Acide Hyaluronique, Ácido Hialurónico, Glycoaminoglycan, Glycoaminoglycane, Hyaluran, Hyaluronan, Hyaluronate de Sodium, Hyaluronate Sodium, Hylan, Sodium Hyaluronate.
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.
How does it 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.
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).
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.
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).
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.
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.
The following doses have been studied in scientific research:
- 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.
- For mouth sores: Hyaluronic acid (Gelclair, Helsinn Healthcare SA) can be mixed with water and used as a mouth rinse.
- For aging skin: Healthcare providers can inject a hyaluronic acid product (Juvéderm Ultra Plus, Allergan) into skin wrinkles.
- 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.
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
Baker, C. L., Jr. and Ferguson, C. M. Future treatment of osteoarthritis. Orthopedics 2005;28(2 Suppl):s227-s234. View abstract.
de, Maio M. The minimal approach: an innovation in facial cosmetic procedures. Aesthetic Plast.Surg. 2004;28(5):295-300. View abstract.
Holmes and et al. Hyaluronic acid in human articular cartilage: Age-related changes in content and size. Biochem.J 1988;250:435-441.
Kalman, D. S., Heimer, M., Valdeon, A., Schwartz, H., and Sheldon, E. Effect of a natural extract of chicken combs with a high content of hyaluronic acid (Hyal-Joint) on pain relief and quality of life in subjects with knee osteoarthritis: a pilot randomized double-blind placebo-controlled trial. Nutr J 2008;7:3. View abstract.
Laurent, T. C., Dahl, I. M., Dahl, L. B., Engstrom-Laurent, A., Eriksson, S., Fraser, J. R., Granath, K. A., Laurent, C., Laurent, U. B., Lilja, K., and . The catabolic fate of hyaluronic acid. Connect.Tissue Res 1986;15(1-2):33-41. View abstract.
Lupo, M. P. Hyaluronic acid fillers in facial rejuvenation. Semin.Cutan.Med Surg. 2006;25(3):122-126. View abstract.
Lupo, M. P., Smith, S. R., Thomas, J. A., Murphy, D. K., and Beddingfield, F. C., III. Effectiveness of Juvederm Ultra Plus dermal filler in the treatment of severe nasolabial folds. Plast.Reconstr.Surg. 2008;121(1):289-297. View abstract.
Paker, N., Tekdos, D., Kesiktas, N., and Soy, D. Comparison of the therapeutic efficacy of TENS versus intra-articular hyaluronic acid injection in patients with knee osteoarthritis: a prospective randomized study. Adv.Ther. 2006;23(2):342-353. View abstract.
Petrella, R. J. Hyaluronic acid for the treatment of knee osteoarthritis: long-term outcomes from a naturalistic primary care experience. Am J Phys.Med Rehabil. 2005;84(4):278-283. View abstract.
Rohrich, R. J., Ghavami, A., and Crosby, M. A. The role of hyaluronic acid fillers (Restylane) in facial cosmetic surgery: review and technical considerations. Plast.Reconstr.Surg. 2007;120(6 Suppl):41S-54S. View abstract.
Smith, K. C. Practical use of Juvederm: early experience. Plast.Reconstr.Surg. 2007;120(6 Suppl):67S-73S. View abstract.
Uthman, I., Raynauld, J. P., and Haraoui, B. Intra-articular therapy in osteoarthritis. Postgrad.Med J 2003;79(934):449-453. View abstract.
Altman RD, Moskowitz R. Intraarticular sodium hyaluronate (Hyalgan) in the treatment of patients with osteoarthritis of the knee: a randomized clinical trial. Hyalgan Study Group. J Rheumatol 1998;25:2203-12. View abstract.
Altman RD. Intra-articular sodium hyaluronate in osteoarthritis of the knee. Semin Arthritis Rheum 2000;30(2 Suppl 1):11-8. View abstract.
Becker LC, Bergfeld WF, Belsito DV, et al. Final report of the safety assessment of hyaluronic acid, potassium hyaluronate, and sodium hyaluronate. Int J Toxicol 2009;28(4 Suppl):5-67. View abstract.
Chen CP, Hung W, Lin SH. Effectiveness of hyaluronic acid for treating diabetic foot: a systematic review and meta-analysis. Dermatol Ther. 2014;27(6):331-6. View abstract.
Chen WY, Abatangelo G. Functions of hyaluronan in wound repair. Wound Repair Regen 1999;7:79-89. View abstract.
De Vita D, Antell H, Giordano S. Effectiveness of intravesical hyaluronic acid with or without chondroitin sulfate for recurrent bacterial cystitis in adult women: a meta-analysis. Int Urogynecol J 2013;24(4):545-52. View abstract.
Dougados M. Sodium hyaluronate therapy in osteoarthritis: arguments for a potential beneficial structural effect. Semin Arthritis Rheum 2000;30(2 Suppl 1):19-25. View abstract.
Duperre J, Grenier B, Lemire J, Mihalovits H, Sebag M, Lambert J. Effect of timolol vs. acetazolamide on sodium hyaluronate-induced rise in intraocular pressure after cataract surgery. Can J Ophthalmol 1994;29:182-6. View abstract.
FDA. Center for Devices and Radiological Health. StaarVisc. Sodium Hyaluronate. http://www.fda.gov/cdrh/pdf/P960033c.pdf. (Accessed 11 October 2002).
