Hyaluronic Acid

Last Updated: November 18 2022

Hyaluronic acid is a large polysaccharide found in many tissues, especially cartilage and synovial fluid. It is often supplemented for skin and join health, as well as for dry eyes when used as an ingredient in eye drops.

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Hyaluronic Acid is most often used for

Are hyaluronic acid eye drops good for dry eyes?

Dry eyes are caused by a lack of tear production or fast evaporation. One method for managing the systems is to use “artificial tear” products—eye drops that can lubricate eyes. Hyaluronic acid (HA) has been investigated as a component of artificial tear products due to its ability to bind to ocular surface cells, enhance wound healing, and reduce the viscosity of the overall fluid.[1]

A 2021 meta-analysis of randomized, controlled trials on participants with dry eye syndrome compared eye drops containing HA with eye drops not containing HA, including many artificial tear products with other ingredients.[2] Hyaluronic acid improved tear production relative to saline and some artificial tear products, but not all artificial tear products. The same was true of tear break-up time and Ocular Surface Disease Index, while an analysis comparing HA products to those without HA didn’t find a difference for Corneal Fluorescein Staining Score. Trials where HA is compared to artificial tear products are often confounded with other ingredients that make it difficult to discern the efficacy of HA. A 0.3% HA solution appeared to be the most effective relative to saline, though the evidence doesn't allow us to say that this dose is the best with much certainty. Doses as low as 0.1% have seen some benefit and may be useful as an addition to multi-ingredient artificial tear products, though much more research with the proper study design is needed to evaluate the ideal formulae.

Hyaluronic acid is likely a beneficial ingredient in eye drops intended to treat dry eye syndrome, and a high dose solution (0.3%) may be especially useful. In addition, artificial tear products that contain hyaluronic acid may be optimal, though much more evidence is needed to establish the ideal formulae.

What else is Hyaluronic Acid known as?
Note that Hyaluronic Acid is also known as:
  • Hyaluronan
  • Hyaluronate (as sodium or potassium salt)
Dosage information

Dry eyes: If hyaluronic acid is the only active ingredient, 0.3% solution may be best. If other active ingredients are present, a minimum of 0.1% has been shown to be effective.

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References
1.^Lyndon Jones, Laura E Downie, Donald Korb, Jose M Benitez-Del-Castillo, Reza Dana, Sophie X Deng, Pham N Dong, Gerd Geerling, Richard Yudi Hida, Yang Liu, Kyoung Yul Seo, Joseph Tauber, Tais H Wakamatsu, Jianjiang Xu, James S Wolffsohn, Jennifer P CraigTFOS DEWS II Management and Therapy ReportOcul Surf.(2017 Jul)
2.^Yun-Jung Yang, Won-Young Lee, Young-Jin Kim, Yeon-Pyo HongA Meta-Analysis of the Efficacy of Hyaluronic Acid Eye Drops for the Treatment of Dry Eye SyndromeInt J Environ Res Public Health.(2021 Mar 1)
3.^Weiping Wu, Lifen Chen, Yanzhong Wang, Jing Jin, Xinyou Xie, Jun ZhangHyaluronic acid predicts poor prognosis in breast cancer patients: A protocol for systematic review and meta analysisMedicine (Baltimore).(2020 May 29)
4.^Ziwen Zhang, Detao Tao, Ping Zhang, Xue Liu, Yuchao Zhang, Jie Cheng, Hua Yuan, Laikui Liu, Hongbing JiangHyaluronan synthase 2 expressed by cancer-associated fibroblasts promotes oral cancer invasionJ Exp Clin Cancer Res.(2016 Nov 25)
5.^Andreas Josefsson, Hani Adamo, Peter Hammarsten, Torvald Granfors, Pär Stattin, Lars Egevad, Anna Engström Laurent, Pernilla Wikström, Anders BerghProstate cancer increases hyaluronan in surrounding nonmalignant stroma, and this response is associated with tumor growth and an unfavorable outcomeAm J Pathol.(2011 Oct)
6.^Man Wu, Manlin Cao, Yiqing He, Yiwen Liu, Cuixia Yang, Yan Du, Wenjuan Wang, Feng GaoA novel role of low molecular weight hyaluronan in breast cancer metastasisFASEB J.(2015 Apr)
7.^Essi L J Hiltunen, Maarit Anttila, Anne Kultti, Kirsi Ropponen, Jorma Penttinen, Merja Yliskoski, Arja T Kuronen, Matti Juhola, Raija Tammi, Markku Tammi, Veli-Matti KosmaElevated hyaluronan concentration without hyaluronidase activation in malignant epithelial ovarian tumorsCancer Res.(2002 Nov 15)
8.^Zoe K Price, Noor A Lokman, Carmela RicciardelliDiffering Roles of Hyaluronan Molecular Weight on Cancer Cell Behavior and Chemotherapy ResistanceCancers (Basel).(2018 Dec 3)
9.^Xiao Tian, Jorge Azpurua, Christopher Hine, Amita Vaidya, Max Myakishev-Rempel, Julia Ablaeva, Zhiyong Mao, Eviatar Nevo, Vera Gorbunova, Andrei SeluanovHigh-molecular-mass hyaluronan mediates the cancer resistance of the naked mole ratNature.(2013 Jul 18)
10.^Peter K Kim, Christopher J Halbrook, Samuel A Kerk, Megan Radyk, Stephanie Wisner, Daniel M Kremer, Peter Sajjakulnukit, Anthony Andren, Sean W Hou, Ayush Trivedi, Galloway Thurston, Abhinav Anand, Liang Yan, Lucia Salamanca-Cardona, Samuel D Welling, Li Zhang, Matthew R Pratt, Kayvan R Keshari, Haoqiang Ying, Costas A LyssiotisHyaluronic acid fuels pancreatic cancer cell growthElife.(2021 Dec 24)
11.^Satoshi Seino, Fumitaka Takeshita, Akira Asari, Yasunobu Masuda, Masaaki Kunou, Takahiro OchiyaNo influence of exogenous hyaluronan on the behavior of human cancer cells or endothelial cell capillary formationJ Food Sci.(2014 Jul)