lumps, folds and dimples often settle as swelling goes down and tissue adjusts. When they do not, options such as gentle repositioning, massage or removal of a problem thread are commonly used.

Using hyaluronic acid to speed up thread breakdown remains a research idea. It should not be assumed to work, and patients should not seek out products or injections from unregulated sources in the hope of dissolving threads. The availability and authorization of any product for a given use can vary, so decisions belong with a qualified physician who can examine you.

If you are considering threads, our overview of PDO thread complications covers what can go wrong and how it is managed.

Warning signs to report

Contact your clinic promptly for a thread you can see or feel poking through the skin, folds or dimples that are worsening, or increasing redness, warmth, pain or discharge. Seek urgent care for facial weakness, fever or rapidly spreading swelling.

Questions to ask at your consultation

• How long do the threads you use take to dissolve?
• What would you do if a thread became visible or caused a dimple?
• Is a thread lift right for my skin, or would another approach suit me better?

Frequently asked questions

How long do PDO threads last?

PDO threads usually dissolve over several months. Any lifting effect tends to fade gradually, and results vary from person to person.

Can hyaluronic acid filler dissolve my threads?

This report raised the idea, but it is unproven. It involved a different, non-cross-linked form of hyaluronic acid, one patient and one lab sample.

Is a visible thread dangerous?

Usually not, but a thread that breaks through the skin can let bacteria in, so it should be assessed and often removed by a clinician.

If you have questions about thread lifts or concerns after one, HealthPark Medical Aesthetics can explain your options, the risks involved, and whether treatment suits you at all.

Source

Suárez-Vega D, Velazco de Maldonado G, García-Guevara V, Miller-Kobisher B, Morena-López K. Microscopic and clinical evidence of the degradation of polydioxanone lifting threads in the presence of hyaluronic acid: a case report. Medwave, 2019. Read the study