What is Deoxycholic Acid: Uses, Dosage, Side Effects and More

Deoxycholic acid is a prescription medication designed to reduce stubborn fat deposits under your chin, commonly called a "double chin." This naturally occurring bile acid works by breaking down fat cells in targeted areas where diet and exercise haven't been effective.

The treatment involves a series of injections given directly into the fat beneath your chin. Many people find this option appealing because it offers a non-surgical way to address something that might make them feel self-conscious about their appearance.

What is Deoxycholic Acid?

Deoxycholic acid is a synthetic version of a substance your body naturally produces to help digest fats. When injected under your skin, it destroys fat cells permanently by breaking down their outer walls.

Your body already makes this acid in your liver as part of bile, which helps you digest fatty foods. The injectable form is concentrated and purified specifically for cosmetic use. Once the fat cells are destroyed, your body naturally processes and eliminates them over several weeks.

This medication received FDA approval specifically for treating submental fat, the technical term for excess fat under the chin. The treatment is considered a minimally invasive cosmetic procedure that doesn't require surgery or general anesthesia.

What is Deoxycholic Acid Used For?

Deoxycholic acid treats moderate to severe submental fat in adults. This means it's specifically designed for people who have noticeable fat deposits under their chin that create a "double chin" appearance.

The medication works best for people who have good skin elasticity and whose double chin is primarily due to fat rather than loose skin. Your doctor will evaluate whether you're a good candidate based on the amount of fat present and your skin's condition.

Currently, this is the only FDA-approved use for injectable deoxycholic acid. While some practitioners might discuss off-label uses for other small fat deposits, the safety and effectiveness have only been proven for submental fat reduction.

How Does Deoxycholic Acid Work?

Deoxycholic acid works by destroying fat cell membranes, causing the cells to break down and die. This process is called cytolysis, and it's permanent - once these fat cells are gone, they cannot regenerate.

When injected into the fat layer under your chin, the medication targets only the fat cells while leaving other tissues largely unaffected. Your body's natural cleanup system then removes the destroyed fat cells through your lymphatic system over the following weeks.

The treatment is considered moderately strong because it permanently destroys tissue. However, it's also precise - the effects are limited to the injection area, making it a targeted approach rather than a systemic medication that affects your entire body.

How Should I Take Deoxycholic Acid?

Deoxycholic acid is only administered by a qualified healthcare provider in a clinical setting. You cannot take this medication at home - it requires professional injection technique and medical supervision.

The procedure typically takes about 15-20 minutes per session. Your doctor will mark the injection sites under your chin and use a very fine needle to inject small amounts of the medication into multiple points across the treatment area.

You don't need to fast before treatment, but it's wise to eat a light meal beforehand since some people feel lightheaded during the procedure. Avoid alcohol for 24 hours before treatment, as it can increase swelling and bruising risk.

Most people receive treatments every 4-6 weeks. Your doctor will space sessions apart to allow swelling to subside and to assess your progress before the next treatment.

How Long Should I Take Deoxycholic Acid For?

Most people need 2-4 treatment sessions spaced about a month apart to achieve their desired results. The exact number depends on how much fat you're starting with and your individual response to the medication.

Each treatment session builds on the previous one, gradually reducing the fat layer under your chin. Your doctor will evaluate your progress after each session and determine whether additional treatments would be beneficial.

Once you've completed your treatment series, the results are permanent. The destroyed fat cells cannot return, so you won't need ongoing maintenance injections. However, significant weight gain could cause remaining fat cells to enlarge.

What Are the Side Effects of Deoxycholic Acid?

Side effects from deoxycholic acid are very common and expected as part of the treatment process. Nearly everyone experiences some degree of swelling, bruising, and tenderness at the injection sites.

Here are the most common side effects you might experience, and understanding them can help you prepare for what's normal during recovery:

• Swelling: This is the most universal side effect, often making your chin and neck area look puffy for 1-2 weeks
• Bruising: Purple or yellow discoloration around injection sites, typically lasting 5-10 days
• Pain and tenderness: Soreness that feels like you've been pinched, usually mild to moderate
• Numbness: Temporary loss of sensation under your chin, which can last several weeks
• Redness: Pink or red appearance at injection sites that fades within a few days
• Firmness: The treated area may feel hard or lumpy as your body processes the destroyed fat cells

These common effects are actually signs that the medication is working as intended. They're temporary and part of your body's natural healing response.

