Is Hyaluronic Acid Good for Acne? Let’s Break Down What Science Found

Hyaluronic acid has a long list of medical benefits, ranging from skincare to arthritis treatment. In dermatology, we prescribe the topical form to combat skin dryness and aging. The dermal fillers we use at the BHSkin Dermatology clinic, JuvedermⓇ and RestylaneⓇ, are derived from hyaluronic acid. 

But patients often ask, “Is hyaluronic acid good for acne?”

If you’re curious about the answer, read on. In this article, I discuss how hyaluronic acid works and what it can do for acne-prone skin. I also explain how you can prevent acne and when to see your dermatologist for this skin condition.

What Is Hyaluronic Acid, and How Does It Make Your Skin Look Radiant?

Hyaluronic acid is a long molecule made of special simple sugars. You can find this substance’s natural form in various parts of your body, being a vital component of connective tissue. Hyaluronic acid’s unique structure allows it to draw and retain water from the air or any moist surface it touches. Water absorption makes hyaluronic acid molecules expand significantly. It sounds simple, but these tiny changes translate into many health benefits you can actually see.

When applied to the skin’s surface, hyaluronic acid binds moisture from the surroundings. This hydrates and adds volume to your skin, soothing dryness and evening fine lines. Dry skin is irritation-prone. Preventing skin dryness is one of the ways that hyaluronic acid minimizes skin irritation.

As part of your connective tissue, hyaluronic acid promotes wound healing by various mechanisms. First, it supports immune cell function in the skin repair process. Second, it reduces inflammatory substances on the skin. Third, it enhances skin collagen and elastin production. So, besides skin hydration and protection from irritation, hyaluronic acid helps improve skin elasticity.

How Can Hyaluronic Acid Help Treat Acne?

Before exploring how hyaluronic acid can benefit pimple-prone skin, you must understand how acne forms. Acne arises from the inflammation of the “pilosebaceous unit,” or the part of your skin consisting of the hair follicle and its attached oil or sebaceous gland. Various factors can trigger an acne breakout, but the most common ones include hormonal changes, unhealthy eating, stress, poor hygiene, and medications.

Any of these triggers can cause abnormal growth of hair follicle and sebaceous gland cells. Uncontrolled hair follicle cell proliferation clogs the pores. Deranged oil gland cell growth makes your skin oily, but sebum quality is poor. Normal sebum has antimicrobial properties, which are lost due to oil gland dysfunction.

Oily skin is the breeding ground for pimple-causing bacteria, particularly Propionibacterium acnes. These microbes usually are harmless, but their waste products and unchecked reproduction can irritate the skin. The hair follicle gets inflamed, with pore clogging, sebaceous gland dysfunction, and bacterial overgrowth happening all at once. Acne subsequently develops and can grow, pop, or form pus.

A 2017 laboratory study showed that hyaluronic acid treatment can reduce abnormal oil gland growth and sebum formation. When you add this effect to its anti-inflammatory properties, hyaluronic acid may be able to protect your skin against acne breakouts.

However, hyaluronic acid’s impact on acne treatment or prevention when used alone remains to be seen. Currently, no large-scale clinical studies have proven its benefits as a stand-alone pimple treatment. Still, various topical hyaluronic acid formulations, such as serums and moisturizers, are widely prescribed as part of a complete acne skincare routine.

What Is the Best Way to Use Hyaluronic Acid for Acne?

Before I answer this question, allow me to share with you how healthcare providers generally approach acne treatment. First, we determine the nature and severity of the skin problem and the patient’s skin type after performing a thorough medical examination. From there, we create a personalized treatment regimen according to research-based guidelines.

For patients with mild acne, we often start with skin-applied isotretinoin, a vitamin A-like drug. This medication normalizes the growth of skin cells and enhances the skin’s immune reaction to pimple-causing bacteria. Some patients may benefit from benzoyl peroxide, which can also ward off microbes. Both these agents can dry the skin.

Topical antibiotics like erythromycin, clindamycin, and minocycline can get rid of bacteria and curb inflammation. However, these medications may induce antimicrobial resistance that can make them less effective over time. For people with recurrent acne breakouts, relying on such treatments may prove unsuitable in the long run. 

Clascoterone is a skin-applied agent that counters testosterone-like hormones stimulating acne formation. Salicylic acid can help remove blackheads and whiteheads by speeding up skin shedding. Azelaic acid improves blackheads and whiteheads and has antimicrobial and anti-inflammatory properties. This agent is appropriate for sensitive skin and skin of color, as it can lighten dark spots.

For moderate to severe acne, we often consider oral antibiotics, hormonal agents, and isotretinoin. Steroid injections are also an option. Oral antibiotics have pros and cons similar to topical ones, except they affect the whole body. Hormonal medications like oral contraceptives reduce the promotive effects of testosterone-like hormones on acne formation. 

I previously wrote about oral isotretinoin (Accutane), which is highly effective against severe acne but has potentially serious side effects if taken inappropriately. Dryness of the skin and mucosal surfaces, such as the eyes and lips, are some of its side effects. You need to be closely supervised by your dermatologist when using this medication.

Steroid injections suppress skin inflammation and significantly reduce the size of deep lesions. The procedure shouldn’t lead to scarring if done properly. Potential side effects include pigmentation problems and skin thinning, especially after repeated treatments.

At the BHSkin Dermatology clinic, we may also perform other in-office procedures to treat severe or resistant acne. These techniques include acne surgery, chemical peel application, phototherapy, laser treatment, and microneedling. These methods target different stages of acne formation.

After deciding on a definitive acne treatment, we formulate a skincare regimen that can support the skin’s recovery from the inflammatory condition and the treatment’s side effects. This is where hyaluronic acid comes in.

Hyaluronic acid is best used as part of one’s skincare routine during acne therapy. Acne skincare basics include cleansing with a gentle face wash, followed by applying a hydrating serum, the medicated acne treatment, and sun protection. Other anti-inflammatory agents like vitamin C and a fat-based moisturizer may be added if necessary.

Acne-prone individuals have inherent skin barrier defects that make them susceptible to skin dryness and irritation. Acne treatments like isotretinoin and benzoyl peroxide can worsen this problem. Integrating hyaluronic acid serum into these patients’ skincare regimens can counter these drugs’ side effects.

Notably, a recent study showed that combining hyaluronic acid with topical clindamycin may enhance the antibiotic’s effectiveness. Oily skin typically does not absorb topical antibiotics well. Using modified hyaluronic acid molecules as drug carriers can increase antibiotic penetration of oily skin. Hyaluronic acid has also been used as an ingredient in eye drops for people experiencing dry eye from Accutane treatment.

How Else Can Hyaluronic Acid Benefit Your Skin?

Acne scar treatment is another dermatological application of hyaluronic acid. One method involves injecting the substance into the skin during subcision or microneedling—two minimally invasive procedures that loosen up acne scar tissue, jumpstart collagen production, and elevate pitting acne scars. The second method entails applying hyaluronic acid serum to the skin during recovery from laser scar treatment. The third is injecting it simply as a dermal filler. 

Other hyaluronic acid benefits include the following:

Skin Rejuvenation

Advancing age causes the skin to produce less hyaluronic acid. Thus, aging skin is dry and thin. Regular hyaluronic acid serum use promotes skin hydration and volumizes thinning areas where skin wrinkles form.

Sunscreen Ingredient

Hyaluronic acid and its alternate form, sodium hyaluronate, are potent moisturizers that can easily blend with various skincare product types. One example is sunscreen. Hyaluronic acid and hyaluronate have UV-protective and anti-inflammatory properties, protecting your skin from photoaging.

Hair Care

UV exposure and oxidative stress can cause hair loss. Hyaluronic acid revitalizes the hair follicles by protecting them from UV rays and suppressing oxidative stress from inflammation. Hyaluronic acid is increasingly becoming a popular hair care ingredient.

Nail Care

Nails can become brittle and dry with repeated use of nail products. Hyaluronic acid can penetrate the nails, moisturizing them from within and minimizing their fragility. Regular use of hyaluronic acid-containing moisturizers can produce these effects.

