Hyaluronic acid treatment

30 suppliers, 70 different products that are sold as so-called “fillers”. The situation in this country is indeed confusing and constantly changing. Due to the many innovations, new hyaluronic acid products are constantly coming onto the market, which requires great know-how and circumspection on the part of the treating doctors.

As beneficial as the effect of hyaluronic acid is – over time, the substance degrades in the body or is no longer produced in sufficient quantities. The result is a loss of elasticity of the skin and the appearance of wrinkles. This natural ageing process can be counteracted by injecting an equally natural preparation. Of course, hyaluronic acid is also contained in a number of creams, but here the firming effect is only apparent for a short time, whereas the injections last for a long time”.

Treatment with hyaluronic acid is particularly suitable in the lip area. Through targeted “injections”, the shape as well as the size and volume are positively influenced. Wrinkles can also be permanently removed by hyaluronic acid, with the effect becoming more pronounced with each additional treatment.

Hyaluronic acid is not recommended during pregnancy, in the case of allergies, autoimmune diseases or even severe heart disease or when taking blood thinners. In case of rare side effects, hyaluronic acid can always be quickly neutralised by administering the enzyme hyaluronidase.

In earlier times, artificial hyaluronic acid was produced from cockscombs, among other things. Nowadays, however, more gentle and, above all, animal-friendly processes are used.

Despite the abundance of different products, differences can be detected with a trained eye. The number one on the market is the Swedish manufacturer QMed with its products Restylane, Perlane, SubQ, Restylane Vital, Restylane White/Light and Macrolane. Restylane is considered one of the pioneers in the field of non-animal stabilised hyaluronic acid (NASHA) and is also very popular in the USA. Experienced and renowned clinics in Germany also use this product time and again. Also worth mentioning are Belotero Soft, Belotero Basic and Belotero Intense as well as the Hyal system (non-cross-linked hyaluronic acid) from the German company Merz, which are primarily used by dermatologists for whom aesthetic medicine is a sideline. Also worth mentioning is the US company Allergan, which made a name for itself with Relaxans and produces Juvederm Ultra in various viscosities. The plethora of hyaluronic acid preparations is rounded off by Teosyal, although there are a number of other manufacturers on the market.

The degree of purity shows that not all hyaluronic acid is the same. Thus, one should pay attention to the lowest possible endotoxin content, where a value below 0.05 E.U./mg is optimal. In old products, this value is often higher and yet these are repeatedly put on the market under different names.

After the injection, some general reactions associated with the injection may occur in the treatment area, such as mild redness, swelling, tenderness and itching. These associated reactions are generally described as mild to moderate and usually resolve on their own within one to two days after injection into the skin.

During the first 6 hours, the treated areas of the face should not be touched unnecessarily often. Afterwards, light make-up, but also gentle washing with soap is possible without any problems. Until the initial skin redness and swelling have subsided, you should not expose yourself to extreme heat (e.g. solarium and sunbathing) or extreme cold.

To lift a wrinkle, the filler substance is injected under the skin in tiny amounts using a thin needle. The substance gives the skin natural volume and thus smoothes the wrinkle. To achieve the best possible lift, there are customised products that are injected into different depths of the skin to achieve optimal lifting capacity from fine lines to deep wrinkles.

If you suffer from allergies, e.g. to animal proteins, then you must inform the treating doctor in any case. It would then be advisable to use products with natural hyaluronic acid that are not of animal origin and are produced by biosynthesis (e.g. RESTYLANE). Permanent fillers can cause defensive reactions such as granuloma formation even a long time after treatment. For this reason, many doctors reject the use of permanent substances. The advantage of hyaluronic acid and lactic acid is that the products are completely degraded.

Since the material is usually injected linearly under the wrinkle line, only a few punctures per wrinkle are necessary. Most patients find the injection relatively painless. If desired, the area to be treated can be anaesthetised with a local anaesthetic cream or spray. As wrinkle injections are an uncomplicated and outpatient procedure, a stay in hospital is not necessary.