One of the newest ingredients in mainstream dermatology rather than natural dermatology is hyaluronic acid. Hyaluronic acid is essentially a carbohydrate in your skin that stores water and directs structural proteins. This skingredient’s exact role in acne is unknown, but there’s immediately a promising connection.
You might be aware that some strains of propionibacterium acnes, the classic “acne bacteria”, are much deadlier than others. One study identified ten different strains, and found that 84% of strain 4 came from acne patients, while 99% of strain 6 came from clear-skinned patients.
Their dark powers are also known, as p.acnes subtype 1a secretes more lipases, which break down fats in the skin and produce inflammatory by-products. The deadly strains have more antigens in their cell walls, compounds which are targeted by your immune system’s inflammatory agents…
…and compared to beneficial strains, malicious p.acnes strains secrete much more hyaluronidase. That’s a natural enzyme for breaking down hyaluronic acid, normally to replace it, but in this case for malicious purposes.
The deadliest types of acne bacteria are known to reduce your hyaluronic acid levels. Is this phenomenon a coincidence, or does hyaluronic acid have an overlooked connection to acne?
What is hyaluronic acid?
The name hyaluronic acid sounds like the latest miracle chemical invented in a high tech lab when you first hear it, but hyaluronic acid is as natural as can be. Hyaluronic acid is a glycosaminoglycan, a structural molecule in human skin.
50% of hyaluronic acid in humans is located in the skin, with varying amounts in joints, nerves and eyes too. It’s manufactured by hyaluronic acid synthases, and once in place, controls numerous aspects of wound healing, elasticity, and skin structure. Most important, however, is hyaluronic acid’s role in hydration, as a natural humectant.
While the equally important collagen constructs your skin itself, and keeps it strong, hyaluronic acid is designed to lock moisture into skin. Hyaluronic acid molecules are able to hold 1000 times as much water relative to their size; 0.03 ounces (1 gram) can carry six whole litres of water. This seemingly impossible figure is more disproportionate than any other biological substance.
Hyaluronic acid is nature’s ultimate solution for plumpness, firmness, pliability, texture, and a smooth appearance. It is one of your most important inbuilt moisturisers.
Hyaluronic acid – the reason you look young (or old)
You might have therefore predicted that hyaluronic acid is heavily involved with ageing. One of the main properties of older skin is its dryness and loss of plumpness, and depletion of hyaluronic acid is the single biggest factor behind this. Levels remain constant in the dermis, the second layer of skin, but decline sharply in the epidermis, the outermost layer of skin. The reason for the difference is currently unknown.
What’s more, the size of hyaluronic acid polymers shrinks progressively, preventing them from retaining as much moisture. With age, you literally lose the water containers on your face.
Somehow, the body slowly loses its ability to manufacture them, and what’s more, external forces can accentuate the depletion. UV radiation can decrease hyaluronic acid levels in the skin, over decades of sun exposure. This actually contributes to the dry and weathered skin of the photoaged.
Hyaluronic acid levels can decline to 5% of youthful levels in old people. Along with elastin decline, this is also why the skin loses its elasticity.
Consider the case of Yuzurihara village in Japan. The locals eat a diet extremely rich in natural hyaluronic acid, featuring rare potato-related vegetables like satoimo and imoji. Yuzurihara residents have been observed to stay freakishly young, and are more likely to live to age 85 than anywhere in the United States. Their hair and skin look astonishingly youthful, and the overall appearance of 80 and 90 year-olds is years behind where it should be. Yuzurihara has been dubbed “the village of long life”, and it’s all thanks to hyaluronic acid.
Yet another role in skincare, again for smoother skin and even skin, is wound healing. Hyaluronic acid remains shrouded in mystery, but in the earliest phases of wound healing, sudden and massive accumulations of hyaluronic acid occur. And the main thing to remember – we know only a fraction of this carbohydrate’s powers.
Hyaluronic acid deficiency may be everywhere
The next question is whether hyaluronic acid levels differ from person to person outside of age, otherwise this is just a science lesson. Hyaluronic acid has a very high turnover rate, with a half life of 3 to 5 minutes in the blood, 1 to 3 weeks in the cartilage, and less than a day in skin.
Therefore there’s plenty of opportunity for levels to vary, and one factor is free radical activity.
Ordinarily, the natural degradation of hyaluronic acid is controlled by hyaluronidase, the enzyme which certain p.acnes strains churn out. There’s several types of this enzyme; HL3 degrades hyaluronic acid in joint cartilage, while HL2 degrades small amounts in skin and HL1 degrades the bulk in the skin.
That’s the healthy and natural process, in moderation, but free radicals are also proven to destroy hyaluronic acid. Free radicals generated by harsh UV radiation have been specifically proven to destroy it (study). If your skin is overloaded with free radicals, your hyaluronic acid levels will be suppressed and your skin will pay.
The p.acnes strains are also confirmed, as are air pollution and smoking, whether because of free radicals or another mechanism. What’s not confirmed is whether deficiency is an epidemic like with collagen, or whether one guy has optimal levels and youthful skin, while another has dry and crusty skin, only for levels across civilisation to average out at normal.
Nevertheless, given how obscure the p.acnes strains connection was, it’s likely that many hidden factors affect hyaluronic acid levels.
The connection to acne
Firstly, the moisturising properties themselves will help with acne. Dry, cracked and weak skin is much more vulnerable to microfissures, tiny breaches in skin tissue. With the first immune system repair squad comes a bunch of pro-inflammatory chemicals, which are intended to break the toxic tissue down but actually inflame acne further. During a dry and flaky phase you’ll have witnessed this scientific process first hand.
