8Beautiful skin with hyaluronic acid

Did you know that back in medieval France, King Henry II’s wife, Princess Catherine, believed that if she ate chicken combs she would become beautiful? Even before that (in the 700s) Yang Guifei, one of the four beauties of ancient China, also ate chicken combs.


Chicken combs, as it turns out, contain a lot of a substance known as hyaluronic acid. Recent clinical studies show that ingesting hyaluronic acid actually can increase the moisture content of the skin. This shows up as more hydrated, and “beautiful” younger-looking skin.


Nowadays, hyaluronic acid is not just made from chicken combs, but also from microbial fermentation. It’s found in many skin supplements. It’s also used as an injectable filler to reduce wrinkles.


Let’s dive into how this ancient beauty enhancer actually works.


Hyaluronic acid in the “matrix”


Before we dive into the skin, let’s talk a bit about the “matrix.” All tissues, including the skin, have what’s known as an “extracellular matrix” (ECM).


This matrix is made from two types of substances: proteins and “proteoglycans.”


The proteins are fibrous and give the tissue structure and elasticity. This means they help to retain the shape (i.e. structure) of the tissue. The main proteins in the matrix are collagen and elastin.


Proteoglycans, on the other hand, are a gel-like substance made from carbohydrates. This substance fills in the spaces and keeps things moist and hydrated. One of the main proteoglycans is hyaluronic acid.


You can think of the matrix as a thick gel-like substance (think: egg white).


Collagen is a protein that helps to maintain structure. One of its main roles is to help the cells join together by forming a kind of a scaffold within the matrix. This allows tissues to maintain their shape and stiffness, while allowing flexibility. It helps reduce sagging.


Hyaluronic acid (a.k.a. hyaluronan, HA, or HLA) allows tissues to be squished without breaking. It’s a type of carbohydrate made from sugars bound together in very long chains.


Hyaluronic acid also has a special ability to attract and hold onto water. Because of its special chemical structure, it can hold 1000x more water than its own solid volume.

It is found in several lengths (i.e. thousands and even millions of sugars long). The longer the length, the better it is.


Both the proteins (e.g. collagen) and the proteoglycans (e.g. hyaluronic acid) work together, along with other substances. Together they form complexes and cross-link to create the gel-like matrix.


This matrix is constantly being remodeled and rebalanced by the cells to ensure optimal structure. elasticity, and water retention (hydration). It changes when tissue ages, gets wounded, or develops a tumour.


It’s this matrix around skin cells that keeps skin healthy and beautiful.


Hyaluronic acid in the skin


For skin health and a “youthful” appearance, the skin needs structural support, moisture, and good blood flow. Structure and moisture for the skin is made from not just the cells, but also from the important “matrix” that they secrete and surround themselves with. Blood supply is needed to bring nutrients and oxygen to the skin, while removing waste.


In the skin, the proteins (e.g. collagen) and the proteoglycans (e.g. hyaluronic acid) are secreted by cells called “fibroblasts.”


Hyaluronic acid is found throughout the body, but is most important in the eyes, the joints, and the skin. In fact, half of the body’s hyaluronic acid is found in the skin.


Hyaluronic acid helps to retain water to keep skin hydrated and plump. It also does this in the eye and the fluid cushioning the joints (synovial fluid). This is why when the amount of hyaluronic acid in the body decreases with age, this increases dry and sagging skin, as well as joint pain.


This is what makes hyaluronic acid a great moisturizer for your skin.


“HA is extremely abundant in the dermis under normal circumstances. It is also a major ingredient in moisturizing creams, due to its tremendous hygroscopic (hydrating) properties, which also helps to explain why injected HA-based fillers excel at “plumping up” the dermis.” Maytin, E.V., 2016.


Your skin replaces about ⅓ of its hyaluronic acid every single day. This means that each molecule only sticks around for a couple of days before it’s naturally recycled and replaced with a new molecule.


The hyaluronic acid in the matrix of the skin cells help to keep it hydrated and prevent sagging.


Aging and wounded skin


When it comes to skin health and visible aging, the matrix’s collagen and hyaluronic acid are big players.


As we age, our skin gets “looser” and start to show fine wrinkles. It thins slightly thinner and the cells produce less collagen and hyaluronic acid. This is common and occurs naturally over time in everyone. It’s thought to be, at least partly, related to hormone changes. It’s referred to as “intrinsic aging.”


