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Hyaluronic acid

From arthritis to skincare

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Some beauty experts have called it the fountain of youth. Scientists call it hyaluronic acid. Found across the body, but most commonly in the skin, this naturally occurring polymer compound  ( think of a molecule that’s made up of lots of identical chain links) is used in the body for a variety of functions, from joint lubrication to tissue structure, to providing ‘highways’ for cell migration. It’s also used in healing and building up of blood vessels.

Interestingly, hyaluronic acid can bind up to 6,000 times its volume in water, and it’s this property that makes it of special interest to people who are worried about the dryness of their skin. There are many causes for dry skin, including exposure to pollution, smoking, UV light and age, as well as diet and genetics.

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The science

As we age, hyaluronic acid disappears from the outermost layer of skin, called the epidermis, but remains in the later underneath that, the dermis. The epidermal content of hyaluronic acid decreases from 0.03% in women from 19 to 47, to 0.015% in women of 60 years and halves to 0.007% in women aged 70. Older women don’t have any epidermal hyaluronic acid at all. Without this moisture-hoarding compound, our skin can dry and rough up, develop wrinkles more severely, and become saggy. There’s another issue with having less hyaluronic acid. It’s part of the reason why as we age we are less able to heal quickly and properly.

Hyaluronic acid is a polymer and can come in different sizes. While bigger hyaluronic acids can stop what doctors refer to as proliferation and migration, the part of wound healing where cells travel to the centre of the injury to help seal up the exposed tissue, smaller ones can promote the development of new blood vessels, aid in inflammation, and, even support proliferation. A trial in mice found that topical hyaluronic acid improved wound healing and increased production of collagen III, which provides scaffolding for the healing process.

 

Hyaluronic acid and arthritis

Speaking of healing, it also has a stark effect on arthritis. In healthy joints, hyaluronic acid acts as a lubricant and a shock absorber. People who have osteoarthritis have hyaluronic acid or lubricant over time. Treating with hyaluronic acid can help “calm down” the joint that makes arthritis so painful. Studies from 2016 and 2017 concluded that hyaluronic acid is a better treatment than saline or corticosteroid injections, respectively (two common treatments for arthritis).

However, injecting it straight into the knee may not be necessary. Injections are both expensive and can be mildly unpleasant, especially for patients who are afraid of needles. Oral supplements are an alternative method for relief: there’s a lot of clinical data that shows that oral hyaluronic acid supplements are effective.

 

Hyaluronic acid and skincare

There’s a wealth of information that proves that hyaluronic acid supplements make the skin more moist, more elastic, less wrinkly and smoother overall. That’s probably where most people have heard of it. Maybe you’ve seen $100 beauty products promising anti-aging, powered by hyaluronic acid.  “Anti-aging” is a slight misnomer — you won’t look decades younger, but you will have noticeably more supple, softer, healthy-looking skin. It can also be injected, providing a safe, non-allergenic alternative to collagen injections, for plumping lips and lifting wrinkles. Best of all, it’s non-toxic, doesn’t cause mutations, and it’s safe for pregnant women to take.

Hyaluronic acid is by no means a solution to all of your problems, but it does have some amazing properties. Every few years, scientists learn more and more about what it can do. As we gain a better understanding of how humans heal and age, we can expect to hear a lot more about it in the future.

 

Summary Q&A

What is hyaluronic acid?

It’s a compound important for skin moisture, structure, and wound healing.

 

Where does it come from?

Our bodies make it, but when we get older, they stop producing as much. This is part of why older people have dry skin and take longer to recover from injuries.

 

Which foods contain it?

The only foods that have meaningful concentrations of it are animal parts with high-cartilage. Bone broth may have a little, but even that will degrade during the long cooking process.