Secondly, there’s some limited but promising evidence for free radical reduction. The structure of hyaluronic acid molecules basically consists of N-acetyl-D-glucosamine and D-glucuronic acid. Hyaluronic acid is also a particularly large structural compound, which is vital for its water holding powers. The glucuronic acid in the centre of hyaluronic acid molecules has been found to trap free radicals roaming around the skin, like a Venus fly trap or an insect stuck in tree amber.
Even better, hyaluronic acid isn’t found inside your cells; it exists as the single greatest part of the extracellular matrix (ECM) which sits between cells. Hyaluronic acid forms a thick, viscous meshwork around cells and physically decreases the movement of free radicals. Hyaluronic acid is yet another part of your natural antioxidant defenses, just a completely unique one.
Hyaluronic acid can therefore decrease total free radical activity in the skin, prevent clogged pores, prevent acne, and keep cells healthy. The wound healing qualities will also help acne, by accelerating the healing of pimples. Elsewhere, we can only speculate, but scientists themselves have admitted that “much work needs to be done to elucidate the multifaceted role of HA“.
There’s no doubt that hyaluronic acid is excellent for skin hydration and youthfulness. For acne itself, the evidence is trickling in, but we can connect the dots using common sense.
But are there any effective strategies?
Despite its promising role in acne, the prospects for hyaluronic acid products are much murkier, because it’s doubted that hyaluronic acid even penetrates the skin.
Your body is designed to manufacture hyaluronic acid – will applying it work? With collagen, eating vitamin C and glycine, or applying topical treatments like vitamin C or tamanu oil is much more effective than applying raw collagen itself.
Hyaluronic acid has a big problem with the molecule size being far too high. In fact, hyaluronic acid is a rare structural component which is manufactured outside of cells rather than inside, because of its size. Hyaluronic acid cannot penetrate the skin deeply; it simply sits on the surface. Once there, hyaluronic acid can actually drain the moisture from your skin, particularly in hot climates, where the scorching heat of the atmosphere depletes the hyaluronic acid containers and forces them to retrieve moisture from the skin cells they sit on.
Applying hyaluronic acid to your skin will simply make it look moist, rather than truly moisturise it.
Hyaluronic acid has also become popular for filling acne scars lately, relying on its plumping properties, but most treatments rely on injection. This method can indeed fill in acne scars, but you have to inject yourself every 3 to 12 months. Your body will metabolise and remove the foreign injection eventually. There’s no wider benefit for plumpness or hydration either, just an accumulation in certain sites. Not to mention that an injection is unnatural and inconvenient.
One glimmer of hope is some studies where hyaluronic acid creams effectively reduced solar keratoses, unsightly accumulations of keratin proteins on the skin. Hyaluronic acid can therefore improve some skin conditions on the outermost layers, and that could easily apply to acne if there’s a more direct benefit which we don’t know about.
What topical application won’t do is moisturise your skin, plump up your skin, or delay ageing.
So what is the best strategy?
The strategy is identical to collagen: increase hyaluronic acid by eating its ingredients, or indirectly with topical treatments. We’re in the dark for both strategies, but what is confirmed is that supplements work.
This study on 35 patients found that hyaluronic acid supplements significantly increased moisture retention in the skin. Their skin grew smoother while existing wrinkles were erased into nothingness. This study from 2014 tested patients with dry skin and observed a significant increase in moisture.
In both studies, the oral supplements correlated closely to extra hyaluronic acid formation in the skin. The hyaluronic acid doesn’t literally flow through your stomach, into your bloodstream and settle in your skin; instead, existing hyaluronic acid contains the exact nutrients your body needs to manufacture a new batch.
Excellent news then: you don’t have to travel to Japan and start a new life in Yuzurihara village, you can take a supplement. This is a good one: Pure Encapsulations Hyaluronic Acid.
It’s also known that hyalouronic acid levels increase in the presence of retinoic acid, a topical form of vitamin A. Ensure that your dietary vitamin A levels are sufficient.
As for topical strategies, hyaluronic acid is even less understood, because of everybody being distracted with the ingredient itself. There are no secret oils and plants in the wilderness like with tamanu oil or shea butter for collagen – yet.
Things are slowly picking up steam. For example, it’s now known that the protein complex called transforming growth factor (TGF) activates hyaluronic acid formation, just like it activates collagen formation. In this article, we discussed how royal jelly and lavender oil increase collagen specifically via TGF activation – will they work for hyaluronic acid as well? More hints like this will doubtlessly appear soon. We can also speculate that vitamin A-loaded topical treatments like sea buckthorn oil and rosehip seed oil will succeed.
You have to avoid the confirmed villains of cigarette smoke, air pollution, and free radicals. Finally, there’s the issue of those malicious p.acnes strains. P.acnes can be dealt with by unclogging your pores to deprive them of a home, or by killing them with raw honey, tea tree oil, or tamanu oil, but how to kill the evil strains specifically is another mystery in the world of acne.
How important is hyaluronic acid in the grand scheme of acne? Its benefits for acne are at least moderate, but its benefits for overall skin tone, texture and glow are huge. It’s the single most important compound for skin moisture and hydration.
Additionally, it all depends on how common deficiency is, an unanswered question. I would bet that deficiency is common, given how heavily the confirmed villains like free radicals and air pollution plague our civilisation today. Mainstream dermatology has the right idea about the powers of hyaluronic acid, but the wrong strategy. Supplements are your way forward for superhuman levels; living cleanly is the solution for normal levels.
Finally, remember that the very worst strain subset for acne vulgaris, strain subset 1a, is proven to pump out higher amounts of hyaluronidase. What is p.acnes’ intention? Who knows, but hyaluronic acid likely contains some nutrients it needs for its own hard-fought survival.
Regardless, this fact alone is a good reason to watch any developments with hyaluronic acid like a hawk.
Thanks for reading!