Hyaluronic acid is a member of the family of molecules known as glycosaminoglycans. This family also includes chondroitin sulfate and some other large carbohydrate-containing molecules. Hyaluronic acid is an important component of the connective tissue that fills the spaces between cells of the skin and other tissues, and is a major ingredient of the synovial fluid that lubricates and cushions joints as well as the vitreous humor that fills the inner chamber of the eye.1
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For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.
3 Stars Reliable and relatively consistent scientific data showing a substantial health benefit.
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1 Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.
Apply five times per day for one week or twice per day for three weeks
Gels and sprays containing hyaluronic acid, an important connective tissue component in the gums, have been shown to help reduce bleeding tendency and other indicators of gingivitis.
Hyaluronic acid is an important connective tissue component in the gums.3 Double-blind studies of topical hyaluronic acid treatments have shown that applying either a gel twice a day or a spray five times per day to the gum tissues helps reduce bleeding tendency and other indicators of gingivitis.4 , 5 However, plaque removal is still necessary for best results, and one study found that adding weekly topical hyaluronic acid treatments to a single session of scaling and root planing did not make a significant difference in healing.6 No research has investigated whether hyaluronic acid supplements that are swallowed are effective for treating gingivitis.
Apply a gel containing a partial benzyl ester derivative of hyaluronan under compression bandaging daily
A trial found that topical application of a hyaluronic acid compound with compression bandaging was significantly better than bandaging alone for healing chronic venous skin ulcers.
A controlled trial found that topical application of a hyaluronic acid compound with compression bandaging was significantly better than bandaging alone for healing chronic venous skin ulcers.7No research has investigated whether oral hyaluronic acid supplements might be similarly effective.
1% solution for ears
Topically applied hyaluronic acid is sometimes used in skin wound dressings to improve healing.
Topical application of hyaluronic acid and related compounds is sometimes used in skin wound dressings to improve healing.8 One controlled trial found a hyaluronic acid compound helpful for healing skin ulcers associated with chronic venous insufficiency.9 Improved healing of nasal surgery wounds with topical hyaluronic acid was reported in one controlled study,10 but not in another.11 A double-blind study found improved healing of perforated eardrums in patients using drops of 1% sodium hyaluronate.12 Whether oral hyaluronic acid supplements might improve wound healing has not been investigated.
Refer to label instructions
Injection of hyaluronic acid compounds into osteoarthritic joints, primarily the knee, has been shown to improve symptoms.
Hyaluronic acid is a normal component of joint fluid, but its amount and molecular structure are altered in osteoarthritic joints.13 Injection of hyaluronic acid compounds into osteoarthritic joints, primarily the knee, has been investigated in many double-blind trials with some improvement demonstrated.14 , 15 , 16 However, no research has been done to determine whether oral supplementation with hyaluronic acid is an effective treatment for osteoarthritis.
Amounts for oral supplementation have not been established, due to lack of research, and it is unknown whether hyaluronic acid can be absorbed from the gastrointestinal tract. Topical products are applied in the mouth two or more times per day, to the nose three to four times per day, or with bandaging for skin ulcers. Eye drops containing 0.1 to 0.4% sodium hyaluronate are used three or more times per day, and ear drops containing 1% sodium hyaluronate are used once a day.
Hyaluronic acid is produced in the human body and is found in the tissues of all animals. A nonanimal source of hyaluronic acid can be synthesized by bacterial fermentation.
Hyaluronic acid is produced naturally in the human body and is not considered an essential nutrient. However, hyaluronic acid levels in osteoarthritic joints are below normal.17
A controlled study reported that males taking 600 mg per day of hyaluronic acid for four weeks had higher blood levels of the enzyme alkaline phosphatase.18 The significance of this finding is unclear.
There have been anecdotal reports of skin rash following oral supplementation with hyaluronic acid.19
1. Laurent TC, Fraser JR. Hyaluronan. FASEB J 1992;6:2397-404.
2. Vogel R, Crockett RS, Oden N, et al. Demonstration of efficacy in the treatment of dry eye disease with 0.18% sodium hyaluronate ophthalmic solution (Vismed, Rejena). Am J Ophthalmol 2010;149:594-601.
3. Moseley R, Waddington RJ, Embery G. Hyaluronan and its potential role in periodontal healing. Dent Update 2002;29:144-8 [review].
4. Pistorius A, Martin M, Willershausen B, Rockmann P. The clinical application of hyaluronic acid in gingivitis therapy. Quintessence Int 2005;36:531-8.
5. Jentsch H, Pomowski R, Kundt G, Gocke R. Treatment of gingivitis with hyaluronan. J Clin Periodontol 2003;30:159-64.
6. Xu Y, Hofling K, Fimmers R, et al. Clinical and microbiological effects of topical subgingival application of hyaluronic acid gel adjunctive to scaling and root planing in the treatment of chronic periodontitis. J Periodontol 2004;75:1114-8.
7. Taddeucci P, Pianigiani E, Colletta V, et al. An evaluation of Hyalofill-F plus compression bandaging in the treatment of chronic venous ulcers. J Wound Care 2004;13:202-4.
8. Anderson I. The properties of hyaluronan and its role in wound healing. Prof Nurse 2001;17:232-5 [review].
9. Taddeucci P, Pianigiani E, Colletta V, et al. An evaluation of Hyalofill-F plus compression bandaging in the treatment of chronic venous ulcers. J Wound Care 2004;13:202-4.
10. Soldati D, Rahm F, Pasche P. Mucosal wound healing after nasal surgery. A controlled clinical trial on the efficacy of hyaluronic acid containing cream. Drugs Exp Clin Res 1999;25:253-61.
11. Miller RS, Steward DL, Tami TA, et al. The clinical effects of hyaluronic acid ester nasal dressing (Merogel) on intranasal wound healing after functional endoscopic sinus surgery. Otolaryngol Head Neck Surg 2003;128:862-9.
12. Rivas Lacarte MP, Casasin T, Pumarola F, Alonso A. An alternative treatment for the reduction of tympanic membrane perforations: sodium hyaluronate. A double blind study. Acta Otolaryngol 1990;110:110-4.
13. Tehranzadeh J, Booya F, Root J. Cartilage metabolism in osteoarthritis and the influence of viscosupplementation and steroid: a review. Acta Radiol2005;46:288-96 [review].
14. Modawal A, Ferrer M, Choi HK, Castle JA. Hyaluronic acid injections relieve knee pain. J Fam Pract 2005;54:758-67 [review].
15. Bellamy N, Campbell J, Robinson V, et al . Viscosupplementation for the treatment of osteoarthritis of the knee. Cochrane Database Syst Rev 2005;(2):CD005321 [review].
16. Arrich J, Piribauer F, Mad P, et al. Intra-articular hyaluronic acid for the treatment of osteoarthritis of the knee: systematic review and meta-analysis. CMAJ 2005;172:1039-43 [review].
17. Tehranzadeh J, Booya F, Root J. Cartilage metabolism in osteoarthritis and the influence of viscosupplementation and steroid: a review. Acta Radiol2005;46:288-96 [review].
18. Bates B. Supplements trigger potassium, alkaline phosphatase changes. Skin and Allergy News 2003;July:43.
19. http://www.raysahelian.com/hyaluronic-acid.html, accessed May 13, 2006.
Last Review: 07-22-2014
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