The hype on hyaluronic acid

As dermatologists, we often hear questions from patients about ingredients in beauty and skincare products. Recently, hyaluronic acid (HA) has been hitting the shelves in a variety of products, from serums and moisturizers to sheet masks, night creams, and lip products. So what is HA? What benefits does it offer? And what are the most effective ways of using this ingredient?

What is hyaluronic acid?

HA is a humectant — a substance that retains moisture — and it is capable of binding over one thousand times its weight in water. This substance is naturally found in many areas of the human body, including the skin, eyes, and synovial fluid of the joints. HA used in beauty and skincare products is primarily made by bacteria in a lab via a process called biofermentation.

As we age, the production of key substances in the skin, including hyaluronic acid (along with collagen and elastin) decreases. As a result, our skin loses volume, hydration, and plumpness.

Lotions, potions, and injectable HA

Many skincare products containing HA claim to increase hydration within the skin. But is this true? The answer requires a closer look at the type of HA in the product. HA comes in different molecular sizes. Larger HA molecules, despite being the best at binding water and offering hydration, cannot penetrate into the skin. When applied topically (to the skin), these molecules sit on top of the skin, offering hydration only at the very surface. Smaller HA molecules, which bind less water than larger HA molecules, can penetrate deeper into the skin (though only into the epidermis, the topmost layer of skin). For maximum surface hydration, look for a product that contains HA molecules in a variety of sizes.

HA is also used in dermal fillers, many of which are composed of HA in an injectable gel form. HA fillers add volume by physically filling the area where they are placed, as well as by drawing water to enhance the filling effect. HA fillers can be used to address a multitude of cosmetic concerns, including lifting the cheeks, softening deeper folds and creases around the mouth and chin, improving the look of sunken, dark, undereye circles, hydrating and enhancing the lips, and rejuvenating the hands and earlobes.

HA hope or hype?

So is topical HA worth the hype? First, let’s establish that topical HA will never be as effective as an injectable HA filler for replacing lost volume, even though some topical HA products are misleadingly marketed as topical “fillers.” Topical HA is an excellent moisturizer. However, if the goal is to improve volume loss and laxity of the skin that naturally occurs with aging, injectable HA, rather than topical HA, is the preferred treatment method.

Topical HA has many positive attributes: it is generally well tolerated; it does not frequently cause allergic reactions or irritate sensitive skin; and it is safe to use on the skin during pregnancy and while breastfeeding.

For individuals with dry skin, or for those who crave a more dewy, moisturized feel to their skin during the cooler months, a serum or moisturizer containing HA can be a great choice. But keep in mind that topical HA will provide hydration on a surface level, not deep within the skin.

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