Hyaluronic Acid (Hyaluronan) Serum, Injections, Side Effects, Benefits
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. It can be taken by mouth or injected into the affected joint by a healthcare professional.
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, 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.
Hyaluronic Acid and the Skin
The skin is the largest organ in the body comprising about 15% of the body weight. Roughly 50% of the Hyaluronic Acid in our body is found in the skin. HA and Collagen are vital to maintaining the skin’s layers and structure. It is the collagen that gives the skin its firmness but it is the HA that nourishes and hydrates the collagen. Imagine the collagen as the stretchy fibers that restore the skin back to shape when stretched. Collagen is like a rubber band but stretch that rubber band a million times, like what we do with our skin and without any moisture. Eventually that rubber band gets overstretched (saggy) and dried out and will most likely break. This is much the same way the collagen in our skin reacts leaving our skin in need of moisture. Now imagine that same rubber band stretched a million times while under water the whole time. Chances of that rubber band drying out and breaking are minimal. Consider the Hyaluronic Acid as the water that keeps the collagen moist and elastic. Collagen is continuously surrounded and nourished by the gelatinous HA substance. Young skin is smooth and highly elastic because it contains high concentrations of Hyaluronic Acid, which helps skin stay healthy. As we grow older or have defects, the body loses its ability to maintain this same concentration in the skin. With decreasing levels of HA in the skin, so goes the ability of the skin to hold water. The result, the skin becomes drier and loses its ability to maintain its hydration. Hyaluronic acid acts as a space filler by binding to water and thus keeping the skin wrinkle-free.
Benefits of Hyaluronic Acid
Hyaluronic Acid (Hyaluronic Acid or Sodium Hyaluronate) has many benefits and is one of the most interesting ingredients in skin care. Hyaluronic acid is a glycosaminoglycan (polysaccharides that are an important component of connective tissue). It is distributed widely throughout connective, neural, and epithelial tissue. It is of the chief components of the extra-cellular matrix (the tissue that provides structural support to cells).
Interestingly, the average human has approximately 15 grams of hyaluronan (hyaluronic acid) in the body, one-third of which is "turned over" (degraded and synthesized) every day.
Functions of Hyaluronic Acid
As one of the chief components of the extra-cellular matrix, Hyaluronan is an important component of articular cartilage, where it is present as a coat around each cell (chondrocyte). Hyaluronan is responsible, in part, for the resilience of cartilage (its resistance to compression). Thus, its presence is important for soft tissue function, such as in joint support or in fighting osteoarthritis.
Benefits of Hyaluronic Acid and Skin Care
As a Topical
Hyaluronic Acid is also a major component of skin, where it is involved in tissue repair. Topically applied, hyaluronic acid forms an air permeable layer and penetrates into the dermis, thus boosting the elasticity and hydration of the skin. The protective barrier on the skin locks in moisture, which gives the skin a youthful appearance. As we age, skin moisture can drop significantly, which creates aging like effects on skin appearance as it loses its elasticity. Thus hyaluronic acid can play a critical role in skin health with its unique ability to hold in moisture (1000 ml of water per gram of hyaluronic acid).
Hyaluronic acid is also a “smart nutrient” as it can adjust its moisture absorption rate based on the humidity—relative to the season and the climate.
Benefits of Hyaluronic Acid and UVB Sun Protection
One of the most skin damaging elements are UVB rays from the sun. Hyaluronic acid also protects the skin from UVB rays (and the scavenging reactive oxygen species they generate), which can cause sunspots.
Benefits of Hyaluronic Acid as an Oral Supplement
Hyaluronic acid also plays a critical role in the production of collagen-the most abundant protein in the body. Collagen’s main function is to sustain tendons, skin and cartilage. It provides integrity, firmness and elasticity to their structures. Maximizing collagen levels will keep skin supple. Because of this maintaining body levels of Hyaluronic acid is not only desirable for keeping moisture levels up, but also to keep collagen synthesis up, helping to provide an anti-aging effect on skin.
