Subcutaneous immunoglobulin therapy (Subcutaneous immunoglobulin replacement therapy (SCIG))

A treatment that replaces missing antibodies through a needle under the skin, often given by the patient at home, to reduce serious infections in people with certain immune deficiencies.

✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review

In short

SCIG replaces missing antibodies through a needle under the skin, usually weekly and often self-given at home after training, to reduce serious infections.
It is a human blood product made from many donors; the risk of passing on infection is very low but not zero, and consent should cover sourcing, safety and alternatives.
Compared with IVIG, it usually causes fewer whole-body reactions but more reactions at the injection site, and it suits people who prefer home treatment or have difficult veins.
It reduces but does not abolish infections and does not cure the underlying condition; for many people it is lifelong and needs regular review.

A plain-English summary. The detail — including risks and recovery — is below.

At a glance

TypeRegular under-the-skin infusion of a human blood product

AnaestheticNot needed

How long it takesOften under an hour per session; depends on the method and dose

Hospital stayUsually no hospital stay — commonly self-given at home after training

Time off workUsually minimal; many people fit it around daily life

When you'll see resultsFewer and less severe infections build up over months; antibody (IgG) levels are checked to guide dosing

On the NHS?Provided on the NHS for approved indications under the national immunoglobulin programme; private provision exists but supply is managed

A general guide. Your specialist will give you advice for your situation.

Best fit

Replaces antibodies the body cannot make, reducing the number and severity of infections

Pause if

Conditions where immunoglobulin has no proven benefit — it should not be used for unproven indications, given it is a limited blood product.

Main recovery point

You give the immunoglobulin under the skin. Some swelling, redness or itching at the site is normal and is not usually a cause for concern.

Good aftercare

Thorough training and a named contact for reactions, site problems and new infections.

During the session

You give the immunoglobulin under the skin. Some swelling, redness or itching at the site is normal and is not...

First few hours

Local swelling and redness settle as the immunoglobulin is absorbed. A firm lump may take a little longer to...

Each week (or each cycle)

Sessions are repeated regularly — often weekly for standard SCIG, or closer to monthly for facilitated SCIG —...

First weeks

You build confidence with the technique, and the dose and timing are checked against your antibody levels and how...

Medical line illustration of iv infusion treatment for Subcutaneous immunoglobulin therapy. — Illustration only - not a diagnosis, medical advice or a promise of result. Your anatomy and treatment plan may differ. Vuemedics does not publish before-and-after photos.

What is subcutaneous immunoglobulin therapy (SCIG)?

Subcutaneous immunoglobulin therapy gives a person the antibodies (immunoglobulins) their own immune system cannot make enough of, through a small needle into the fatty layer just under the skin — usually in the tummy or thigh. Antibodies are proteins that help fight infection. Because smaller amounts are given more often than with a drip into a vein, this route is usually used weekly, or sometimes every couple of weeks, and is often given by the patient at home after training.

Like the intravenous form (IVIG), immunoglobulin is a human blood product. It is made from plasma pooled from thousands of blood donors and goes through careful steps to reduce — but never entirely remove — the theoretical risk of passing on infection. In the UK, plasma for these medicines has historically been imported because of concerns about variant CJD; sourcing and safety are taken very seriously, and your team should explain them.

A newer version, called facilitated SCIG (for example HyQvia), adds an enzyme that lets a larger amount be given less often — closer to monthly — through one site. Your team will explain which method suits you.

SCIG is used to replace missing antibodies in people with certain primary (inherited) and secondary (acquired) immunodeficiencies, to reduce the number and severity of infections. It tends to cause fewer whole-body reactions than IVIG but more reactions at the injection site. It is not a cure for the underlying condition, it does not stop every infection, and for many people it is a lifelong treatment that needs regular review.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Standard (conventional) SCIG

Smaller doses given under the skin, usually weekly, often through one or more sites using a small pump or by hand. Many people learn to do this themselves at home.

Facilitated SCIG (fSCIG, for example HyQvia)

An enzyme (hyaluronidase) is given with the immunoglobulin so a larger volume can be absorbed from one site, allowing less frequent dosing — often closer to monthly.

Home self-administration

After training and assessment, many people give SCIG themselves at home, with support from a specialist nurse or homecare service and a plan for problems.

Nurse-supported administration

For those who prefer it or are not yet confident, infusions can be given or supervised by a nurse, at home or in a clinic, while skills and confidence build.

SCIG compared with IVIG

	SCIG (under the skin)	IVIG (into a vein)
How often	Often weekly (or monthly with fSCIG)	Usually every 3–4 weeks
Where	Usually self-given at home	Hospital, day unit or supervised home
Whole-body reactions	Less likely	More likely
Local site reactions	More common (swelling, redness)	Cannula site only

Neither is simply better. SCIG suits people who want home treatment, have difficult veins, or get reactions to IVIG; many people can switch between the two.