Talk of naringenin in citrus fruits impeding the action of hyaluronidase (the enzymes that destroy hyaluronic acid) is technically correct. However, there isn’t a high enough concentration of it in fruits for it to be effective. A study had participants drink a variety of supermarket orange juices and then ran blood and urine tests on them. It found that peak concentration of naringenin in blood plasma was lower than the amount that could properly inhibit hyaluronidase by a factor of a hundred. That said, the effects of naringenin are very interesting.
You can read up more about them here.

In short, if people claim that a food other than chicken combs will help boost hyaluronic acid levels, they are (probably) lying to you.
If it’s not in food, then, where can I get it?
Supplements are both easy to get and widely available..

 

References

  1. Papakonstantinou E, Roth M, Karakiulakis G. Hyaluronic acid: A key molecule in skin aging. Dermatoendocrinol. 2012;4(3):253-8.
  2. Moreland LW. Intra-articular hyaluronan (hyaluronic acid) and hylans for the treatment of osteoarthritis: mechanisms of action. Arthritis Res Ther. 2003;5(2):54-67.
  3. Arrich J, Piribauer F, Mad P, Schmid D, Klaushofer K, Müllner M. Intra-articular hyaluronic acid for the treatment of osteoarthritis of the knee: systematic review and meta-analysis. CMAJ. 2005;172(8):1039-43.
  4. Wang CT, Lin J, Chang CJ, et al. Therapeutic effects of hyaluronic acid on osteoarthritis of the knee: a meta-analysis of randomized controlled trials J Bone Joint Surg. 2004;86:538–545
  5. Johansen M., Bahrt H., Altman R.D., Bartels E.M., Juhl C.B., Bliddal H., Lund H., Christensen R. Exploring reasons for the observed inconsistent trial reports on intra-articular injections with hyaluronic acid in the treatment of osteoarthritis: Meta-regression analyses of randomized trials. Semin. Arthritis Rheum. 2016;46:34–4
  6. Bisicchia S, Tudisco C. Hyaluronic acid vs corticosteroids in symptomatic knee osteoarthritis: a mini-review of the literature. Clin Cases Miner Bone Metab. 2017;14(2):182-185.
  7. Oe M, Tashiro T, Yoshida H, et al. Oral hyaluronan relieves knee pain: a review. Nutr J. 2016;15:11.
  8. Reed MJ, Damodarasamy M, Chan CK, Johnson MN, Wight TN, Vernon RB. Cleavage of hyaluronan is impaired in aged dermal wounds. Matrix Biol. 2012;32(1):45-51.
  9. Damodarasamy M, Johnson RS, Bentov I, MacCoss MJ, Vernon RB, Reed MJ. Hyaluronan enhances wound repair and increases collagen III in aged dermal wounds. Wound Repair Regen. 2014;22(4):521-6.
  10. Kawada C, Yoshida T, Yoshida H, et al. Ingested hyaluronan moisturizes dry skin. Nutr J. 2014;13:70
  11. Kawada C, Yoshida T, Yoshida H, et al. Ingestion of hyaluronans (molecular weights 800 k and 300 k) improves dry skin conditions: a randomized, double blind, controlled study. J Clin Biochem Nutr. 2014;56(1):66-73.
  12. Göllner I, Voss W, von Hehn U, Kammerer S. Ingestion of an Oral Hyaluronan Solution Improves Skin Hydration, Wrinkle Reduction, Elasticity, and Skin Roughness: Results of a Clinical Study. J Evid Based Complementary Altern Med. 2017;22(4):816-823.
  13. Maytin EV. Hyaluronan: More than just a wrinkle filler. Glycobiology. 2016;26(6):553-9.
  14. Moon SH, Lee NK, Kim KT, Han YN et al.  Inhibitory Effects of Naringenin and Its Novel Derivatives on Hyaluronidase Food Science and Biotechnology 2009;18(1):267-270
  15. Vallejo F, Larrosa M, Escudero E, Zafrilla MP, Cerda B, Boza J, Garcia-Conesa MT et al. Concentration and Solubility of Flavanones in Orange Beverages Affect Their Bioavailability in Humans J. Agric. Food Chem. 2010;58(10): 6516-6524

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