Effectiveness of oral Hyaluronic Acid supplementation has been somewhat controversial. There have been studies showing hyaluronic acid to be extremely effective with oral supplementation. Theories abound on if the Hyaluronic Acid is actually directly affecting the outcome, or if it is an indirect effect due to higher blood levels (proven due to the supplementation), serving as the raw material for the body to draw upon to increase extra-cellular hyaluronic levels.
The Bottom Line
Hyaluronic Acid supplementation was directly correlated to measured increases in skin moisture. Microscopic skin surface analysis shows increased skin smoothness, and amelioration of wrinkles.
Based on studies of Hyaluronic Acid’s function and mechanisms (and the growing research), it looks like Hyaluronic acid will remain one of the most exciting and interesting nutrients for natural skin care for the foreseeable future.
What is Hyaluronic Acid?
Hyaluronic Acid (HA), also known as hyaluronan or hyaluronate, is a carbohydrate, more specifically a mucopolysaccharide occurring naturally throughout the human body. It can be several thousands of sugars (carbohydrates) long. When not bound to other molecules, it binds to water giving it a stiff viscous quality similar to “Jello”. This viscous Gel is one of the most heavily researched substances in medicine today with thousands of trials mostly in the fields of orthopedics and eye surgery. Its function in the body is, amongst other things, to bind water and to lubricate movable parts of the body, such as joints and muscles. Its consistency and tissue-friendliness allows it to be beneficial in skin-care products as an excellent moisturizer. Because HA is one of the most hydrophilic (water-loving) molecules in nature with numerous benefits for the human body it can be described as "nature's moisturizer".
Does Hyaluronic Acid Have any Benefits for the Body?
If we compare the joints of the human body to an automobile engine, the joint fluid in the body mimics the oil in a car engine. At regular intervals we replace the oil in our car engines because the heat and friction breakdowns the oils viscosity. The oil becomes thinner and less able to protect the metal surfaces from excessive wear. Hyaluronic acid benefits our joints in the same way. As we age the viscosity of the joint fluid lessens. HA helps to maintain normal joint cushioning.
What is Hyaluronic Acid's Chemical Structure?
It is naturally produced in the human body and is chemically classified as a Glycosaminoglycan. In the body, hyaluronic acid always presents itself as a large high molecular weight molecule. The molecule is made up of a repetitive sequence of two modified simple sugars, one called glucuronic acid and the other N-acetyl glucosamine. These compounds are both negatively charged and when put together, they repel producing an exceptionally long stretched out molecule (high molecular weight). HA molecules that are long and large in size produce a high viscosity (lubrication) effect which resists compression and allows our joints and skin to bear weight.
When was Hyaluronic Acid discovered?
HA was first used commercially in 1942 when Endre Balazs applied for a patent to use it as a substitute for egg white in bakery products. Its discovery was very unique. No other molecule had ever been discovered that has such unique properties to the human body. Balazs went on to become the leading expert on HA, and made the majority of discoveries concerning hyaluronic acid benefits.
Where is Hyaluronic Acid located in the body?
Hyaluronic Acid is found naturally in most every cell in the body and occurs in high concentrations in specific body locations. In each body location, it serves a different function. Unfortunately, HA also has a half-life (the time it takes for the molecule to get broken down and excreted from the body) of less than 3 days and possibly even as little as one day in the skin. For this reason, it is imperative that the body continually replenish itself with HA. Below are some of the areas in the human body where it is present and critical to anatomical function.
Hyaluronic Acid in Bones and Cartilage
Hyaluronic Acid is found in all bones and cartilage structures throughout the body. Both of these structures provide a resilient rigidity to the structure of the human body. HA is especially found in various forms of cartilage but none more than the hyaline cartilage. As you've probably guessed it, hyaline is short for hyaluronic acid. Hyaline cartilage covers the ends of the long bones where articulation (bending) occurs and provides a cushioning effect for the bones. The hyaline cartilage has been called the "gristle cartilage" because its resistance to wear and tear. Hyaline cartilage also supports the tip of the nose, connects the ribs to the sternum and forms most of the larynx and supporting cartilage of the trachea and bronchial tubes in the lungs.