More serious but rare side effects can occur, though they're uncommon when the treatment is performed by an experienced provider:

• Nerve injury: Very rarely, the facial nerve could be affected, causing temporary weakness in your smile
• Difficulty swallowing: Extremely rare but serious, this would require immediate medical attention
• Severe allergic reactions: Signs include difficulty breathing, widespread rash, or throat swelling
• Skin ulceration: If medication is injected too superficially, it could cause skin breakdown
• Uneven fat removal: Rarely, results might be asymmetric, requiring additional treatments

If you experience any severe symptoms or anything that seems unusual, contact your healthcare provider immediately. Most side effects resolve completely within 2-4 weeks.

Who Should Not Take Deoxycholic Acid?

Deoxycholic acid isn't appropriate for everyone, and your doctor will carefully evaluate whether you're a good candidate. People with certain medical conditions or circumstances should avoid this treatment.

You should not receive deoxycholic acid injections if you have any of these conditions or situations:

• Infection at the injection site: Any active skin infection under your chin needs to heal first
• Pregnancy or breastfeeding: The safety hasn't been established for pregnant or nursing women
• Bleeding disorders: Conditions that affect blood clotting increase risks of severe bruising
• Previous bad reactions: If you've had serious side effects from deoxycholic acid before
• Unrealistic expectations: If you're hoping for dramatic weight loss rather than targeted fat reduction

Your doctor will also be cautious if you have certain other conditions that might increase your risk of complications:

• Autoimmune conditions: Diseases affecting your immune system might alter healing
• History of keloid scars: You might be more prone to unusual scarring responses
• Significant loose skin: The treatment works on fat, not sagging skin
• Very minimal fat deposits: If there's not enough fat to treat, results will be disappointing

Your healthcare provider will discuss your medical history thoroughly to ensure this treatment is safe and appropriate for your specific situation.

Deoxycholic Acid Brand Names

The most well-known brand name for deoxycholic acid is Kybella, which is the original FDA-approved version. This brand is manufactured by Allergan and is widely available at dermatology and plastic surgery practices.

Kybella has been on the market since 2015 and has the most extensive clinical trial data supporting its safety and effectiveness. Most insurance plans consider it a cosmetic procedure, so it's typically not covered.

Some other formulations of deoxycholic acid may be available, but Kybella remains the gold standard with the most proven track record. When discussing treatment options, make sure to ask specifically which brand your provider uses and why they prefer it.

Deoxycholic Acid Alternatives

If deoxycholic acid isn't right for you, several other options exist for reducing submental fat. Each approach has different benefits, risks, and recovery requirements.

Here are the main alternatives your doctor might discuss with you, each offering different advantages depending on your specific situation:

• CoolSculpting: Freezes fat cells without injections, but requires multiple sessions and gradual results
• Radiofrequency treatments: Uses heat energy to reduce fat and tighten skin simultaneously
• Ultrasound therapy: Focused ultrasound energy targets fat cells non-invasively
• Liposuction: Surgical removal of fat that provides immediate, dramatic results
• Neck lift surgery: Addresses both fat and loose skin for comprehensive improvement

Non-invasive alternatives typically require more treatment sessions but involve less downtime. Surgical options provide more dramatic results but require recovery time and carry surgical risks.

The best choice depends on your specific anatomy, goals, budget, and comfort level with different types of procedures. Your doctor can help you weigh these factors to make the right decision.

Is Deoxycholic Acid Better Than CoolSculpting?

Both deoxycholic acid and CoolSculpting can effectively reduce submental fat, but they work differently and suit different people. Neither is universally "better" - the right choice depends on your specific situation and preferences.

Deoxycholic acid offers more precise control and typically requires fewer sessions (2-4 treatments versus 2-6 for CoolSculpting). The results tend to be more predictable, and your doctor can adjust the treatment area more precisely during each session.

CoolSculpting involves no needles and causes less acute swelling, making it appealing for people who want to avoid injections. However, it takes longer to see results and may require more treatment sessions to achieve the same level of fat reduction.

Recovery differs significantly between the two. Deoxycholic acid causes noticeable swelling for 1-2 weeks, while CoolSculpting typically involves milder, shorter-lasting effects. Your tolerance for downtime might influence your choice.

Cost considerations vary by location and provider, but both treatments are generally comparable in total investment. The number of sessions needed with each approach will affect your final costs.