Rosacea Treatment

Patients with rosacea have persistent facial redness due to facial blood vessel irritability. Hyaluronic acid can help by enhancing the skin’s antioxidant and anti-inflammatory capacity. Applying topical hyaluronic acid can minimize facial redness and tightness.

Hyaluronic acid is widely used in medical fields other than dermatology. This substance can speed up the healing of oral ulcers and gum disease and relieve pain from some types of joint diseases.

What Are the Possible Side Effects of Hyaluronic Acid Skin Treatments?

Pure hyaluronic acid is generally safe until mixed with potential irritants, which is the case in some skincare products. On the other hand, hyaluronic acid skin injections may cause complications if performed by an inexperienced provider.

Hyaluronic acid injection often causes only mild and transient redness, pain, and swelling if done correctly. Bruise-prone patients may also develop bruises. However, in the hands of an unqualified provider, hyaluronic acid may result in the following side effects, some of which can be serious:

• Severe allergies
• Inflammatory skin lumps
• Infection
• Cold sore reactivation
• Dermal filler migration, leading to undesirable cosmetic results
• Skin discoloration from the hyaluronic acid filler itself (blue) or posttreatment pigmentation problems (white or brown to black)
• Injection site scarring
• Inadvertent injection into a blood vessel in the head, which can cause stroke, blindness, skin ulceration, and other conditions arising from insufficient blood flow 

You can avoid these nasty side effects by entrusting your injectable procedures only to a board-certified dermatologist. At BHSkin Dermatology, for example, our skin specialists have years of experience performing dermal filler treatments. 

How Can You Take Care of Your Skin to Prevent Acne?

Skin hygiene is essential in preventing pimples and, more importantly, acne scars. Skin cleansing unclogs your pores by removing dead skin cells, excess oils, and debris.

Use a gentle cleanser to wash your face twice daily. Soap-free cleansers are best for acne-prone, sensitive skin. Avoid skin scrubs and ordinary soap, which can strip your skin of moisture and introduce micro-injuries on its surface. Washing your face more than necessary dries your skin and makes it prone to irritation.

Your dermatologist may prescribe a personalized skincare routine. Ensure you use only products specially formulated for sensitive, acne-prone skin. Some of these products are labeled “non-comedogenic,” “hypoallergenic,” “dermatologist-formulated,” or “specially formulated for sensitive skin.”

Alternatively, you can research the ingredients declared on the product label and identify the ones that can trigger your symptoms. You can also ask your skin specialist for skincare product recommendations.

If your face is wet from washing or bathing, pat it dry without scrubbing. Avoid picking at facial lesions or touching your face with dirty hands. Ensure that phones, sunglasses, and other objects that may touch your face are always clean.

The exact role of diet in pimple formation is unclear. However, some foods, notably sugary and fatty foods, chocolate, and milk, have been linked to this skin condition. Evidence does not show that removing these edibles from the diet can predictably eliminate acne flare-ups. However, you must avoid foods that you know can trigger your breakouts. At BHSkin Dermatology, we encourage patients to eat healthily and ensure adequate body hydration.

When Should You See Your Dermatologist About Acne?

Many patients would have tried home remedies or treatments their primary care physicians prescribed before consulting a dermatologist for acne. Sadly, most people have this notion that acne is a simple problem. However, pimples can cause severe psychological distress in some individuals, especially if they produce unsightly scars. Thus, the saying “Prevention is better than cure” holds particularly true in the medical realm.

You may see a board-certified dermatologist even if you only have mild acne, as the American Academy of Dermatologists recommends. To be sure, you may take the following test, noting which statements apply to your case:

• You’ve tried various acne treatments, but nothing works.
• The acne goes away but recurs.
• Pimple-like bumps are present in unusual places, such as the armpit, thighs, backs of the upper arms, and groin.
• The lesions first appeared between ages 8 and 11 or younger.
• Painful, deep pimples are present.
• You’ve had acne for years but cannot explain why you still have it.
• The condition has made you feel anxious, depressed, or less inclined to hang out with friends.
• The condition has made you feel like hiding your face.
• You have a breakout within 6 months of taking a medication.
• You can see scars or dark spots when the lesion clears.
• Acne persists on your back and chest even after the lesions on your face are gone.

