Is oral hyaluronic acid (HA) more beneficial than topical facial serum for skin health?

From the Guidelines

Oral hyaluronic acid (HA) is not proven to be more beneficial than topical facial serum for skin health, and the current evidence does not support its use as a first-line treatment for skin health. When considering the management of skin health, the most recent and highest quality study available is from 2019, which focuses on the management of congenital ichthyoses and emphasizes the importance of topical therapy 1. While this study does not directly compare oral hyaluronic acid to topical facial serum, it highlights the effectiveness of topical agents in reducing scales, skin discomfort, and pruritus, and improving the general appearance of the skin. Some key points to consider when evaluating the benefits of oral hyaluronic acid versus topical facial serum include:

• The mechanism of action: topical agents work directly on the skin's surface, while oral supplements aim to increase the body's natural production of hyaluronic acid
• The onset of results: topical serums can deliver immediate visible results, while oral supplements may take longer to show benefits
• The potential for whole-body benefits: oral hyaluronic acid supplements may provide benefits beyond skin health, such as joint health However, without direct evidence comparing the two, it is essential to prioritize the approach with the strongest evidence base, which currently supports the use of topical therapy 1. In real-life clinical practice, the decision to use oral hyaluronic acid or topical facial serum should be made on a case-by-case basis, taking into account individual patient needs and preferences. Ultimately, the most effective approach may involve a combination of both oral and topical therapies, but this should be guided by the best available evidence and expert recommendations.

From the Research

Comparison of Oral and Topical Hyaluronic Acid for Skin Health

• Oral hyaluronic acid (HA) has been shown to improve skin condition, including wrinkle assessment, stratum corneum water content, transepidermal water loss, and elasticity 2, 3, 4.
• Topical HA serum has also been found to increase skin hydration, smoothness, plumping, and improve fine lines and wrinkles 5, 6.
• Both oral and topical HA have been demonstrated to be well-tolerated and effective in improving skin health, with no significant side effects reported 2, 5, 3, 4, 6.
• The studies suggest that oral HA may have a more prolonged effect on skin health, with significant improvements seen after 8-12 weeks of ingestion 2, 4.
• Topical HA serum, on the other hand, has been shown to provide immediate and sustained increases in skin hydration, with improvements seen immediately after application and lasting for up to 6 weeks 5.

Key Findings

• Oral HA ingestion has been found to suppress wrinkles and improve skin condition, with significant improvements in wrinkle assessment, skin elasticity, and hydration 2, 3, 4.
• Topical HA serum has been shown to provide excellent skin hydration, with a sustained increase in skin hydration of 55% after 6 weeks of use 5.
• The combination of topical HA with other treatments, such as Botulinum toxin type A, has been found to lengthen the duration of the treatment's effect in reducing wrinkles 6.

Mechanisms of Action

• HA has been found to have a critical moisturizing property and high water retention capacity, making it useful for improving skin hydration and reducing wrinkles 2, 5, 3, 4, 6.
• The exact mechanisms of action of oral and topical HA are not fully understood, but it is thought that HA may help to preserve tissue hydration and improve skin elasticity 2, 3, 4.