“Aging skin is skin that is losing its ability to hold water.” When first hearing this statement, upon which Dr. Murad’s anti-aging philosophy is based, one might be inclined to think that the easy remedy to this parched predicament is to simply drink more water. But unfortunately, after the body has reached its natural saturation point, drinking more simply means more trips to the potty and not necessarily more supple skin. (By the way, a quick way to determine hydration levels is by the color of your urine; the more close to clear it is, the higher the hydration.) So if you are determined to find ways to trick the skin into staying as positively plump as possible without having to move to the tropics, it’s time to get acquainted with the miracle molecule, hyaluronic acid.
Hyaluronic acid (HA), is a “goo” molecule; a polymer of disaccharides (two sugars) which are glucuronic acid and glucosamine. You have probably heard of the latter as a supplement for joint lubrication and health. Together along with silicon, they form the ultimate hydrating particle which can hold 1,000 times its weight in water! It is produced in the body, offering a natural way to keep skin youthful without the introduction of toxic skin products. It is highest in concentration in the skin, joints, eye sockets, and other tissues where it helps retain water and collagen, providing elasticity and flexibility. HA is a key piece of the biological scaffolds upon which new cells are constructed during skin wound repair and is also involved in the inflammatory response.
Otherwise known as sodium hyaluronate (the salt of HA that is smaller and able to penetrate the epidermis) and hyaluronan, it was first used as an eye lube and now has slipped its way into all kinds of creams to hydrate skin. It is considered a miracle moisturizer because it is able to address both intrinsic chronoaging (aging caused by father time) and extrinsic photoaging (exposure to sun and other oxidative stressors). But unfortunately, as we age, the amount of hyaluronic acid in our tissues begins to decline. Also, when skin is exposed to excessive UVB rays, it becomes inflamed – what we recognize as a sunburn. This causes the cells in the dermis to produce less hyaluronan[2], further reducing their ability to retain water and then, just like Dr. Murad said, we have “aging skin.” Just one more reason to encourage the consistent use of sunblock. Even better – a sun cream that includes HA.
• WEAR IT
The easiest way to incorporate hyaluronic acid into your client’s beauty regimen is to choose products containing this plumping polymer. Hyaluronic acid is a humectant, drawing water out of the environment and locking it onto the surface of the skin. These products help to naturally prevent transepidermal water loss, reducing the signs of aging such as wrinkles, flakiness and dryness. A study published in the Journal of Cosmetic Dermatology indicated that a Swiss product that incorporates five different molecular weights of HA was “able to provide an improvement in the appearance of chronoaged skin in subjects showing mild-to-moderate clinical signs of ageing skin on the face.”[3] Some study participants reported increased cheek volume and fuller lips; two traits associated with youthfulness.
Concentrated serums and eye creams may yield improvements in as little as two to four weeks, but many immediately report dewier and smoother skin right after application.
• INJECT IT
The most highly researched benefit of hyaluronic acid is its ability to alleviate aching joints. In 2007, the EMA (Europe’s equivalent of the FDA) approved Hylan-GF20 as an injectable treatment for ankle and shoulder osteoarthritis pain. It is a major component of cartilage and synovial fluid that bathes the joints with a thick gelatinous liquid allowing bones to glide and cartilage to act like shock absorbers. When HA levels drop, dryness sets in and so do creaks, degenerative joint disease and pain. The re-introduction of it in the form of a “lube job” buffers bones, provides resistance to wear and tear and keeps things working smoothly.
Speaking of smooth, it is also being injected into the dermis to fill out wrinkles (thus its general name in the beauty industry, “filler”). Since it normally exists in our tissue, HA is a safe way to fill in creases such as the laugh lines between our nose and mouth (nasolabial folds) and inflate areas of hollowness on cheeks and even puff your pout. Nearly all challenges with the product come from the actual injection itself, as HA is compatible with the human body. So what kind of complications are most common? Bruising and swelling, and there is often substantial pain during injection, but these go away with time.
Yes, there are possibilities of other needle blunders and even a chance that your body will have a less than ideal response and these have been noted in the Journal of Dermatology & Dermatologic Surgery.[4] But, the biggest filler faux pas that can be avoided is by heeding to that age old adage that “less is more.” Remember, when Mae West said “Too much of a good thing can be wonderful,” fillers had not been invented! But even over-injection with too much product can be immediately corrected with the enzyme that breaks down HA, known as hyaluronidase.
So, if your clients are ready to pull’er into the station and filler’up – than the following considerations are recommended. First, stick with an FDA approved product. Second, there is a variation in the degree of cross linking and molecular weight and therefore densities of different HA products. Generally speaking, the more dense products are better for larger areas where more volume and firmness may be desired such as the cheeks. These denser varieties also tend to last longer. Medium dense products are suitable for the nasolabial folds, and less dense forms do well in the lip area and under eyes in the “tear troughs.” Third, find a highly skilled injector with lots of experience. There is an artform to injection, and identifying an individual who has mastered their craft is worth the time and effort.
Hyaluronic acid is a humectant, drawing water out of the environment and locking it onto the surface of the skin
• EAT IT
Now here is the fun part that most of your clients do not know about. Hyaluronic acid is edible! Oral hyaluronic acid is relatively cheap and as simple as placing an order on the internet and doing an add-on to your morning smoothie. You can soothe joints, hydrate tissues and, in the least, lube your digestive tube with one big blob of berry flavored goo in your favorite beverage. So here is how it works. When taken orally, especially in the liquid form, hyaluronic acid ramps up your own body’s natural production of this protective polymer presenting a non-invasive therapy for alleviating the symptoms of osteoarthritis.[5] It has also been shown that the molecules can actually be absorbed and are available to the human body.[6] Mix it in with a little glucosamine (the other sugar of the disaccharide pair that links together with glucuronic acid to make HA) and you’ve got a repair system that even Jiffy Lube would be proud of.
There is scientific support that oral supplementation with hyaluronic acid is useful in maintaining skin elasticity,[7] joint flexibility,[8] and sharp vision[9] among adults. Furthermore, HA also stimulates collagen production – so clients will be plump and firm. Win-win!
