Physiochemical properties and application of hyaluronic acid: a systematic review

J Cosmet Dermatol. 2016 Dec;15(4):520-526. doi: 10.1111/jocd.12237. Epub 2016 Jun 21.


Background: Hyaluronic acid is a widely available, biocompatible, polysaccharide with distinguishing physiochemical properties which inspire its application throughout several fields of medicine.

Objective: We aim to investigate the application of hyaluronic acid and its effectiveness throughout several fields of medicine, including several therapies administered and prescribed by general health practitioners.

Methods: We conducted a systematic review on randomized controlled trials about the physiochemical properties of hyaluronic acid and its application through primary care. Studies included in this review were peer reviewed and met our inclusion criteria.

Findings: Factors were clustered into the following: uses throughout several fields of medicine, physiochemical properties, bioavailability, tolerance, effectiveness, and adverse effects. Therapies with hyaluronic acid provided long-lasting, pain relieving, moisturizing, lubricating, and dermal filling effect. Tissue hydration, elasticity, and durability improved.

Conclusions: Adjunct therapy with hyaluronic acid provides longer-lasting therapeutic effect when compared to the use of glucocorticosteroids and NSAIDs in osteoarthritic chronic diseases, is well-established in ophthalmology due to its lubricating properties for the corneal endothelium, and improves tissue hydration and cellular resistance to mechanical damage in aesthetic dermatology, and has marginal adverse effects. Several trials indicated its role in tumor markers, liver diseases, and in pharmaceuticals, but further research would be necessary to draw conclusive results in those fields.

Keywords: adjuvant therapy; bioavailability; hyaluronic acid; long-lasting effect; tolerability; wound healing.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Biological Availability
  • Cosmetic Techniques
  • Dermal Fillers / adverse effects
  • Dermal Fillers / pharmacokinetics
  • Dermal Fillers / therapeutic use*
  • Dry Eye Syndromes / drug therapy
  • Humans
  • Hyaluronic Acid / adverse effects
  • Hyaluronic Acid / metabolism
  • Hyaluronic Acid / pharmacokinetics
  • Hyaluronic Acid / therapeutic use*
  • Neoplasms / metabolism*
  • Osteoarthritis / drug therapy
  • Randomized Controlled Trials as Topic
  • Viscosupplements / adverse effects
  • Viscosupplements / pharmacokinetics
  • Viscosupplements / therapeutic use*


  • Dermal Fillers
  • Viscosupplements
  • Hyaluronic Acid