Hyaluronic acid
Hyaluronic acid applied to the skin as a cream or serum improves hydration and elasticity against a plain base in small trials, and eye drops ease dry-eye symptoms in a systematic review of 39 trials. It does not work like a filler when applied to skin, oral supplements have mixed results for skin, and for knee osteoarthritis NICE advises against the injections.
The one serious risk is with dermal fillers, which the FDA says can cause tissue death, blindness and stroke if injected by an unqualified provider.
At a glance
Last reviewed 10 October 2026What it's used for
Evidence is rated per use. The same ingredient can be strong for one thing and traditional for another.
| Use | Evidence | What the research shows |
|---|---|---|
| Skin hydration and elasticity, topicalCompare remedies for skin → | Moderate | In a trial of 76 women aged 30 to 60 with wrinkles around the eyes, 0.1% hyaluronic acid creams applied twice daily for 60 days improved skin hydration and elasticity against a plain cream on the other side, at every molecular weight tested (50 to 2,000 kDa); only the 50 and 130 kDa creams reduced wrinkle depth. In 36 nursing-home residents aged 60 to 80 with dry skin, low-molecular-weight hyaluronic acid gave a skin hydration reading of 56.37 units against 49.01 for the plain base after four weeks (p < 0.001), but water loss through the skin and symptom scores did not differ, and no side effects were found. So it hydrates the skin surface; it does not fill wrinkles, and we found no trial comparing it with an ordinary moisturiser.1,2 |
| Dry eye, eye drops | Moderate | A systematic review of 39 randomised trials (3,469 patients) found hyaluronic acid drops gave greater improvement in patient-reported symptoms than placebo, other lubricants and active drugs, most clearly at 0.15 to 0.18% (mean difference on the OSDI symptom score -14.23). Objective measures such as tear break-up time and corneal staining were variable and often not significant. The authors describe it as a first-line option for mild-to-moderate dry eye, with the caveat that formulations differ between trials.9 |
| Wrinkles and skin quality, oral supplement | Limited | In a trial of 60 Japanese adults aged 22 to 59, 120 mg a day of oral hyaluronic acid for 12 weeks gave better wrinkle measures than placebo, and the 300 kDa form significantly reduced wrinkles from week 8. A second trial of 40 healthy adults aged 35 to 64 taking 120 mg a day found better wrinkle scores, skin water content and elasticity than placebo at 12 weeks. Both had authors employed by the supplement maker Kewpie. A 2025 systematic review of 40 photoageing trials found hyaluronic acid did not show a significant benefit for photoageing or skin elasticity, while finding oral supplements safe over trials of up to 24 weeks.3,10,4 |
| Knee osteoarthritis, oral supplementCompare remedies for joints and inflammation → | Limited | One double-blind trial gave 60 adults with grade 2 or 3 knee osteoarthritis 200 mg a day for 12 months, plus daily quadriceps exercises. Knee scores improved in both groups and tended to be better with hyaluronic acid; the difference from placebo was significant only in people aged 70 or under, and only at months 2 and 4. This is one small trial, so the evidence is thin.5 |
| Knee osteoarthritis, injection (medical procedure) | Traditional | Not a self-treatment. NICE's 2022 osteoarthritis guideline says not to offer intra-articular hyaluronan injections. A network meta-analysis of 57 large trials (22,795 participants) found that in the lower-risk trials hyaluronic acid had no effect on pain (standardised difference -0.04, 95% credible interval -0.19 to 0.11, 11 trials), against a minimum clinically important difference of -0.37, and caused more dropouts due to side effects (OR 2.01) and serious adverse events (OR 1.86) than placebo. Rated at the bottom because the best current evidence shows no pain benefit.6,7 |
How much
Ranges below are what studies used and what supplements commonly contain. They are not a recommendation for you. Start at the low end.