If at least 6 of these statements apply to you, the American Academy of Dermatologists recommends seeing a dermatologist for acne.

Hyaluronic Acid and Acne: The Takeaways

Hyaluronic acid, an innately occurring substance in human connective tissue, is now a lot of people’s favorite skincare ingredient. Laboratory research shows that it can inhibit abnormal oil secretion and inflammation—properties that may benefit people with acne. Large clinical studies have not proven that hyaluronic acid can clear pimples on its own. However, real-world reports on this substance’s supportive role in acne treatment abound.

People may include hyaluronic acid in their acne skincare regimens, particularly to lock in moisture after cleansing, reduce inflammation, and boost sun protection. Clinical trials show that hyaluronic acid may also be combined with dermatologic procedures for acne scar treatment.

Everyone’s skincare routine is unique due to various factors at play. Your best move is to talk to your dermatologist if you want to know if hyaluronic acid is suitable for you.

And, as always, to ensure you get the best results, trust only a board-certified dermatologist for your acne treatment. Only a bona fide skin specialist can expertly formulate the right regimen for you.

Frequently Asked Questions

Can Hyaluronic Acid Cause Acne?

Presently, evidence is insufficient to prove that topical hyaluronic acid can cause acne. However, this substance may be found with known irritants in various commercial cosmetic formulations. Skincare products may also be inadvertently contaminated with acne inducers during manufacturing.

Can You Use Hyaluronic Acid on Hormonal Acne?

Hormonal acne may arise during periods like puberty, pregnancy, and menopause, which are times of significant hormonal fluctuations. Some medical conditions, including polycystic ovarian syndrome, are also associated with hormonal acne. The same acne treatment guidelines I previously discussed apply to patients with this condition, though regimens differ because of the diverse origins of hormonal acne. 

As previously mentioned, hyaluronic acid may be used as part of the acne skincare regimen, even in the hormonal type. Hyaluronic acid is one of the preferred moisturizers in menopausal acne skincare regimens.

Acne breakouts from using these products may be due to other chemicals, not hyaluronic acid. Applying hyaluronic acid serum to the skin with dirty hands may also cause acne.

Is Hyaluronic Acid Good for Acne Scars?

As mentioned previously, hyaluronic acid injection or topical application may be combined with dermatologic procedures to treat acne scars. However, the suitability of these procedures depends on many personal factors, including allergy history, keloidal scarring tendencies, skin type, and immune status.

What Is a Patch Test, and Do You Need It Before Using a Hyaluronic Acid Product?

A patch test is a diagnostic tool that helps identify symptom triggers in people with allergic contact dermatitis. The test requires exposing your skin to various allergens. Besides the fact that it can get expensive—each potential allergen placed on your skin adds to your cost—the test may produce unwanted side effects, as it is designed to stimulate an allergic response.

This test is primarily indicated for people suspected of having contact dermatitis or a similar eczematous condition. It is not routinely done before using a skincare product, though people with chronic allergic eczema may benefit from it.

Get Clear and Healthy Skin from LA’s Top Skincare Specialists

Have you ever taken acne treatment advice from a friend that didn’t work on you? Not surprising. Acne treatment regimens differ for every person simply because everyone’s skin is unique. Recurrent acne is a problem for experts. In LA, the top acne specialists are here at BHSkin Dermatology.

BHSkin Dermatology’s skincare specialists are some of California’s best. Visit us at our Glendale or Encino clinic, or use our telehealth portal for your consultation.

Book your appointment today!

References:

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Author: Don Mehrabi

Don Mehrabi, MD, FAAD, is LA’s leading board-certified dermatologist who treats patients, builds the BHSkin clinics, and raises three kids. This blog builds on medical studies combined with Dr. Mehrabi's first-hand experiences from practicing in Encino-Tarzana, Glendale, and online