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Hyaluronic acid and its function in the skin.
Hyaluronic acid is a ground substance. Combined with collagen and elastin it forms the mainstay of the dermis. HA is produced by cells called fibroblast. Hyaluronic acid has come a long way over the past few decades with new formulations, both delivered as a cream topically to the epidermis as well as fillers delivered into the dermis. New methods of making HA has resulted in better, longer lasting HA molecules.
 
How is hyaluronic acid made?
Hyaluronic acid is manufactured using sterile techniques.  In the past, hyaluronic acid was manufactured using rooster combs.  Newer forms of hyaluronic acid for creams contain different-sized particles known as polymolecular HAs. These variable size molecules enable better penetration into the epidermis.  As yet, there are no forms of hyaluronic acid applied topically that can reach the dermis.
 
What HAs are best to use?
Most manufacturers now provide a poly molecular weight hyaluronic acid creams.  Companies such the Ordinary makes a cost-effective hyaluronic acid.  In my opinion due to the fact that hyaluronic acid is degraded within 24 to 36 hours, spend your money on hyaluronic acid for dermal fillers rather than creams.  Dermal fillers act in the deeper parts of the skin using cross-linked hyaluronic acid.  Dermal fillers will last anywhere between 6 to 24 months depending on the brand and cross-linking.  Hyaluronic acid applied on the skin will degrade within a day or two.
 
How can I incorporate hyaluronic acid into my skin care routine?
If you are living in a humid environment, hyaluronic acid can be used on skin without preparation.  This is because hyaluronic acid acts as a humectant drawing moisture in to the skin.  If you live in a low-humidity environment, hyaluronic acid should be applied after a bath or shower and occluded with your moisturiser of choice.  This is to decrease dehydration from your skin due to large-particle HA creams which may not go into the lower aspects of your epidermis.
 
Hyaluronic acid in dermal fillers.
There are many types of dermal fillers consisting of hyaluronic acid, I do believe that working with many different brands and subtypes is important because it gives a good selection of material for your dermatologist or plastic surgeon.  Hyaluronic acids which are cross-linked and dense can be used as a foundation; however, more fluid hyaluronic acid fillers can be used to improve areas such as under the eyes. 

What Hyaluronic Acid creams do I recommend?
Every skin care company will have a variation of their formulation of HA in either a serum or cream. The Ordinary produces cheap, cost effective HAs. If you have sensitive skin, opt for a cream over a serum. If you live in a low humidity environment make sure you moisturise after applying HA creams/serums.

Can Hyaluronic Acid be mixed with other skin care?
Absolutely. HA can increase penetration of actives into the deeper epidermis. Because pure HA is part of your natural component of your dermis, this molecule is banal meaning it does not present itself as an antigen. Allergy to pure HA is almost unheard of, if you do react to HA creams, it is more than likely due to other components of the cream- for example Propylene Glycol, SLS, fragrance, preservatives etc..

Guys, thanks for watching this short video on hyaluronic acid. Cheers,
Dr Davin S. Lim, laser and aesthetic dermatologist
Brisbane. Australia. Cutis International

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