What are they for and in what case are they indicated?


Hyaluronic acid has become the quintessential anti-aging substance in recent years. Omnipresent in a multitude of creams and aesthetic treatments, it is the undisputed star in aesthetic medicine treatments for those people who do not want to go through the operating room to eliminate the signs that age leaves on the skin.

To clarify some doubts about the treatments with this substance and its effects, We spoke with Dr. Javier Lima, from the Dray Clinic, and head of Postgraduate Studies in Facial Aesthetics and Anti-Aging at CEUFP (Center for University Studies Training and Postgraduate).

What is hyaluronic acid

Hyaluronic acid produces our own body and is responsible for keeping the skin hydrated and firm thanks to its great capacity to retain water, “It is a polysaccharide that we have endogenously in the body, which generate fibroblasts naturally and is present in the joints and in the skin. It is basically a molecule that captures water. ”

With age, our body produces less hyaluronic acid, which makes the skin more easily dehydrated, some wrinkles appear, we lose volume on the face and sagging appears. To counteract these effects, In aesthetic medicine, a hyaluronic acid created in the laboratory is used, but, as Dr. Lima told us, “it is manufactured from a bacterium and is identical to that of the human body. Therefore, it is 100% compatible. ”

Different treatments for different problems

In aesthetic medicine treatments, two types of hyaluronic acid are used, each of them indicated to treat different problems:

Linear hyaluronic acid (not crosslinked):

Hyaluronic acid molecules are free and are basically used to hydrate the skin through small injections, "it is administered through mesotherapy, small punctures in the dermis, and its goal is to capture water and moisturize the skin." This type of hyaluronic acid is indicated mainly for dehydrated skinHowever, Dr. Lima clarifies that, in many cases, “it is combined with other substances to get more benefits. With vitamins and minerals that regulate the function of skin cells, with amino acids, which are the precursors of collagen and elastin, to treat photoaging or as depigmenting to treat stains. ” That is, it would be recommended to improve the quality and overall appearance of the skin, but not to fill in wrinkles.

Reticulated hyaluronic acid:

In this case it is the same molecule, but crosslinked, that is, compacted and intertwined with each other to give them greater solidity, “it does not capture water, but volumizes, that is, it gives volume to areas that have lost volume with the passage of time for the reabsorption of fat, bone. This causes the skin, which is ahead of these structures, to fall. "When we inject the crosslinked hyaluronic acid, we vectorize the face through small volumes and there is a moderate mechanical lifting effect," Lima told us. The crosslinked hyaluronic acid is therefore indicated for sagging skin, whose main signs are "marked nasogenian grooves, wrinkles under the lips, the corners, when the mandibular profile falls … In cases of mild to moderate sagging. When there is severe sagging, there is nothing left but to resort to a specific surgery treatment. ” Nor is it recommended for expression lines, crow's feet, "for that, botulinum toxicity is better", better known as Botox.

Its advantages

The advantages of hyaluronic acid treatments over surgery treatments are several:

•It's cheaper. Although it depends on many factors, each clinic, treatments and specific areas, etc., a session with hyaluronic acid is usually not more than 500 euros, much lower than any surgery. Besides that It is a much less aggressive treatment. And, as Dr. Lima told us, “what people look for when they opt for a hyaluronic acid treatment is an economically affordable treatment, not having to go through the operating room with all that entails, to be able to return to their lives immediately , that is not painful, that is fast… ”.

• It is more natural. Both because of the result and because, being a substance that is naturally in the body, there is virtually no risk of allergies. "The effect we achieve with cross-linked hyaluronic acid is to strain through volumes returning harmony back to the face" Nothing to do with the cheekbones prostheses or implants that, Dr. Lima equates to breast prostheses: “from age 65 you have an aged body, with the chest of a young girl. And in the face it is the same. You can wear an implant, which is permanent, but the passage of time will continue to have its effect on the face reabsorbing bone, muscle, fat … and the implant will remain intact. The long term result will be worse. Hyaluronic acid, on the other hand, produces a much more natural effect, with which you get to be told ‘how good I see you and not what have you done?”

• It is temporary. For many, this could be a disadvantage, because if you want the effect to be permanent, you will have to repeat the treatment over time. However, taking into account the previous point, and that, there may always be patients who are not happy with the result, it has more advantages than disadvantages.

• It has no contraindications. Being a substance present in our body, it is not necessary to test for allergy, “there are no contraindications, as it is a biocompatible substance with our body. In fact, it is the same in all animals. Maybe, if a disease comes with an autoimmune disease, I could consider it, but it is not a formal contraindication. ”

How long do its effects last?

Again, its duration depends on many factors, “by internal mechanisms of the body, hyaluronic acid is reabsorbed, and the average duration of treatment is one year. It can vary because the mechanism of degradation of hyaluronic acid is made through the blood. In areas where there is more irrigation, the filling will last less, like the lips. It also lasts less in areas where there is movement, more friction when we gesture, we move… ”.

And what about the creams with hyaluronic acid

In recent years, virtually all brands add to their ranges hyaluronic acid anti-aging, something in the opinion of Dr. Lima, totally useless. “There really is no cream to moisturize the skin, what they can do is prevent the water from evaporating, getting lost and the skin becoming dehydrated. The only way to hydrate in drinking water. Therefore, I, in particular, do not find much sense to have hyaluronic acid put on creams, ”He states sharply.

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