Hyaluronic Acid in Synovial fluid
Our joints (like the elbows and knees) are surrounded by a membrane called the synovial membrane which forms a capsule around the ends of the two articulating bones. This membrane secretes a liquid called the synovial fluid. Synovial fluid is a viscous fluid with the consistency of motor oil. It has many functions, but none more than providing the elastic shock absorbing properties of the joint. Its second most important function in the joint is to carry nutrients to the cartilage and to also remove waste from the joint capsule.
Hyaluronic Acid in Tendons and Ligaments/Connective tissue
Connective tissue is found everywhere in the body. It does much more than connect body parts; it has many forms and functions. Its major functions include binding, support, protection, and insulation. One such example of connective tissue is the cordlike structures that connect muscle to bone (tendons) and bone to bone (ligaments). In all connective tissue there are three structural elements. They are ground substance (hyaluronic acid), stretchy fibers (collagen and elastin) and a fundamental cell type. Whereas all other primary tissues in the body are composed mainly of living cells, connective tissues are composed largely of a nonliving ground substance, the hyaluronic acid, which separates and cushions the living cells of the connective tissue. The separation and cushioning allow the tissue to bear weight, withstand great tension and endure abuse that no other body tissue could. All of this is made possible because of the presence of the HA and its ability to form the gelatinous ground substance fluid.
Hyaluronic Acid in Scalp Tissue and Hair Follicles
Structurally the scalp is identical to the skin tissue located throughout the body except it also contains about 100,000 hair follicles that give rise to hair. Actually the hair and the hair follicle are a derivative of skin tissue. There are two distinctive skin layers, one, the epidermis (outer layer) which gives rise to the protective shield of the body and the other, the dermal layer (deep layer) which makes up the bulk of the skin and is where the hair follicle is located. This dermal layer is composed of connective tissue and the connective tissue, with its gelatinous fluid like characteristics provides support, nourishes and hydrates the deep layers of the scalp. The result is healthy lustrous hair and a moisturized scalp. Again, all of this is made possible because of the presence of HA in the scalp.
Hyaluronic Acid in Lips
The lips are a core of skeletal muscle covered by skin tissue. The dermal layer of the lips is composed primarily of connective tissue and its components hyaluronic acid and collagen that give the structure (shape) and plumpness to the lips. The HA binds to water creating a gelatinous fluid that hydrates the surrounding tissue and keeps the collagen (responsible for keeping the skin tight) nourished and healthy. The result is healthy well hydrated and plump lips that are well protected from the environment.
Hyaluronic acid in the eyes
Hyaluronic acid is highly concentrated inside the eyeball. The fluid inside the eye called the vitreous humor is composed almost completely of hyaluronic acid. The HA gives the fluid inside the eye a viscous gel like property. This gel acts as a shock absorber for the eye and also serves to transport nutrients into the eye. HA has been directly injected into the eye during procedures to help maintain the shape of the eye during surgery. It has been said that after the 5th decade of life, our eyes stop producing the much needed hyaluronic acid resulting in various eye needs.
Hyaluronic acid in the gums
The Gums (gingivoe) are composed of dense fibrous connective tissue (ligaments) which secure the teeth to the aveloar bone (jaw bone). Once again, connective tissue is composed of a fibrous tissue surrounded by hyaluronic acid (extra-cellular matrix). Without the presence of HA, the gum tissue becomes unhealthy. If it is present it helps to provide the tensile strength of the ligaments that secure the tooth in place by providing hydration and nourishment. The result is a healthy set of gums.
Hyaluronic acid in the skin
Although Hyaluronic Acid (HA) can be found naturally in most every cell in the body, it is found in the greatest concentrations in the skin tissue. Almost 50% of the bodies HA is found here. It is found in both the deep underlying dermal areas as well as the visible epidermal top layers. Young skin is smooth and elastic and contains large amounts of HA that helps keep the skin stay young and healthy. The HA provides continuous moisture to the skin by binding up to 1000 times its weight in water. With age, the ability of the skin to produce HA decreases.
