Hyaluronic Acid

• Hyaluronic acid (HA) moisturizes skin from the inside out, smoothing out wrinkles in the process. HA acts as an internal cosmetic to hydrate the skin.
• Hyaluronic acid is for people who need to ease the flexing of their joints, especially their knees, by moisturizing their joints.
• Hyaluronic acid is for men and women in their 30s and 40s who are beginning to see the first signs of aging.
• Hyaluronic acid is for seniors who have established joint conditions.

Basic Functions of Hyaluronic Acid
As Hyaluronic Acid is present in every tissue of the body; hyaluronic acid’s importance cannot be underestimated. Retention of water is one of the most important biological functions of hyaluronic acid (references), second only to providing nutrients and removing waste from cells that do not have a direct blood supply, such as cartilage cells. With a lower than adequate amount of hyaluronic acid, nutrients cannot be moved into these cells and waste cannot be eliminated from cells. Hyaluronic acid is sometimes abbreviated as HA.

Hyaluronic acid is found in the synovial joint fluid, the vitreous humor of the eye, the cartilage, blood vessels, extracellular matrix, skin and the umbilical cord (references).

Hyaluronic Acid in the Skin
In the skin, the extracellular matrix is composed of hyaluronic acid and other sulfated GAGs, combined with collagen and elastin. Large amounts of water are held in the ECM. When elastin is not bathed in water, it becomes dry and brittle, thus the look of dry, brittle, wrinkled skin (references).

Half-life is defined as the time required for one half of the total amount of a particular substance to be consumed, broken down, or depleted. The half-life of hyaluronic acid in the cartilage is 2-3 weeks. But the half-life of hyaluronic acid in the skin is less than 1 day! Hyaluronic acid is present in both the dermis and the epidermis. 50% of the body’s naturally produced hyaluronic acid that is found in the epidermis is metabolized and excreted in less than 24 hours. Like hyaluronic acid produced in the body, hyaluronic acid taken as a nutritional supplement moisturizes from the dermis to the epidermis - from deeper layers of the skin to the outer layer.

The extracellular matrix fills up the space between the skin cells. This makes the skin soft, smooth and elastic. But as we age, hyaluronic content in the skin changes due to two separate clinically proven factors.
There is a decrease in synthesis of hyaluronic acid.

Recompartmentalization – from the epidermis to the dermis.
Both changes leave the epidermis depleted in hyaluronic acid resulting in thinning, aging, and decreased moisture in the skin.

Medical Treatment with Hyaluronic Acid
Hyaluronic acid for use by humans has been derived from rooster combs. Rooster combs provide the purest form of hyaluronic acid available.

Skin Treatment
Hyaluronic acid injection can be used to improve the skin's contour and reduce depressions in the skin due to acne, scars, injury or lines. Immediately or within a few hours after injection the site may be red and swollen. This usually disappears within a week. Another one or two treatments (at least a week apart) may be necessary to achieve the desired correction. Hyaluronic acid implantation is not permanent. Like natural hyaluronic acid, manufactured hyaluronic acid once injected into the skin will gradually break down and be absorbed by the body. In most cases, the hyaluronic acid augmentation usually lasts between 6-9 months. Compared to collagen implants hyaluronic acid appears to have a longer augmentation effect, possibly lasting 2 to 3 times longer than the average collagen implant. To maintain the initial results, repeat hyaluronic acid injections or top-up treatments will be necessary. Most people following this protocol have 2 to 3 treatments per year (references).

Alternative Treatments
Alternative treatments which impact the hyaluronic acid in the skin include Retinoids prescribed by physicians which increase the natural synthesis of hyaluronic acid and accelerate the shedding of the skin. Chemical peels remove the top, dry layer(s) of the skin. Facials cleanse the pores and superficially moisturize the skin.

Conclusion

• Hyaluronic acid is essential for the health of the synovial fluid which supports the bones and joints.
• Hyaluronic acid is essential for the structure of the extracellular matrix in the skin and to insure that the matrix has the ability to hold onto its essential fluid – hydration of the skin.
• The extracellular matrix in the skin keeps the skin moist and supple.
• The skin must have hyaluronic acid introduced from the inside out – from the dermis to the epidermis.
• Hyaluronic acid for supplementation is extracted from rooster combs. It is the purest form available.
• Proprietary processing by a method such as the Injuv™ method is done to produce low molecular weight hyaluronic acid which is absorbable through the intestinal tract.
• Supplementation with hyaluronic acid is crucial due to decreased synthesis or recompartmentalization of hyaluronic acid that occurs with aging.

References
Block, A., and Bettelheim, F.: Water Vapor Sorption of Hyaluronic Acid, Biochim Biophys Acta 201, 69, 1970

Goa K. L. and Benfield P.: Drugs 1994, 47: 536-566.

Laurent, T., and Gergely, J.: Light Scattering Studies on Hyaluronic Acid, J Biol Chem 212, 325, 1955.

George E. Intra-articular hyaluronan treatment for osteoarthritis. Ann Rheum Dis 1998;57:637-40.

Wobig M, Bach G, Beks P, Dickhut A, Runzheimer J, Schwieger G, et al. The role of elastoviscosity in the efficacy of viscosupplementation for osteoarthritis of the knee: a comparison of hylan G-F 20 and a lower-molecular-weight hyaluronan. Clin Ther 1999;21:1549-62.

Weiss C, Balazs EA, St. Onge R, Denlinger JL. Clinical studies of the intraarticular injection of HealonR (sodium hyaluronate) in the treatment of osteoarthritis of human knees. Osteoarthritis symposium. Palm Aire, Fla., October 20-22, 1980. Semin Arthritis Rheum. 1981;11(suppl 1):143-4.

New Zealand Dermatological Society, Dec 2, 2002.