How people take it
Safety
Who should avoid
- Dermal fillers from unlicensed providers — FDA warns of tissue death, blindness and stroke
- Knee osteoarthritis — NICE advises against hyaluronan injections; discuss other options
- Urgent: unusual pain, vision changes or pale skin after a filler — seek immediate care
- Pregnancy and breastfeeding — we found no safety data for oral or topical use
Known interactions
Questions people ask
Does hyaluronic acid work for skin?
Applied to skin it improves hydration and elasticity compared with a plain base in small trials, but it hydrates rather than filling wrinkles. Oral supplements gave better wrinkle scores in two small trials whose authors worked for a supplement maker, while a systematic review of photoageing trials found no significant benefit.
How do I use hyaluronic acid serum?
The cream trial used a 0.1% product twice a day for 60 days, and lower-molecular-weight forms did better. We found no trial on whether to apply it to damp or dry skin, or before or after other products, so follow the label and give it about a month.
What are the side effects of hyaluronic acid?
No side effects were found in the topical dry-skin trial, and oral supplements were judged safe over trials of up to 24 weeks. The serious risks are with procedures: knee injections caused more dropouts and serious adverse events than placebo in large trials, and the FDA warns that dermal fillers can cause tissue death, blindness and stroke.
Is hyaluronic acid good for hair?
We found no human trial of hyaluronic acid for hair growth or hair quality, so we cannot say it works. Any benefit from a serum on the scalp would be surface hydration at most.
Sources (10)
- Randomised controlled trial Pavicic T, Gauglitz GG, Lersch P, et al. Efficacy of cream-based novel formulations of hyaluronic acid of different molecular weights in anti-wrinkle treatment. J Drugs Dermatol. 2011.
- Randomised controlled trial Muhammad P, Novianto E, Setyorini M, et al. Effectiveness of topical hyaluronic acid of different molecular weights in xerosis cutis treatment in elderly: a double-blind, randomized controlled trial. Arch Dermatol Res. 2024.
- Randomised controlled trial Oe M, Sakai S, Yoshida H, et al. Oral hyaluronan relieves wrinkles: a double-blinded, placebo-controlled study over a 12-week period. Clin Cosmet Investig Dermatol. 2017.
- Systematic review Yang Q, Li H, Zhang H, Ma L, Zhang X, Wu J. Effectiveness of dietary supplements for skin photoaging in healthy adults: a systematic review and meta-analysis of randomized controlled trials. Front Med (Lausanne). 2025.
- Randomised controlled trial Tashiro T, Seino S, Sato T, Matsuoka R, Masuda Y, Fukui N. Oral administration of polymer hyaluronic acid alleviates symptoms of knee osteoarthritis: a double-blind, placebo-controlled study over a 12-month period. ScientificWorldJournal. 2012.
- Clinical guideline NICE. Osteoarthritis in over 16s: diagnosis and management (NG226). Recommendations. 2022.
- Systematic review Pereira TV, Saadat P, Bobos P, et al. Effectiveness and safety of intra-articular interventions for knee and hip osteoarthritis based on large randomized trials: a systematic review and network meta-analysis. Osteoarthritis Cartilage. 2025.
- Regulator guidance US Food and Drug Administration. Dermal Fillers (Soft Tissue Fillers).
- Systematic review Martinez-Perez C, Sánchez-González MC, Sánchez-González JM. Optimizing hyaluronic acid therapy for dry eye disease: a systematic review, meta-analysis, and meta-regression by concentration and comparator type. Cont Lens Anterior Eye. 2026.
- Randomised controlled trial Hsu TF, Su ZR, Hsieh YH, et al. Oral hyaluronan relieves wrinkles and improves dry skin: a 12-week double-blinded, placebo-controlled study. Nutrients. 2021.
Last reviewed 10 October 2026 · Next review April 2027 · How we rate evidence
Reader notes
Experiences and questions from readers, read by an editor before they appear. They are personal accounts, not evidence, and are not medical advice.