ECM (ground substance)
The extracellular matrix (ECM) is a gelatinous (gel-like) fluid that surrounds almost all living cells and is essential to life. It gives structure and support to the body and without it, we would just be a trillions cells without a shape or function. It is essentially the mortar between the bricks. The skin, bones, cartilage, tendons and ligaments are examples where the ECM is located in the body. The ECM is composed of material (fibrous elements) called elastin and collagen surrounded by a gelatinous substance (Hyaluronic Acid). HA's roles in the ECM is to help the stretchy fibers in the body from overstretching and drying out by continually bathing them in this nutritious water base gelatinous fluid. It also serves as a wonderful medium through which nutrients and waste are transported to and from the cells of these structures. This fluid would not exist if it was not for the ability of the HA molecule to bind up to 1000 times its weight in water.
Hyaluronic Acid Injections for Osteoarthritis
Exercise and other physical activity is important when you have osteoarthritis (OA). But joint pain and stiffness in a knee can make it difficult just to walk, even with medication and other treatments. If that sounds like your situation, or if you can't take oral arthritis medicine, hyaluronic acid injections may help.
Also called viscosupplements, these injections add to the joint’s natural supply of hyaluronic acid, a part of the joint fluid that helps lubricate joints and keep them working smoothly. Hyaluronic acid is also a shock absorber that keeps your bones from bearing the full force of impact when you walk.
When you have osteoarthritis, the concentration of hyaluronic acid lessens. Hyaluronic acid injections are given to supplement the joint area. Experts aren't completely sure how the injections work, however, because the additional hyaluronic acid stays in the joint for only a matter of hours or days.
Getting a Hyaluronic Acid Injection: What to Expect
Five different brands of hyaluronic acid are available and approved for knee osteoarthritis:
Depending on which type your doctor uses, you'll get a single shot or three to five injections spaced a week apart.
The injection procedure is the same for all types. First, the doctor cleans the area. If your knee is swollen with excess fluid, your doctor may inject a local anesthetic to reduce pain, then insert a needle into the joint to withdraw excess fluid. The doctor can usually use the same needle still in place to inject a syringe with the hyaluronic acid preparation into the knee joint.
After an injection, you shouldn't do any excessive weight-bearing activity for one or two days. Otherwise, you should be able to resume normal activities.
How Effective Are Hyaluronic Acid Injections for Osteoarthritis?
Hyaluronic acid injections seem to work better in some people than others. They may be less effective in elderly people and people with severe osteoarthritis.
The results of studies on their effectiveness as an osteoarthritis treatment have been mixed. A 2002 study published in Rheumatology found that in the short term, a shot of hyaluronic acid didn't reduce joint pain any better than an injection of salt water. An analysis of seven studies published in the Journal of Family Practice in 2006 concluded that the benefits -- if any -- were slight.
But another analysis of 20 studies from 2004 found that hyaluronic acid injections did lessen pain and increase knee function in people with osteoarthritis. And an earlier analysis -- of eight clinical trials involving 971 people -- found that people treated with hyaluronic acid did better than those treated with placebo, both at the end of their treatment and six months later.
More recent research has found that the injections relieved pain about as well as nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, or steroid injection. Some studies show that pain relief lasts up to six months or a year.
Hyaluronic Acid Injections for Osteoarthritis: What Are the Risks?
So far, there appear to be no long-term side effects and few short-term side effects from this treatment. The most common side effects in studies were minor pain at the injection site and effusions (build-up of joint fluid), which got better within a few days. Doctors don't know whether the medication or the injections caused these reactions.
Should You Try Hyaluronic Acid Injections?
Doctors can't predict yet who will benefit from hyaluronic acid injections. But many doctors consider them for people with significant knee osteoarthritis symptoms that have not responded to other treatments, and for those who can't take oral medications or have total knee replacement surgery.
Talk to your doctor to discuss whether the injections might help you. Most insurance companies cover hyaluronic acid injections.