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Hyaluronic acid is a high-molecular-weight polysaccharide, which is widely distributed in the connective tissue extracellular matrix. Several hyaluronic acid preparations have become widely available for subcutaneous/intradermal, intraarticular, topical, and ocular use. This activity outlines the indications, mechanism of action, administration, significant adverse effects, and contraindications of various hyaluronic acid preparations to increase practitioners' knowledge regarding how to approach this substance and use it in practice for its indicated purposes. Objectives: Identify the mechanism of action of hyaluronic acid. Outline some of the conditions where hyaluronic acid is useful and indicated. Explain the potential adverse effects of hyaluronic acid. Summarize interprofessional team strategies for improving care coordination and communication to advance improved outcomes using hyaluronic acid when indicated. Access free multiple choice questions on this topic.

The effects of hyaluronic acid filler are reversible with hyaluronidase, an enzyme that breaks down both native and injected hyaluronic acid. Hyaluronidase is particularly useful when the determination is that the filler injection was too superficial, as evidenced by bluish discoloration.

Several healthcare professionals use hyaluronic acid, including the plastic surgeon, primary care clinicians (including PAs and NPs), dermatologists, and internists, to enhance cosmesis. The hyaluronic acid filler can only be injected by the prescription of a licensed health care provider. Hyaluronic acid filler has become popular because of its low allergic response, ease of injection, rapid recovery, reproducibility, and immediate results. It is also frequently used for symptoms relief from knee osteoarthritis by several healthcare professionals, including orthopedics, rheumatologists, physical medicine and rehabilitation providers, and primary care providers. It is essential to educate the patient that hyaluronic acid treatment is not permanent, and results may last anywhere from 8 to 16 weeks for the dermal filler and up to 6 months for intraarticular injection, depending on the type of product.[3][15] Nursing staff can assist during the procedure, offer to counsel following the injection, verify post-procedure compliance with the treating clinician's orders, and assist patients with any post-procedural complication recognition. Often, these products are supplied via compounding pharmacies, so the pharmacist must understand the needs and wishes of the clinician and compound the proper formulation for the particular procedure; close communication is essential. While not an overly complicated process, it still requires the collaboration of an interprofessional team approach to successfully direct outcomes. [Level 5]