Felson DT, Anderson JJ. Hyaluronate sodium injections for osteoarthritis: hope, hype, and hard truths. Arch Intern Med 2002;162:245-7. View abstract.
Frizziero L, Govoni E, Bacchini P. Intra-articular hyaluronic acid in the treatment of osteoarthritis of the knee: clinical and morphological study. Clin Exp Rheumatol 1998;16:441-9. View abstract.
Gelclair Prescribing Information. Cell Pathways, Inc. Horsham, PA, 2002.
Goa KL, Benfield P. Hyaluronic acid. A review of its pharmacology and use as a surgical aid in ophthalmology, and its therapeutic potential in joint disease and wound healing. Drugs 1994;47:536-66. View abstract.
Goldberg LD, Crysler C. A single center, pilot, double-blinded, randomized, comparative, prospective clinical study to evaluate improvements in the structure and function of facial skin with tazarotene 0.1% cream alone and in combination with GliSODin Skin Nutrients Advanced Anti-Aging Formula. Clin Cosmet Investig Dermatol. 2014;7:139-44. View abstract.
Hyalgan Prescribing Information. Sanofi-Synthelabo, Inc. New York, NY, 2002.
Kavouni A, Stanec JJ. Human antihyaluronic acid antibodies. Dermatol Surg 2002;28:359-60. View abstract.
King SR, Hickerson WL, Proctor KG. Beneficial actions of exogenous hyaluronic acid on wound healing. Surgery 1991;109:76-84. View abstract.
Kramer K, Senninger N, Herbst H, Probst W. Effective prevention of adhesions with hyaluronate. Arch Surg 2002;137:278-82. View abstract.
Mayer O, Simon J, Rosolova H, et al. The effects of folate supplementation on some coagulation parameter and oxidative status surrogates. Eur J Clin Pharmacol 2002;58:1-5.. View abstract.
Migliore A, Bizzi E, Herrero-Beaumont J, et al. The discrepancy between recommendations and clinical practice for viscosupplementation in osteoarthritis: mind the gap! Eur Rev Med Pharmacol Sci 2015;19(7):1124-9. View abstract.
Nelson FR, Zvirbulis RA, Zonca B, et al. The effects of an oral preparation containing hyaluronic acid (Oralvisc) on obese knee osteoarthritis patients determined by pain, function, bradykinin, leptin, inflammatory cytokines, and heavy water analyses. Rheumatol Int. 2015;35(1):43-52. View abstract.
New Product: Gelclair concentrated oral gel. Pharmacist's Letter/Prescriber's Letter 2002;18(7):180711.
Nieman DC, Shanely RA, Luo B, Dew D, Meaney MP, Sha W. A commercialized dietary supplement alleviates joint pain in community adults: a double-blind, placebo-controlled community trial. Nutr J 2013;12(1):154. View abstract.
Palmieri B, Merighi A, Corbascio D, Rottigni V, Fistetto G, Esposito A. Fixed combination of hyaluronic acid and chondroitin-sulphate oral formulation in a randomized double blind, placebo controlled study for the treatment of symptoms in patients with non-erosive gastroesophageal reflux. Eur Rev Med Pharmacol Sci 2013;17(24):3272-8. View abstract.
Percival SP. Complications from use of sodium hyaluronate (Healonid) in anterior segment surgery. Br J Ophthalmol 1982;66:714-6. View abstract.
Percival SP. Sodium hyaluronate in perspective: experiences from a four-year clinical trial. Trans Ophthalmol Soc U K 1985;104:616-20. View abstract.
Petrella RJ, DiSilvestro MD, Hildebrand C. Effects of hyaluronate sodium on pain and physical functioning in osteoarthritis of the knee: a randomized, double-blind, placebo-controlled clinical trial. Arch Intern Med 2002;162:292-8. View abstract.
Rolando M, Valente C. Establishing the tolerability and performance of tamarind seed polysaccharide (TSP) in treating dry eye syndrome: results of a clinical study. BMC Ophthalmol 2007;7:5. View abstract.
Ruusuvaara P, Pajari S, Setala K. Effect of sodium hyaluronate on immediate postoperative intraocular pressure after extracapsular cataract extraction and IOL implantation. Acta Ophthalmol (Copenh) 1990;68:721-7. View abstract.
Soderberg O, Hellstrom S. Consequences of using hyaluronan-coated tympanostomy tubes. Acta Otolaryngol Suppl 1987;442:50-3. View abstract.
Stamper RL, DiLoreto D, Schacknow P. Effect of intraocular aspiration of sodium hyaluronate on postoperative intraocular pressure. Ophthalmic Surg. 1990;21:486-91. View abstract.
Synvisc Prescribing Information. Wyeth-Ayerst Pharmaceuticals, Philadelphia, PA, 2000.
Torella M, Schettino MT, Salvatore S, Serati M, De Franciscis P, Colacurci N. Intravesical therapy in recurrent cystitis: a multi-center experience. J Infect Chemother 2013;19(5):920-5. View abstract.
von Tirpitz C, Klaus J, Bruckel J, et al. Increase of bone mineral density with sodium fluoride in patients with Crohn's disease. Eur J Gastroenterol Hepatol 2000;12:19-24.. View abstract.