Hyaluronic Acid Side Effects

Hyaluronic acid is naturally present in the body of human beings, with the highest concentrations occurring in the eye and joint fluids. The acid for medicinal use is extracted from rooster combs or synthesized in the laboratory using bacteria. Hyaluronic acid is used as oral preparation or injection for various purposes as follows:

  • Treatment of joint disorders such as osteoarthritis.
  • During some eye surgeries such as removal of cataract, transplantation of cornea, detached retina repair and certain eye injuries. FDA has approved the use of hylaronic acid for such surgeries.
  • As a lip filler in plastic surgery.
  • In the healing of wounds, burns and skin ulcers and also as a skin moisturizer.
  • In preventing effects of aging.

Hyaluronic acid works by providing a cushioning and lubricating effect to the joints and tissues. It also modifies the body’s response to an injury.

Generally, prescriptions forms of hyaluronic acid have been found to be safe with most people. However, some people may develop some side effects. The most common hyaluronic acid side effects are pain and redness in the area of injection, increased pressure in the eye after a surgery, itching, swelling and tenderness. Hyaluronic acid rarely causes severe allergic reactions. Adverse side effects include necrosis or tissue death, acne, infection and allergic reactions in a few instances.

As far as interactions with other medicines are concerned, it has been observed that vitamin E supplements, aspirin and certain nonsteroidal anti-inflammatory drugs increase bleeding or bruising following an injection of hyaluronic acid. It is, therefore, recommended that patients stop taking these medications at least a week before going in for hyaluronic acid injection. Pregnant and breast-feeding women should avoid the use of hyaluronic acid in any form.

Common hyaluronic acid side effects such as bruising, inflammation and skin soreness usually disappear in 2 – 3 days time and may not require medical attention as the body adjusts to the medication. If some of the side effects persist or become bothersome, it is important that the doctor is informed of the same. Further, immediate medical attention must be sought if other side effects that are not mentioned in the article occur.

The side effects caused by hyaluronic acid supplements are not fully known and have not been scientifically studied till now. However, consumption of these supplements by cancer patients with lymphedema and rheumatoid arthritis patients is not recommended as it may lead to worsening of the symptoms. The side effects of hyaluronic acid indicated for topical application may include mild skin irritation, but scientific studies have not yet been conducted to recognize other severe or adverse side effects.


Hyaluronic Acid Injection Side Effects – Individual Case Reviews


A male patient with a history of osteoarthritis experienced redness of knee, warmth in the knee, swelling in the knee and knee after the second injection of synvisc (Hylan G-F 20).A lady who was given an injection each of perlane and restylane (both cross-linked hyaluronic acid dermal fillers) at nasolabial fold and the prejowl area was not able to move the right side of the face well after the procedure.


A lady who received an injection of prevelle silk (non-animal stabilized Hylan B gel with lidocaine HCl) for crow’s feet and vertical perioral lines experienced moderate side effects like redness, burning, swelling, slight itching at the site of the injection around both eyes and the mouth.


A lady treated with three injections of hyalgan intra-articular hyaluronic acid in the knee. The patient had earlier taken hyalgan injection in the left shoulder and had experienced eruption on left ear, oedema, erythema and puritus. Three months prior to this she had received hyalgan 20 mg/2ml and had experienced urticaria, fever and serum sickness. The patient recovered following corticotherapy.


Summarizing, hyaluronic acid is a natural occurring compound in the human body and hence its preparations are well tolerated by most people who undergo treatment for osteoarthritis, anti-aging, etc. Hyaluronic acid is available in different forms: as injections, ointments for topical application, supplements, etc. Generally, hyaluronic side effects, if they occur, are mild and mostly associated with preparations used for injections. Some of the serious side effects usually happen after multiple injections. However, a patient should discuss in detail with the doctor about the side effects before receiving any hyaluronic acid treatment.


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