Intrinsic aging is partly because of the natural reduction in amounts of collagen and hyaluronic acid in the skin. Over time our skin simply makes less. This is mostly true for the outermost layer of the skin, the “epidermis.”


At the same time as intrinsic aging, other external factors can affect our skin’s appearance as well. The result is considered premature aging, or “extrinsic” aging. For example, ultraviolet (UV) light from chronic sun exposure causes deeper wrinkles, dryness, lines, colour changes, reduced elastic ability (elastosis), and taking on a “leathery” appearance. This UV aging is referred to as “photoaging.”


Because our faces are exposed to the sun, about 80% of facial skin aging is from UV exposure. The other 20% is from smoking cigarettes, air pollution, and certain medications (corticosteroids). These all have a similar damaging effect and contribute to extrinsic aging.


With chronic exposure to UV light, there is a change in both the type of collagen and size of the hyaluronic acid molecules. The long chains of hyaluronic acid become more degraded into  smaller chains. These smaller chains are inflammatory. The overall result is less flexible skin that wrinkles more easily and becomes drier.


Extrinsic aging does this due to oxidative stress and an increase in an enzyme (“metalloproteinase”) that breaks down collagen and hyaluronic acid.


Vitamin A creams are sometimes used to help the skin’s appearance. They work by helping to prevent breakdown of the collagen in the skin.


Hyaluronic acid has another interesting role in the skin. It helps wounded skin heal. When skin is wounded, a large part of the fluid secreted is hyaluronic acid. In fact, you make more hyaluronic acid when skin is injured or wounded specifically to help the wound heal. It’s even thought that scarring from wounds increases with age due to the reduced amount of hyaluronic acid in the skin.


The bottom line is that aging skin is partly the result of a change in the collagen, and lower levels of the large hyaluronic acid molecules in the matrix.




Collagen and hyaluronic acid supplements


There are three types of collagen found in our bodies: type I, type II, and type III. The skin contains mostly type I, with some type III. The cartilage cushioning the joints is mostly type II.


Collagen supplements are made from animal collagen, mostly from bones and/or skin.


There are two main types of collagen supplements:

  • Hydrolyzed and
  • Undenatured type II collagen


Hydrolyzed collagen is collagen that’s been broken down by enzymes to make it easier to absorb and digest. Hydrolyzed collagen (a.k.a. collagen hydrosylate) can be taken at about 10 g/day for skin health and some joint benefit.


Undenatured collagen can be taken at about 40 mg/day for osteoarthritis and autoimmune rheumatoid arthritis.


Hyaluronic acid supplements are available in many countries, including Canada and the United States. It’s very popular in Japan where sales were about $250 million USD in 2012. Hyaluronic acid supplements are made from chicken combs, eggshell membrane, or by microbial fermentation of molasses or cheese whey.


“HA is a safe dietary supplement that does not harm the body.” Kawada et al., 2014.


NOTE: Always read and follow directions for use for a dietary supplement.


Skin benefits from ingesting hyaluronic acid (as a food and supplement)


The trend to ingesting hyaluronic acid (a.k.a. HA) for skin improvement started here:


“HA dietary supplements are expected to be effective anti-aging supplements because an American ABC News program, which aired in November 2002, stated that the key to longevity in a specific Japanese village was their HA-rich diet.” Kawada, et al., 2014


While just about all of the research on skin benefits of hyaluronic acid was done using supplements, it is found in food. Usually the amount in food is much smaller than that of supplements, so it’s hard to say if the same benefits will be seen.


Hyaluronic acid was initially sold as a food back in 1942. It was used as a substitute for egg whites in baked goods.


It’s naturally found in fish intestines and livers. These are often considered delicious and nutritious food in China. It’s also found in breastmilk.


Hyaluronic acid is still used in some processed foods because of it’s gel-like consistency and ability to retain water.


“HA is safe as a daily ingestible food.” Kawada et al., 2014.


Hyaluronic acid is considered to be a skin health supplement because it increases the moisture content (hydration) of the skin. It actually helps to moisturize the skin from the inside.


“The hydration of the skin critically depends on the HA-bound water in the dermis and in the vital area of the epidermis…”, Papakonstantinou, et al., 2012.


NOTE: “Dermis” and “epidermis” are two layers of the skin. The epidermis is the outermost layer that we see and touch. The dermis is the layer directly underneath it.


Skin moisture goes beyond appearance of softer and smoother skin. When the skin has more moisture, it can help reduce wrinkles as well. Perhaps more importantly, because dry skin can cause itching, consuming hyaluronic acid to moisturize the skin can reduce itching as well.


Several clinical studies have shown skin benefits of hyaluronic acid supplementation.


For example, people with chronically rough and dry skin took hyaluronic acid supplements for six weeks. Their skin’s dryness significantly improved. It had more moisture and was smoother. They also found that both the 120 mg/day and the 240 mg/day had the same effects on the skin. (So the researchers don’t see a need to take more than 120 mg/day.)


In another placebo-controlled study, 280 mg hyaluronic acid per day for 30 days significantly increased skin’s moisture and pH (a measure of the skin’s acidity).


These skin moisturizing benefits have been seen with different sources of hyaluronic acid. Benefits were seen in people with dry skin taking hyaluronic acid supplements made from chicken combs, as well as those made from microbial fermentation. They both have been shown to work compared with placebo.


Plus, because the skin normally rejuvenates every 28 days, improvement continues for up to 2 weeks after stopping daily use.


Skin benefits from supplementing with hyaluronic acid and collagen


Supplementing with collagen has also shown many skin benefits.


For example, supplementing with type II collagen can accumulate in the skin. Secondly, it promotes the production of both type I collagen and hyaluronic acid in the skin.


Supplementing with hydrolyzed collagen can also help the skin because it stimulates the cells to produce hyaluronic acid.


Similar results happen when hyaluronic acid is taken along with collagen.


For example, a supplement containing both hydrolyzed collagen and hyaluronic acid was taken daily for 12 weeks. The results was a significant reduction in dryness and wrinkles, and a significant increase in the amount of collagen and hemoglobin in the skin. The increased hemoglobin represents improved blood flow, which is great to getting nutrients and oxygen to the skin, and taking away waste.


Another study tested hydrolyzed collagen and hyaluronic acid (plus chondroitin). The result was reduced facial wrinkles and lines after 12 weeks of daily ingestion in one study. There was no visible change in crow’s feet at the end of the study. The supplement increased the skin’s overall level of hydration, so it was not as dry. Finally, the supplement increased the level of hemoglobin in the skin, suggesting that the blood supply was enhanced as well.


A supplement with collagen and hyaluronic acid from eggshell membrane was also tested. After 5 weeks of use, there was a significant improvement in skin elasticity.  After 50 days participants were happy with the softness and hydration of their skin and the appearance of their hair.


This shows several clinical studies of how supplementing with hyaluronic acid, with and without collagen, help to improve the skin’s hydration and appearance.


Skin benefits from other supplements that increase hyaluronic acid


Aloe vera gel powder supplements have been shown to increase the skin’s ability to produce collagen and hyaluronic acid. One study of women in their 40’s with dry skin showed significantly diminished wrinkles (depth of wrinkles). This is thought to be because the plant sterols increase the skin’s production of collagen and hyaluronic acid (but more research is needed).


Pycnogenol is a substance extracted from pine bark. One study involved 20 post-menopausal women who took the supplement for 12 weeks. The result was significant hydration and elasticity of the skin. In fact, the women with drier skin benefitted the most. On a molecular basis, the skin cells increased production of the enzyme that makes hyaluronic acid (hyaluronic acid synthase-1). The researchers also saw an increase in the gene that makes collagen.


There are non-hyaluronic acid supplements that increase the skin’s production of collagen and hyaluronic acid, and can help the skin be more hydrated and diminish the look of wrinkles.


How ingested hyaluronic acid helps the skin


Several studies have shown that ingesting hyaluronic acid can moisturize the skin. But how can swallowing it help your skin?


Ingested hyaluronic acid helps moisturize the skin in three ways:

  • Hyaluronic acid is absorbed by the gut and gets to the skin;
  • Hyaluronic acid helps to increase the number of skin cells called fibroblasts;
  • Hyaluronic acid promotes increased production of hyaluronic acid from fibroblasts.


So, it doesn’t just get to the skin to help retain moisture, it helps the skin make more cells and more hyaluronic acid as well.


“The amount of HA in the skin is one of the main factors that determines the skin moisture content. The metabolites of ingested HA moisturizes the skin.” Kawada et al., 2014.


FUN FACT: Your friendly gut microbes help your body digest and absorb hyaluronic acid from foods and supplements.




All of our skin ages over time. These happen naturally (intrinsic factors), as well as can be worsened with exposure to ultraviolet radiation, smoking, air pollution, and certain medications (extrinsic factors). These cause skin to dry out and wrinkle because they lower the amount of collagen and hyaluronic acid in our skin. The collagen is critical for maintaining good structure and firmness, while the hyaluronic acid maintains moisture and hydration.


Ingesting collagen and hyaluronic acid can actually counteract some of these effects. Several clinical studies show that they improve the skin’s moisture content, and even improve blood flow. Both of which help with the skin’s health and appearance.




Amado, I.R., Vázquez, J.A., Pastrana, L. & Teixeira, J.A. (2016). Cheese whey: A cost-effective alternative for hyaluronic acid production by Streptococcus zooepidemicus. Food Chem. 2016 May 1;198:54-61. doi: 10.1016/j.foodchem.2015.11.062.
LINK:  http://www.sciencedirect.com/science/article/pii/S0308814615302077?via%3Dihub


Aguirre, A., Gil-Quintana, E., Fenaux, M., Erdozain, S. & Sarria, I. (2017). Beneficial Effects of Oral Supplementation With Ovoderm on Human Skin Physiology: Two Pilot Studies. J Diet Suppl, 14(6):706-714. doi: 10.1080/19390211.2017.1310781.
LINK:  https://www.ncbi.nlm.nih.gov/pubmed/28429999


Examine.com. Type II Collagen. Accessed 2017Oct10.

LINK:  https://examine.com/supplements/type-ii-collagen/


Fisher, G.J., Datta, S., Wang, Z., Li, X.-Y., Quan, T., Chung, J.H., … Voorhees, J.J. (2000). c-Jun–dependent inhibition of cutaneous procollagen transcription following ultraviolet irradiation is reversed by all-trans retinoic acid. Journal of Clinical Investigation, 106(5), 663–670.

LINK:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC381286/


Frantz, C., Stewart, K.M. & Weaver, V.M. (2010). The extracellular matrix at a glance. J Cell Sci, 123: 4195-4200; doi: 10.1242/jcs.023820

LINK:  http://jcs.biologists.org/content/123/24/4195.full


Hussain, A., Zia, K.M., Tabasum, S., Noreen, A., Ali, M., Iqbal, R. & Zuber, M. (2017). Blends and composites of exopolysaccharides; properties and applications: A review. Int J Biol Macromol, 94(Pt A):10-27. doi: 10.1016/j.ijbiomac.2016.09.104.

LINK:  http://www.sciencedirect.com/science/article/pii/S014181301631234X?via%3Dihub


Kavasi, R.M., Berdiaki, A., Spyridaki, I., Corsini, E., Tsatsakis, A., Tzanakakis, G. & Nikitovic, D. (2017). HA metabolism in skin homeostasis and inflammatory disease. Food Chem Toxicol, 101:128-138. doi: 10.1016/j.fct.2017.01.012.
LINK:  http://www.sciencedirect.com/science/article/pii/S0278691517300200?via%3Dihub


Kawada, C., Yoshida, T., Yoshida, H., Matsuoka, R., Sakamoto, W., Odanaka, W., … Urushibata, O. (2014). Ingested hyaluronan moisturizes dry skin. Nutrition Journal, 13, 70. http://doi.org/10.1186/1475-2891-13-70

LINK:  https://www.ncbi.nlm.nih.gov/pubmed/25014997

LINK:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4110621/


Kimura, M., Maeshima, T., Kubota, T., Kurihara, H., Masuda, Y. & Nomura, Y. (2016). Absorption of Orally Administered Hyaluronan. J Med Food, 9(12):1172-1179.
LINK:  https://www.ncbi.nlm.nih.gov/pubmed/27982756


Lee, D.H., Oh, J.H. & Chung J.H. (2016). Glycosaminoglycan and proteoglycan in skin aging.
Journal of Dermatological Science, 83(3):174-181.

