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Hyaluronic Acid

What other names is Hyaluronic Acid known by?

Acide Hyaluronique, Ácido Hialurónico, Glycoaminoglycan, Glycoaminoglycane, Hyaluran, Hyaluronan, Hyaluronate de Sodium, Hyaluronate Sodium, Hylan, Sodium Hyaluronate.

What is Hyaluronic Acid?

Hyaluronic acid is a substance that is naturally present in the human body. It is found in the highest concentrations in fluids in the eyes and joints. The hyaluronic acid that is used as medicine is extracted from rooster combs or made by bacteria in the laboratory.

People take hyaluronic acid for various joint disorders, including osteoarthritis and joint pain. It can be taken by mouth or injected into the affected joint by a healthcare professional. Hyaluronic acid can also be injected directly into the bladder for women with frequent urinary tract infections (UTIs) and be taken by mouth for acid reflux.

The FDA has approved the use of hyaluronic acid during certain eye surgeries including cataract removal, corneal transplantation, and repair of a detached retina and other eye injuries. It is injected into the eye during the procedure to help replace natural fluids.

Hyaluronic acid is also used as a lip filler in plastic surgery.

Some people apply hyaluronic acid to the skin for healing wounds, diabetic foot ulcers, dry eyes, burns, skin ulcers, and as a moisturizer.

There is also a lot of interest in using hyaluronic acid to prevent the effects of aging. In fact, hyaluronic acid has been promoted as a "fountain of youth." However, there is no evidence to support the claim that taking it by mouth or applying it to the skin can prevent changes associated with aging.

Likely Effective for...

  • Cataracts. Injecting hyaluronic acid into the eye is effective when used during cataract surgery by an eye surgeon.
  • Sores in the mouth. Hyaluronic acid is effective for treating mouth sores when applied as a gel or used as a rinse.

Possibly Effective for...

  • Aging skin. . Some research shows that injecting a specific hyaluronic acid product (Juvéderm Ultra Plus, Allergan) into facial wrinkles can reduce wrinkles for up to one year. Also taking a product containing hyaluronic acid and other ingredients (GliSODin Skin Nutrients Advanced Anti-Aging Formula) by mouth seems to decrease wrinkles and damage from the sun when used for 3 months.
  • Urinary tract infection (UTI). Research shows that injecting hyaluronic acid alone or with chondroitin sulfate directly in to the bladder reduces the number of UTIs in women with frequent UTIs. Specific products that have been researched include Cystistat (Bioniche Life Sciences) and iAluRil (IBSA Farmaceutici).

QUESTION

What joints are most often affected by osteoarthritis? See Answer

Insufficient Evidence to Rate Effectiveness for...

  • Diabetic foot ulcers. Research shows that applying products containing hyaluronic acid and other ingredients helps heal diabetic foot ulcer compared to regular treatment. It's not known if this benefit is due to hyaluronic acid or other ingredients.
  • Dry eye. Early research shows that using eye drops containing hyaluronic acid (Hyalistil) helps relieve dry eye.
  • Eye trauma. Some research suggests that hyaluronic acid might be injected into the eye to treat detached retina or other eye injuries.
  • Acid reflux. Early research shows that taking syrup containing hyaluronic acid and chondroitin sulfate might improve GERD symptoms that don't improve with medicine used to decrease stomach acid.
  • Joint pain. Research shows that taking a specific product (Instaflex Joint Support, Direct Digital) containing hyaluronic acid and other ingredients can reduce joint pain. But this product does not seem to improve joint stiffness or function.
  • Osteoarthritis. Hyaluronic acid can be injected into the joint by a healthcare provider to reduce joint pain and stiffness. Hyaluronic acid is approved by the FDA for this condition. But not all people benefit. Also, any improvement is usually short-term. As a result, having hyaluronic acid injected into the joint is not recommended for most people with osteoarthritis. It is not known if hyaluronic acid might delay or lessen progressive joint damage when used long-term. Taking hyaluronic acid by mouth might reduce pain in some people with osteoarthritis. But results are conflicting.
  • Healing skin wounds and burns. Early research shows that applying hyaluronic acid to the skin might be helpful for treating burns and skin wounds.
More evidence is needed to rate the effectiveness of hyaluronic acid for these uses.

How does Hyaluronic Acid work?

Hyaluronic acid works by acting as a cushion and lubricant in the joints and other tissues. In addition, it might affect the way the body responds to injury and may decrease inflammation.

Are there safety concerns?

Hyaluronic acid is LIKELY SAFE when taken by mouth, applied to the skin, or given by injection and appropriately. Hyaluronic acid can cause redness and soreness when injected into the joint. Rarely, it may cause allergic reactions. Hyaluronic acid can increase eye pressure when injected into the eye. But this usually resolves within 48 to 72 hours.

Special Precautions & Warnings:

Pregnancy and breast-feeding: Hyaluronic acid is POSSIBLY SAFE when given by injection during pregnancy. However, not enough is known about the safety of hyaluronic acid when taken by mouth or applied to the skin during pregnancy. Stay on the safe side and avoid use.

Hyaluronic acid is POSSIBLY UNSAFE when given by injection during breast feeding. Researchers do not know if it affects breast milk and what effect that might have on an infant. There is not enough reliable information about the safety of taking hyaluronic acid by mouth or applying it to the skin if you are breastfeeding. Stay on the safe side and avoid use.

Dosing considerations for Hyaluronic Acid.

The following doses have been studied in scientific research:

BY MOUTH:

  • For aging skin: A specific product (GliSODin Skin Nutrients Advanced Anti-Aging Formula, Isocell North America Inc.) containing krill oil, sea buckthorn berry oil, cacao bean extract, and hyaluronic acid, has been used daily for 90 days.
APPLIED TO THE SKIN:
  • For mouth sores: Hyaluronic acid (Gelclair, Helsinn Healthcare SA) can be mixed with water and used as a mouth rinse.
BY INJECTION:
  • For aging skin: Healthcare providers can inject a hyaluronic acid product (Juvéderm Ultra Plus, Allergan) into skin wrinkles.
BY A CATHETER:
  • Urinary tract infection (UTI): Solution containing 40 mg of hyaluronic acid (Cystistat, Bioniche Life Sciences Inc.) has been given once weekly for 4 weeks then monthly for 4-5 months. Also, 50 mL of solution containing hyaluronic acid and chondroitin sulfate (iAluRil, IBSA Farmaceutici) has been given once weekly for 4 weeks, then every other week or once monthly for up to 5 months.

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).

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Reviewed on 9/17/2019
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