What is Hyaluronic Acid?
Hyaluronic Acid (HA), a glycosaminoglycan(a molecule that consists of repeating disaccharide units composed of N-acetyl-D-glucosamine alternating with D-glucuronic acid), is one of the principal components of the extracellular matrix of the skin, joints, and the eye [1, 2]. HA is a naturally occurring polymer abundantly found in various parts of the human body, most notably in the body fluids and extracellular matrix of tissues [3]. It is a naturally occurring linear polysaccharide of repeating disaccharide units of N-acetyl-D-glucosamine and β-glucuronic acid [4].
What Does Hyaluronic Acid Do?
HA is critical for maintaining tissue hydration [3] and for cellular functions, including proliferation, differentiation, and the inflammatory response [3]. It has strong hydrating (hydrophilic) and viscoelastic properties necessary for normal physiological functions, including tissue hydration, mechanical protection, and shock absorption [4, 5].
Within the skin and all other tissues, HA actively acts as a humectant – which means that it helps the tissue hold onto water, and this helps to enhance skin appearance – it is also involved in wound healing and tissue repair processes, as well as growth factor release, cellular constituents, and cellular migration – all of which aid – the healing process [6].
It is no wonder that hyaluronic acid has a wide range of medical applications – from promoting wound healing and repairing damaged skin to its use as an antioxidant that may protect the skin from damaging molecules called free radicals. It also reduces knee pain and joint motion in patients with osteoarthritis [1, 6].
In addition to these roles, HA has been investigated as a drug delivery agent for:
- Ophthalmic
- Nasal
- Pulmonary
- Parenteral
- And dermal routes [5]
What are Breakouts?
Breakouts (also known as acne) arise when the opening of a hair follicle or pore becomes clogged by a mixture of dead skin cells, sebum (the skin’s natural oil) and bacteria – which leads to an acne lesion, such as a whitehead, a blackhead, or a pimple. Breakouts most commonly occur in the areas of the body with the highest concentration of oil glands in the skin – namely, the face, chest, upper back, and shoulders – and can appear red, swollen, or inflamed [7].
Causes of Breakouts
Several factors can trigger pimples. Stress is a big one—it increases inflammation throughout the body and spikes oil production, leading to acne or worsening [7].
For example, oil-based or silicon-containing skin care products can lead to breakouts because they clog pores [7]. Too much use of acne-fighting products also causes skin irritation, inflammation and dry skin – which increases oil production and, eventually, breakouts [7].
Dietary choices can also lead to breakouts. Since high-glycemic foods—those that rapidly increase blood-sugar levels—stimulate the production of both insulin and oil, they increase the likelihood of a breakout [7].
Dehydration causes the body to produce much more oil, which can cause breakouts. To prevent dehydration, you should drink 8-ounce glasses of water daily [7].
Touching your face constantly or pressing your phone to your skin transfers acne-causing bacteria to your face and can increase the likelihood of breakouts [7].
Remember, sleep is not just a luxury but a necessity for managing stress and skin oils. By ensuring you get seven to nine hours of sleep each night, you can take control of these factors that contribute to acne [7].
Some drugs, in addition to hormonal changes during puberty and pregnancy, can result in similar acne [8, 9].
Does Hyaluronic Acid Cause Rosacea?
The hallmarks of this condition are redness, flushing, and inflammation, sometimes including small acne-like bumps. Hyaluronic acid is often used in skincare products as a humectant and is thought to aid in skin elasticity. Does hyaluronic acid cause breakouts in rosacea?
No actual studies have shown that hyaluronic acid causes rosacea breakouts. In fact, a cream with low molecular weight hyaluronic acid (LMW-HA) helped treat rosacea by reducing papules, erythema, and dryness by 47%, 51.7%, and 78.8%, respectively, on the fourth week of the study [10].
That said, skin is skin is skin. Just because a person dislikes or has a bad reaction to one product, even with thousands of rave reviews, doesn’t mean it’s the case for everyone – and hyaluronic acid has plenty of anecdotal reports of breakouts. Some fear that the hyaluronic acid might have exacerbated these feelings of anxiety. Due to these inconsistencies (and because hyaluronic acid is an ingredient usually placed near the end of an ingredients list), some feel uncertain about whether they didn’t react well to a hyaluronic acid skincare product, or if hyaluronic acid isn’t the best solution for them [11].
If you use a new skincare product for the first time, you should test it on a skin patch before applying the whole product to your face. Put a tiny amount of the product on the spot on the back of your ear, just below. Wait for 24 hours or even 48 hours, and if you don’t experience any redness, irritation, or swelling, then it’s probably safe to put it on your face [11].
Overall, no concrete proof exists that hyaluronic acid causes people with rosacea to break out. Still, people’s skin reacts differently, and when dealing with something so unpredictable as skin, it’s best to test on a spot on skin before applying it on your entire face.