Hyaluronic Acid Side Effects
November 2, 2011
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Hyaluronic Acid Side Effects, Danger, Risk

Hyaluronic Acid Injection
Hyaluronic acid was well-tolerated in a symptomatic treatment for knee osteoarthritis. The percentage of side effects is
about 2.5%. [8] Petrella RJ. performed three-intra-articular injection series with Suplasyn (10 mg/ml, 2-ml injection) to
patients suffered from knee osteoarthritis over 3 weeks. Dr. Petrella observed hyaluronic acid
side effects limited to
local pain and swelling. [7]

Hyaluronic Acid Injection Side Effect - a rare case
FDA MAUDE Adverse Event Report Event Date 03/29/2007 A female received two injections of hyaluronic acid a few
weeks apart for joint pain. This pt also has ra, taking mtx and prednisone. Within days following her second injection,
she developed n&v, frequent urination, generalized weakness, agitation and could not take her bp meds. Ua negative
for infection, no fever. Patient admitted to er and had a seizure; etiology unknown except her sodium had dropped to
126 within two days. Patient spent almost 2 weeks in the icu and another week in snf before returning home. She is
still weak. No syncope. But she does not remember having a seizure or the events that immediately followed. Her
mental status is 100% as it was prior to this event.

FDA has tried to understand the cause for the side effects of hyaluronic acid preparations. Adverse side effects from
injection of Hyaluronic acid preparations have been reported, which may be inflammatory in nature and involve
macrophages. FDA conducted a study and concluded that Inflammatory reactions, ie the side effect, attributed to
Hyaluronic acid preparations may be due not to the native molecule itself, but to possible endotoxin contamination.
Ascertaining the potential of Hyaluronic acid preparations to induce macrophage inflammation is an important
preclinical and batch-certification test. [FDA1] FDA research group also synthesized ferric hyaluronic acid gels using
two different sources of hyaluronic acid and varied cross linking density and hyaluronic acid concentration. They
measured hyaluronic acid molecular weight and molecular weight distribution. Preliminary experiments suggest that
the Intergel® formulation procedure produces non-homogeneous ferric hyaluronic acid gels due to poor control of
cross linking uniformity. Phase separation of the Fe-HA gels into phases of low and high gel density was visually
observed during formulation. Viscosity of the in-house freshly made Fe-HA gels differed widely from that of the original
Intergel® at the end of its two-year shelf life. FDA agents concluded that the lack of manufacturing control process for
the percent cross linking of Fe-HA could lead to non uniform visco-elastic properties, and compromise its ability to
spread and degrade in vivo. This could explain for the adverse side effects which include post-op pain, non infectious
peritonitis and foreign body reactions. [FDA2]

Hyaluronic Acid Dermal Fillers
Hyaluronic acid dermal fillers are commonly used to minimize the appearance of facial lines and wrinkles. After the
injection of hyaluronic acid, there is normally a mild inflammatory reaction. [17] Facial ischemia and herpes simplex
virus reactivation have also been reported. [
Hyaluronic acid injection]

Hyaluronic Acid Gel
In geneal, side effects of hyaluronic acid gel include bruising, redness, swelling, pain, tenderness and itching  In
addition, hyaluronic acid gel should not be used in patients suffered from severe allergies. [9]

Hyaluronic acid gel Filling
A new technique was proposed for treating "periorbital hollowing" with hyaluronic gel filling using a unique cannula
designed specifically for periorbital use. In a study, 26 patients with contour abnormalities in the periorbital area
(hollow eye ring, hollow cavities and deflated eyebrow) were treated with a cannula specific for periorbital injections.
Treatments where performed using local anaesthesia using the same protocol as Coleman lipostructure but using
hyaluronic acid gel. The hyaluronic acid gel used in each case was Restylane. After analysis of the patient responses
24 patients (92%) with a 6 months' follow-up were satisfied or very satisfied of aesthetic result after hyalurostructure of
periorbital region. However, there were 3 cases of bruising (3/52) and 4 cases of lymphatic stasis (4/52). [
Hyaluronic
acid Injection]
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Hyaluronic acid gel
In another study, 10 patients with tears troughs were treated with a hyaluronic acid gel filler. Side effects such as
bruising, erythema, local swelling, and pain at the injection site were noted. [15]

Oral hyaluronic acid tablets or capsules
Insufficient studies have been done on oral hyaluronic acid supplements to draw a conclusion for the side effects of
oral hyaluronic acid tablets or capsules.
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Hyaluronic acid Quick View
Hyaluronic Acid is a polysaccharide composed of alternating molecules of N-acetyl glucosamine and D-glucuronic acid. It
can be found within collagen throughout the body. As the most important space filling substance in the human body.
Hyaluronic Acid holds water to keep collagen hydrated and "youthful". Hyaluronic Acid forms a viscous fluid with
exceptional lubricating properties necessary for the vital functions of many parts of the human body including the skin,
heart valves, aqueous/ vitreous humor of the eye and synovial fluid (joint lubricant). The skin contains over 50% of the
bodies Hyaluronic Acid. Considering that skin is over 70% water and renews itself more readily than most other bodily
tissues. Definitely hyaluronic Acid may have benefits on skin's structure and daily maintenance.
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