Preparing for your treatment

Make sure you understand why SCIG is recommended, what it can and cannot do, and that it is a human blood product — ask about sourcing and safety.
Tell your team about any previous reactions to infusions or blood products, and about IgA deficiency if known.
Mention all medicines and any skin conditions or problems with the planned injection sites.
Tell your team if you might be pregnant, are pregnant, or are breastfeeding.
Be ready to learn the technique: handling the equipment, choosing and rotating sites, and storing the product correctly.
Have any baseline blood tests done as requested, and be up to date with agreed vaccinations before starting where advised.
Set up a clean space at home for infusions and a safe way to store and dispose of equipment.

What happens

When starting SCIG, you are usually trained by a specialist nurse over one or more sessions. You learn to check the product and batch number (which should be recorded), prepare the immunoglobulin, choose a site such as the tummy or thigh, insert a small needle into the fatty layer under the skin, and give the dose using a pump or by hand.

With standard SCIG, smaller amounts are given regularly, often weekly, sometimes through more than one site. With facilitated SCIG, an enzyme is given first so a larger volume can be absorbed from a single site less often. Each session commonly takes under an hour, though this varies with the method and dose.

It is normal to have some swelling, redness or itching at the site, which usually settles over a few hours. Whole-body reactions are less common than with IVIG. Over the following weeks and months, your antibody (IgG) levels and how you feel guide the dose and timing. Once trained and confident, most people manage SCIG themselves at home with back-up from their team.

Is this treatment right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

May not be suitable if…

Conditions where immunoglobulin has no proven benefit — it should not be used for unproven indications, given it is a limited blood product.
People with severe IgA deficiency and antibodies to IgA may need special products and extra caution.
Someone who cannot safely manage the technique and has no nurse or carer support may not be suited to home self-administration.
A known severe reaction to immunoglobulin without a safe plan to manage it.

Delay or rearrange if…

You have an active severe infection or are acutely unwell, until reviewed by your team.
The planned injection sites are broken, infected or inflamed.
You are pregnant, may be pregnant, or are breastfeeding and this has not yet been discussed.
Baseline tests, training, consent or the right product and batch records are not yet in place.

Alternatives to discuss

Intravenous immunoglobulin (IVIG), if the under-the-skin route does not suit you.
Preventive antibiotics and vaccination, which may be enough in milder antibody deficiency.
Treating the underlying cause in secondary immunodeficiency, which may improve immunity.
Nurse-administered rather than self-administered SCIG if you are not confident.
No replacement if the criteria are not met, with regular review.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

What matters most to me?

Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.

What are all my options?

Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.

What would make me pause?

Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.

What happens if I do nothing today?

For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.

Benefits

Replaces antibodies the body cannot make, reducing the number and severity of infections
Usually causes fewer whole-body reactions than the intravenous route
Can be given at home, fitting around work and daily life
Avoids the need for repeated vein access, helpful when veins are difficult
Tends to keep antibody levels steadier between doses
Gives many people more control and independence over their treatment

Risks & complications

More common

Swelling, redness, itching or a firm lump at the injection site, usually settling within hours
Mild soreness or bruising where the needle goes in
Occasional headache, tiredness or aching
Needing to rotate sites and, at first, some trial and error with technique

Less common

A more troublesome local reaction, or sites that stay sore or lumpy
Leaking of fluid from the site
Mild whole-body symptoms such as fever or chills
With facilitated SCIG, more swelling because of the larger volume given

Rare but serious

A serious allergic reaction (more likely in people with severe IgA deficiency)
Blood clots, kidney problems, or breakdown of red blood cells (haemolysis), which are less commonly linked to SCIG than IVIG
Theoretical risk of a blood-borne infection, despite rigorous donor screening and viral-inactivation steps
Infection at an injection site if technique or hygiene is not followed

The main issues to discuss are that immunoglobulin is a pooled human blood product with a very low but not zero infection risk, that local site reactions are common (though usually mild), and that the treatment is often lifelong and depends on safe, consistent home technique. People with severe IgA deficiency need extra care. Make sure you know which product you receive, that the batch is recorded, how to look after your injection sites, and exactly what symptoms should prompt you to seek urgent help.

Published figures to discuss

Reaction rates vary between people, products and methods, and serious events are rare, so we describe risks honestly in words rather than giving precise percentages that could mislead. Local site reactions are common but usually mild; whole-body reactions are less common than with IVIG. The notes below are cautious and general.

