Hyaluronic acid: the scientific and clinical evidence

Hyaluronic acid is a naturally occurring biopolymer whose molecular structure is highly conserved between mammalian species. First described in 1934, it has since been used across a wide variety of medical fields as diverse as neurosurgery and cutaneous wound heating. Presently it has reached prominence in cosmetic practice where it is now the injectable dermal. filter of choice for most surgeons. We used our experience of this technology with searches in the English language literature for the purpose of a systematic review. We present an overview, including the scientific evidence for its use in wound heating and, briefly, in other fields. We summarise the evidence for and against hyaluronic acid and provide a resume of the current technologies available in fields such as skin regeneration and wound heating, in addition to cosmetic surgery. This overview is not intended to teach the reader about the various formulations currently on the market or how to use these materials clinically - rather to provide a solid scientific background enabling the reader to understand the attributes (and otherwise) of the material. We hope to allow clinicians to assess the evidence for a material now in common use in order that they may be fully aware of its properties. (c) 2007 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons.