Hyaluronic Acid: Benefits for Skin and Joints, Uses & Side Effects

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Hyaluronic acid is a sugar-based molecule your body makes to hold on to water, and it's the key to the moisture that keeps young skin plump, joint fluid slippery and the inside of your eyes full.1 Your body makes it fresh every day, and you can support that work with the foods you eat, a serum on your skin and, if you want more, a daily supplement that raised skin hydration more than placebo in human trials.164

If your skin feels tight after a shower, your fine lines look deeper by the end of the day or your knees complain on the stairs, dryness is part of what you're feeling. Hyaluronic acid sits in the spaces between your cells and binds water there, so when sun, age and the hormone shifts of perimenopause and menopause wear this system down, the tissues it cushions feel it first.19 Getting to the root cause of that dryness means supporting the system that makes and protects your own hyaluronic acid.

Chicken bone broth is a natural place to start supporting your own supply, since it carries hyaluronic acid along with collagen and chondroitin, and in a lab study of human skin cells, a peptide from collagen signaled the cells to make more of their own.610 On top of that foundation, a serum works on the surface within minutes, and a daily supplement works from the inside over several weeks.114

Did you know?

• Researchers first isolated hyaluronic acid in 1934, from the vitreous humor, the clear gel that fills the eye.12

• Researchers attribute about 80% of the visible aging of facial skin to sun exposure.1

• Hyaluronic acid turns over fast: in your blood, your body clears half of it within 3 to 5 minutes.1

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What is hyaluronic acid?

Chemists call hyaluronic acid a glycosaminoglycan, a chain built from two simple sugars repeated over and over, and that chain can grow enormous. In your tissues, it forms a soft, water-filled gel in the spaces between cells, so it turns up wherever your body needs cushioning or slip: the inner layer of your skin, the fluid inside your joints and the vitreous gel of your eyes.1

Your body doesn't keep any one molecule of it for long. In your skin, half of your hyaluronic acid is broken down and replaced in less than a day, and in cartilage that takes 1 to 3 weeks.1 So the hyaluronic acid in your skin this week is mostly new, and how plump and moist your skin feels depends on how well your body keeps making it.

Hyaluronic acid vs. sodium hyaluronate

On a label, you'll often see sodium hyaluronate, the salt form of hyaluronic acid, and a cosmetic safety review assessed the two together, along with potassium hyaluronate.13 The trials on this page tested both names, including sodium hyaluronate taken by mouth for skin and for knees, so either one on a label gives you the same molecule.45 What matters more is size, or molecular weight: smaller molecules travel deeper into skin, a difference the skin section below puts to work.133

What does hyaluronic acid do in your body?

Think of it as a fine sponge woven into the spaces between your cells. Each long chain gathers water around itself, and together the chains form a soft gel that gives young skin its bounce and joint fluid its slippery, cushioning feel.1 Size matters inside your body too: large, intact chains go with healthy tissue, while small fragments, which build up when tissue is injured or stressed, act as alarm signals that draw in inflammation.2

So when your skin turns dry and lined or your joints start to stiffen, it helps to ask what's wearing this system down. Sun is the biggest factor for skin, and in mice, chronic UVB light stripped hyaluronic acid from the skin by turning down all three of the enzymes that make it.19 Age changes where it sits: the outer layer of older skin loses most of its hyaluronic acid, and what's left deeper down binds more tightly to the tissue around it.12 Hormones play a part as well, since falling estrogen and progesterone at menopause bring dryness and wrinkling, and in a trial of 30 postmenopausal women that compared two gels with no untreated group, 24 weeks of an estrogen gel on the face raised the skin's own hyaluronic acid, and so did a gel made from genistein, a plant compound.114 A diet heavy in added sugar works against the whole network, because sugar binds to the collagen and elastin fibers that support your skin and stiffens them, a process called glycation.15

Your body was designed to heal, and it rebuilds this gel every day when it has what it needs. Collagen is one of its best helpers, and food is where that help starts:

Traditional Chinese medicine reads the same pattern from another angle. It treats aging skin, dry eyes and a thinning gut lining as signs of one kind of dryness, a shortfall of yin, the body's cooling and moistening side, and it answers with moistening foods you'll find in the foods section below.18 Movement matters just as much for your joints, and the joint section explains why.

Hyaluronic acid benefits: what is it good for?

These seven benefits are in order of how strong the human research is for each, starting with your skin.

Hyaluronic acid for skin: what the serum and the supplement do

On your skin, size decides how far hyaluronic acid goes. A cosmetic safety review found that hyaluronic acid applied to the skin does reach the dermis, the skin's inner layer.13 In the German cream trial, every size of HA improved hydration and elasticity, but only the two smallest reduced wrinkle depth, and in the nursing-home trial, the small-molecule lotion beat the large-molecule one for very dry skin.319 That's why a serum labeled low-molecular-weight or multi-weight is the one to reach for.

Hyaluronic acid you swallow takes the long way around: in rat studies, gut bacteria break it into smaller pieces that are absorbed from the gut, and when labeled HA was given by mouth, about 90% of the dose was absorbed and more of the labeled material turned up in the skin than in the blood 24 and 96 hours later.3132

That shows up as moister skin in people, too. In the largest skin trial of oral hyaluronic acid so far, 150 healthy adults aged 18 to 60 drank a daily liquid with 60 mg or 120 mg of sodium hyaluronate, or a placebo, for 12 weeks; neither the people nor the researchers knew who got what, and six of the seven authors work for the ingredient's maker. Cheek hydration rose 9.1% more than placebo on 60 mg and 11.5% more on 120 mg, and forehead hydration and water loss through the skin improved on both doses. Skin tone, redness, pore size and gloss didn't change, and on 120 mg, wrinkle depth around the eyes fell compared with placebo.4

A trial in Taiwan tracked the change week by week: 40 healthy men and women aged 35 to 64 took 120 mg a day or a placebo for 12 weeks, and facial hydration on HA rose from 49.5 to 51.5, 52.8 and 54.9 units at weeks 4, 8 and 12, while the placebo group stayed at 49.1, 49.4, 48.9 and 48.8, a significant difference by week 12. Water loss through the facial skin fell and wrinkles improved as well.17

Other trials point the same way. In Japan, 61 women with dry skin took 120 mg a day of a larger or a smaller form of HA, or a placebo, for 6 weeks, and both HA groups gained more skin moisture than the placebo group, with the smaller form significantly ahead of placebo 2 weeks after they stopped.24 In a 28-day placebo-controlled trial of 60 women with signs of skin aging, 200 mg a day of a fermented HA raised hydration 10.6% and reduced wrinkle depth 18.8% in the HA group.33 In a 2025 review of 7 randomized trials, oral hyaluronic acid improved hydration, elasticity and wrinkle depth compared with placebo, and firmness, wrinkle volume and water loss through the skin trended the same way without reaching significance.25

So plan on two timelines: a serum gives you hydration you can feel the day you start, and supplements build their effect over 6 to 12 weeks, the length of these trials. Our guide to how to hydrate your skin adds the everyday habits that help both work.

Hyaluronic acid for joints and knees

The fluid inside a healthy joint is thick and slippery because of hyaluronic acid, and that fluid lets the cartilage on each bone glide over the other.1 When knee pain sets in, the steps with the strongest backing are keeping the joint moving and the muscles around it strong, and an HA capsule fits in as a partner to that work.

Move to keep your joint fluid flowing

The American College of Rheumatology strongly recommends exercise for knee osteoarthritis, along with weight loss for people who are overweight, tai chi and self-management programs.34 Movement also works on the same fluid hyaluronic acid builds. In a lab study of rabbit joint-lining cells, stretching them raised their hyaluronic acid output by 57% over 3 hours, and 10 minutes of stretch worked as well as 3 hours of it.35 It's a lab finding, but it fits what helps people: short, regular bouts of movement through the day, plus strength work that builds the muscles around your knee.

Do the quad sets every day, train the other three moves 2 to 3 days a week, and walk on the days in between. Together, these four moves build the quadriceps, hamstrings and glutes that steady your knee. Brace your core on every rep, move slowly on the way down, and choose the easier version of any move that sharpens pain in the joint itself.

Four knee-friendly moves

The straight-leg raise is the exercise everyone did in the 12-month knee trial described below. When the last reps of a set start to feel easy, add a little weight or move to the harder version. Our guides to knee strengthening exercises and quad exercises add more moves, and strength training for women shows how to build a full program around them.

Hyaluronic acid capsules for knee pain

Hyaluronic acid taken by mouth can help from the inside as well, and an Italian pilot trial measured how much: adults with knee osteoarthritis took 200 mg of sodium hyaluronate or a placebo every day for 8 weeks. Pain scores fell from 6.7 to 4.1 out of 10 on hyaluronic acid, against 6.4 to 6.0 on placebo, and the HA group's overall arthritis scores improved more and they used pain pills less often. Everyone finished the trial without side effects.5

A 20-person placebo-controlled pilot of an HA-rich chicken comb extract, 80 mg a day for 8 weeks, found that pain on the main arthritis scale improved about equally in both groups, while quality-of-life scores for bodily pain and social functioning improved more on the extract.36 Over a full year, a Japanese trial gave 60 adults with knee osteoarthritis 200 mg a day or a placebo, and everyone did a daily quadriceps exercise with straight-leg raises. Among the 38 people who stayed in the analysis, both groups improved, the gains tended to be larger on HA across all ages without reaching significance, and among those aged 70 or younger, the HA group did significantly better than placebo at months 2 and 4.27

Food supports your joints too: the bone broth in the foods section helps here as well,7 and in a lab study of joint tissue from people with osteoarthritis, glucosamine hydrochloride raised hyaluronic acid production.37 Our guide to collagen for joints covers the other half of what cartilage is made of.

Hyaluronic acid injections for knees: what a doctor may offer

Hyaluronic acid injections, also called viscosupplementation, place a thick HA gel directly into the knee, and they're something a doctor may offer when knee pain doesn't settle with other care. In large trials, the benefit is small: a 2022 analysis of 169 trials found that in 24 large placebo-controlled trials, with 8,997 people, injections lowered pain by about 2 points on a 100-point scale more than placebo, well short of the smallest difference that patients count as meaningful.38 The American College of Rheumatology conditionally recommends against HA injections for knee osteoarthritis and strongly against them for the hip.34 Measured against pain pills, injected HA outscored oral pain relievers such as NSAIDs and acetaminophen in an analysis that compared treatments across 137 trials, and the authors suggest part of that edge may come from the placebo effect of an injection itself.39 The safety section covers the procedure's risks, and for most knees, the strength work, walking and food on this page are where your effort pays off most.

Foods and habits that help your body make hyaluronic acid

Bone broth. Drink a cup a day, and make it chicken broth in particular, since a chicken-vegetable bone broth contains hyaluronic acid and chondroitin along with its collagen.67 This chicken bone broth recipe walks you through making your own.

Collagen-rich foods. Eat the skin on fish and chicken and add other collagen-rich foods, and if you use a powder, choose bovine collagen or fish collagen. Aim for about 20 to 30 grams of collagen a day from broth, food and powder together; our collagen guide explains the amount.

Vitamin C, zinc and copper. Your skin needs vitamin C to build collagen, and healthy skin holds high concentrations of it, so eat vitamin C foods such as citrus, bell peppers and berries every day.40 Round them out with zinc-rich foods and copper-rich foods, since your skin relies on these minerals too, and copper helps its collagen mature.41

Moistening foods. Traditional Chinese medicine meets dryness with foods it considers moistening: egg yolks, wild-caught fatty fish such as salmon and sardines, sweet potato, flaxseed, cucumber, watermelon, coconut yogurt and extra virgin olive oil. Snow fungus, also called tremella, goji berries and Asian pear are traditional Chinese foods for moistening the skin, and in a lab study, snow fungus extract raised collagen production in human skin cells much as hyaluronic acid did, by a different route.42

Water and healthy fats. Drink water through the day, about half your body weight in ounces (our guide to how much water you should drink a day has the details), and work in hydrating foods and omega-3 foods such as wild salmon.

Less added sugar. Cutting back on added sugar spares your skin's collagen and elastin from the glycation described above, which protects the network that holds your hyaluronic acid in place.15 Our list of collagen-destroying foods names the others to cut back on.

Sun, without the burn. Since sun exposure drives most visible aging of facial skin, get your daily sunshine in short stretches, then cover up with shade and clothing or a mineral sunscreen when you'll be out for long, and never let your skin burn.19

How to use hyaluronic acid

Hyaluronic acid comes as serums, creams, capsules and eye drops, and each one works best when you use it a particular way.

How to use hyaluronic acid serum on your face

Use it on damp skin: hyaluronic acid works by binding water, so it does its best work when there's water on your skin to hold, and dermatologists advise putting moisturizer on while your skin is still damp after you wash.18 Then seal it in with a moisturizer, so the water stays where you want it. A simple routine looks like this:

1. Wash gently, morning and night, then pat your face so it stays a little damp.43

2. Smooth a few drops of serum over your face and neck while your skin is still damp. Choose one labeled low-molecular-weight or multi-weight; the creams in the German trial were 0.1% HA.3

3. Seal it in with a moisturizer. A cream suits dry skin and a lighter lotion or gel suits oily or breakout-prone skin, and our guides to moisturizer for dry skin and moisturizer for oily skin help you choose.844

4. On days you'll be out in strong sun for long, finish with a mineral (zinc oxide) sunscreen, applied after your other products.43

If you like to make your own, our homemade anti-aging serum and homemade face moisturizer fit right into this routine, and our skin care routine guide builds the rest of your day around it.

When the heat comes on in late fall and winter, indoor air dries out and so does your skin. Keep showers and baths to 5 to 10 minutes in warm water, put your serum and moisturizer on while your skin is still damp, and run a humidifier where you sleep.8 Our guide to dry skin in winter has more ways to get through the season.

Taking hyaluronic acid supplements: how much per day

Take it every day, since the trials gave it daily and your body turns hyaluronic acid over quickly.1 Labels list hyaluronic acid or sodium hyaluronate, and either one works, since the trials used both.174 Keep up the broth and the serum alongside it, and take the capsule with a meal if you like; the 12-month knee trial gave it once a day after breakfast.27

Hyaluronic acid side effects and safety

Good to know before you start:

• Skin reactions. They're uncommon, but test a new serum on the inside of your forearm for a day first, and stop if it stings, itches or turns red.

• Pregnancy and breastfeeding. A serum is a gentle choice: hyaluronic acid wasn't a reproductive or developmental toxicant in animal studies, and it occurs naturally in breast milk.1345 Capsules haven't been studied in pregnancy or breastfeeding, so stay with serums and food during those months.

• Poultry, egg or feather allergy. Some hyaluronic acid is extracted from rooster combs, so choose a product made by bacterial fermentation.13

• Fillers. In rare cases, an injected filler blocks a blood vessel and affects vision: a 2015 review of the world literature found 98 cases of vision changes after fillers, 23.5% of them after HA fillers, and a 2019 update found 48 more, 81.3% of them after HA fillers.4647 Choose an experienced, board-certified injector who knows the anatomy of the face, and get emergency care right away if your vision changes or you feel sudden pain during or after an injection.46

• Knee injections. In 15 large trials with 6,462 people, serious health problems were somewhat more common with HA injections than with placebo, at 1.49 times the rate, so weigh that with the doctor who offers them.38

The bottom line

Hyaluronic acid: frequently asked questions

References

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Dr. Josh Axe, DC, DNM, CNS

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Dr. Axe is a certified doctor of natural medicine, clinical nutritionist, and multiple New York Times bestselling author. He has spent 20+ years in clinical practice helping people heal at the root cause and founded one of the most-visited natural-health platforms in the world.

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