Figure	Reported range	How to interpret it	Source / confidence
Local injection-site reactions (swelling, redness, itching, lump)	Common, especially early on	Usually mild and settle within hours; tend to lessen as the body gets used to treatment and with good site rotation.	Guide sourcesClinical context
Whole-body (systemic) reactions	Less common than with IVIG	One reason SCIG is chosen for people who react to intravenous infusions.	Guide sourcesClinical context
Severe allergic (anaphylactic) reaction	Rare	More likely in people with severe IgA deficiency and anti-IgA antibodies; needs a clear emergency plan.	Guide sourcesClinical context
Transmission of a blood-borne infection	No confirmed cases with modern viral-inactivated products, but not zero in theory	Donors are screened and manufacturing inactivates or removes viruses; product and batch are recorded for traceability.	Facilitated subcutaneous immunoglobulin (fSCIg) therapy — practical considerations (PMC)ncbi.nlm.nih.govSource-linked context

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

There is no surgical recovery. Each session is usually short and most people carry on with their day. 'Afterwards' is mainly about caring for the injection site, watching for reactions, and judging over months whether infections are reducing.

During the session

You give the immunoglobulin under the skin. Some swelling, redness or itching at the site is normal and is not usually a cause for concern.

First few hours

Local swelling and redness settle as the immunoglobulin is absorbed. A firm lump may take a little longer to soften.

Each week (or each cycle)

Sessions are repeated regularly — often weekly for standard SCIG, or closer to monthly for facilitated SCIG — rotating sites to let the skin recover.

First weeks

You build confidence with the technique, and the dose and timing are checked against your antibody levels and how you feel.

Over months

The main benefit — fewer and less severe infections — builds up over time and is reviewed at follow-up.

What's normal — and not a worry

Swelling, redness or a firm lump at the site that settles within hours
Mild soreness or bruising where the needle goes in
Occasional headache or tiredness
Some trial and error with technique and site choice at first
Infections becoming fewer and milder gradually, rather than stopping at once

Aftercare

Keep a record of which immunoglobulin product and batch you have used at each session.
Rotate injection sites and care for the skin to reduce soreness and lumps.
Store the immunoglobulin and equipment correctly and dispose of needles safely.
Report sites that stay red, hot, painful or swollen, which could mean infection.
Report breathlessness, chest pain, a severe headache, dark urine or leg swelling promptly.
Attend for regular blood tests so your antibody levels can be checked.
Keep up agreed vaccinations and infection-prevention advice, and seek help early for new infections.

Before your treatment

Reason for SCIG and what it can and cannot do understood
Consent covering blood-product sourcing, safety and alternatives completed
Training in technique, site rotation and storage completed
Record of product and batch numbers kept
Clean home space and safe needle disposal arranged
List of symptoms that need urgent help saved
Contact route for the immunology or homecare team to hand

Scars and how they heal

There is no surgical scar. A small needle is inserted into the fatty layer just under the skin, usually in the tummy or thigh, for each session. It is normal to get temporary swelling, redness, itching or a firm lump at the site, which usually settles within a few hours. Frequent injections can occasionally leave the skin a little firm or marked, which is why sites are rotated; serious skin marking is uncommon if good technique and site rotation are used.

⚠ Get urgent help if…

Difficulty breathing, wheezing, chest tightness or swelling of the face, lips or tongue — call for help immediately
Feeling faint, a fast heartbeat or collapse
An injection site that becomes increasingly red, hot, painful or swollen, or oozes pus (possible infection)
A severe headache, especially with neck stiffness, fever or dislike of light, in the days after a dose
Dark or reduced urine, or marked tiredness and breathlessness (possible kidney problem or haemolysis)
Swelling, pain or redness in a leg, or sudden breathlessness or chest pain (possible blood clot)
A high fever or signs of a new serious infection; signs of sepsis — call 999

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

A good result is a clear reduction in how often and how severely you get infections, fewer courses of antibiotics and hospital admissions, and steady protection between doses. Your team checks your antibody (IgG) level and, more importantly, how you actually feel, to judge whether the dose and timing are right. Many people also value the independence of treating themselves at home.

SCIG cannot cure the underlying immune condition and does not stop every infection. The benefit builds up over months, and the dose is fine-tuned to you. A 'good level' on a blood test matters less than whether your infections are genuinely fewer and milder, and whether your injection sites are comfortable.

How long it lasts

For many people with antibody deficiency, immunoglobulin replacement is a long-term, often lifelong treatment, because the underlying problem does not go away. In secondary immunodeficiency, treatment may sometimes be stopped and reviewed if the underlying cause improves. The need for treatment is reviewed regularly, and you can usually switch between the under-the-skin and intravenous routes over time to suit your veins, side effects and lifestyle.

Related tests, treatments or support

Subcutaneous immunoglobulin is usually combined with other infection-prevention measures, such as agreed vaccinations and sometimes preventive antibiotics, and with treatment of any complications such as lung damage. It is coordinated with the team treating any underlying condition. The under-the-skin and intravenous routes are alternatives, and people often move between them depending on their needs.