LINK:  https://www.ncbi.nlm.nih.gov/pubmed/27378089

LINK:  http://www.jdsjournal.com/article/S0923-1811(16)30117-7/fulltext


Maccari, F., Mantovani, V., Gabrielli, O., Carlucci, A., Zampini, L., Galeazzi, T., Galeotti, F., Coppa, G.V. & Volpi, N. (2016). Metabolic fate of milk glycosaminoglycans in breastfed and formula fed newborns. Glycoconj J. 2016 Apr;33(2):181-8. doi: 10.1007/s10719-016-9655-5.
LINK:  https://link.springer.com/article/10.1007%2Fs10719-016-9655-5


MacKay, D. & Miller, A.L. (2003). Nutritional support for wound healing. Altern Med Rev, 8(4):359-77.
LINK:  http://www.altmedrev.com/publications/8/4/359.pdf


Marini, A., Grether-Beck, S., Jaenicke, T., Weber, M., Burki, C., Formann, P., Brenden, H., Schönlau, F. & Krutmann, J. (2012). Pycnogenol® effects on skin elasticity and hydration coincide with increased gene expressions of collagen type I and hyaluronic acid synthase in women. Skin Pharmacol Physiol, 25(2):86-92. doi: 10.1159/000335261.

LINK:  https://www.ncbi.nlm.nih.gov/pubmed/22270036

LINK:  https://www.karger.com/Article/Abstract/335261#


Maytin, E.V. (2016). Hyaluronan: More than just a wrinkle filler. Glycobiology, 26(6), 553–559. http://doi.org/10.1093/glycob/cww033

LINK:  https://www.ncbi.nlm.nih.gov/pubmed/26964566

LINK:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4847620/


Oesser, S., Adam, M., Babel, W. & Seifert J. (1999). Oral administration of (14)C labeled gelatin hydrolysate leads to an accumulation of radioactivity in cartilage of mice (C57/BL). Journal of Nutrition, 129(10):1891-1895.

LINK:  http://jn.nutrition.org/content/129/10/1891.long


Oh, J.H., Kim, Y.K., Jung, J.Y., Shin, J.E., Kim, K.H., Cho, K.H., Eun, H.C. & Chung, J.H. (2011). Intrinsic aging- and photoaging-dependent level changes of glycosaminoglycans and their correlation with water content in human skin. J Dermatol Sci, 62(3):192-201. doi: 10.1016/j.jdermsci.2011.02.007

LINK:  https://www.ncbi.nlm.nih.gov/pubmed/21477996


Oishi, Y., Fu, Z.W., Ohnuki, Y., Kato, H. & Noguchi, T. (2002). Molecular basis of the alteration in skin collagen metabolism in response to in vivo dexamethasone treatment: effects on the synthesis of collagen type I and III, collagenase, and tissue inhibitors of metalloproteinases. Br J Dermatol, 147(5):859-68.
LINK:  https://www.ncbi.nlm.nih.gov/pubmed/12410694


Pan, N.C., Pereira, H.C.B., da Silva, M.L.C., Vasconcelos, A.F.D. & Celligoi, M.A.P.C. (2017). Improvement Production of Hyaluronic Acid by Streptococcus zooepidemicus in Sugarcane Molasses. Appl Biochem Biotechnol, 182(1):276-293. doi: 10.1007/s12010-016-2326-y.
LINK:  https://www.ncbi.nlm.nih.gov/pubmed/27900664


Papakonstantinou, E., Roth, M., & Karakiulakis, G. (2012). Hyaluronic acid: A key molecule in skin aging. Dermato-Endocrinology, 4(3), 253–258. http://doi.org/10.4161/derm.21923

LINK:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3583886/


Schwartz, S.R. & Park, J. (2012). Ingestion of BioCell Collagen(®), a novel hydrolyzed chicken sternal cartilage extract; enhanced blood microcirculation and reduced facial aging signs. Clin Interv Aging, 7: 267–273. doi:  10.2147/CIA.S32836

LINK:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3426261/


Song, S., Yu, Q., Zhang, B., Ai, C., Sun, Y., Fu, Y., Zhao, M. & Wen, C. (2017). Quantification and comparison of acidic polysaccharides in edible fish intestines and livers using HPLC-MS/MS. Glycoconj J. doi: 10.1007/s10719-017-9783-6.
LINK:  https://link.springer.com/article/10.1007%2Fs10719-017-9783-6


Tanaka, M., Misawa, E., Yamauchi, K., Abe, F. & Ishizaki, C. (2015). Effects of plant sterols derived from Aloe vera gel on human dermal fibroblasts in vitro and on skin condition in Japanese women. Clin Cosmet Investig Dermatol, 20(8):95-104. doi: 10.2147/CCID.S75441. eCollection 2015.
LINK:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4345938/