Follow-up & long-term care

Follow-up includes regular blood tests and specialist review to check your antibody levels, how you feel, your injection sites and whether infections are reducing. Your technique is reviewed periodically. Ask who to contact about reactions, site problems, missed doses or new infections between appointments, and make sure the product and batch you use are always recorded.

Give doses regularly as planned (often weekly, or monthly with facilitated SCIG)
Rotate injection sites and care for the skin
Have blood tests to monitor antibody levels as advised
Keep a personal record of product and batch numbers
Keep agreed vaccinations and infection-prevention measures up to date
Report new or changing infections, site problems, or any reactions promptly

Repeat, follow-on and what comes next

The dose and frequency are adjusted over time to your antibody levels and how you feel.
Some people switch between standard and facilitated SCIG, or between the under-the-skin and intravenous routes.
Technique and site choice are refined with experience to reduce reactions.
In secondary immunodeficiency, treatment may be paused and reviewed if antibody production recovers.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

Thorough training and a named contact for reactions, site problems and new infections.
A personal record of product and batch numbers at every session.
Scheduled blood tests for antibody levels and periodic review of technique.
Regular specialist review of whether treatment is working and still needed.
Coordinated infection-prevention advice and care with any team treating an underlying condition.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

The immunoglobulin product itself, which is a costly human blood product in limited supply
The dose, which depends on your weight and antibody levels
How often doses are needed (weekly standard SCIG versus less frequent facilitated SCIG)
Training, equipment (pumps, needles) and homecare support
Regular blood tests and specialist review
Management of any reactions or site problems

Make sure your written quote includes

The cost of the immunoglobulin product and the planned dose and frequency
The cost of training, equipment and any homecare service
Whether monitoring and specialist review are included
The cost of regular blood tests
What happens, and what it costs, if you have a reaction or need a brand change
Whether facilitated SCIG and its enzyme are included if relevant
Cancellation policy and arrangements if supply is restricted

On the NHS? Subcutaneous immunoglobulin replacement is provided on the NHS for approved indications under a managed national programme because it is a limited human blood product; private provision exists but is also subject to supply and clear clinical criteria.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Choosing a specialist safely

Check the specialist is on the GMC Specialist Register for this area.
Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Questions to ask your medical professional

Take this to your consultation. A good specialist will welcome every one of these.

Is SCIG right for me rather than IVIG, and could I switch later?
Would standard or facilitated (less frequent) SCIG suit me better?
What product will I receive, and how will the batch be recorded?
What training and back-up will I have for treating myself at home?
What site reactions are normal, and when does a site need reporting?
How will we judge whether it is working, and is this likely to be lifelong?
Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
Will you be the specialist who carries out my treatment, and who looks after me afterwards?
What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
What does a realistic result look like — and what can this treatment not achieve?
What are my options, including waiting, doing nothing for now, or choosing a different approach?
Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Frequently asked questions

Can I really do this myself at home?

Yes — after training and assessment, most people give subcutaneous immunoglobulin themselves at home, with support from a specialist nurse or homecare service and a clear plan for problems. Some people prefer nurse support, especially at first.

Is it a blood product, and is it safe?

Yes, it is made from plasma pooled from many blood donors. Donors are screened and the manufacturing process includes steps to inactivate or remove viruses, so the risk of passing on infection is very low — but not zero. Your team should explain sourcing and safety and record the exact product and batch.

Why is it given so often compared with the drip?

Smaller amounts are absorbed from under the skin, so standard SCIG is usually given weekly to keep antibody levels steady. A facilitated version (with an added enzyme) allows a larger volume less often, closer to monthly.

How does it compare with IVIG?

SCIG usually causes fewer whole-body reactions but more reactions at the injection site, such as swelling and redness. It suits people who want home treatment or have difficult veins. Many people can switch between the two routes.

Will the swelling at the site go away?

Local swelling, redness or a firm lump is normal and usually settles within a few hours as the immunoglobulin is absorbed. Rotating sites helps. A site that becomes increasingly red, hot or painful, or oozes, should be reported, as it could be infected.

Can I get SCIG privately?

Immunoglobulin supply is carefully managed because it is a limited human blood product. It is provided on the NHS for approved indications under a national programme; private provision exists but is also subject to supply and clear clinical criteria.

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: Clinical guidelines for immunoglobulin use (UK Department of Health) — GOV.UK Immunodeficiency UK — immunoglobulin therapy Q&A Facilitated subcutaneous immunoglobulin (fSCIg) therapy — practical considerations (PMC) Adverse effects of immunoglobulin therapy — PMC UK plasma for immunoglobulins and vCJD risk assessment — GOV.UK UK Primary Immunodeficiency Network (UKPIN)

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.