Aging leads to numerous changes of the human body, and most of them are unpleasant. Of all the signs of advancing age, two of the least pleasant are more wrinkles and less supple joints. However, these both seem to respond to a most unlikely-sounding remedy, a substance found in rooster combs (as well as in some vegetables and in the human body) called hyaluronic acid (HA).
Jason Theodosakis, physician and coauthor of The Arthritis Cure claims that “This substance is a lot like egg white, only not quite as thick. In joints, it works to ease movement and absorb impact.” In faces, it gives skin volume and shape.
Hyaluronic acid comes in supplement, cream, and injectable form. Nevertheless, it seems that not all varieties of the hyaluronic acid work equally well. Namely, some of the claims made for HA are more credible than others. It is even believed that in addition to cushioning joints and filling in wrinkles, the pill form, in particular, can also lead to longevity.
According to Theodosakis, this claim resulted from the discovery of a village in Japan where people lived to an unusually old age, and some speculated it might be due to the HA-rich vegetables they ate. Yet, this was based on theory only, and has never been proven.
Even though it has been showed that HA is extremely beneficial for knees and wrinkles, experts claim that the best variety to feel its benefits is still the use of injectable varieties. Apart from the beliefs of those inclined toward less invasive approaches, it seems that the shots may have some distinct advantages for arthritis and aging skin.
Plumping Up Wrinkles
This remarkable acid has gained its popularity in cases of wrinkles in December 2003 and again last April, when the FDA approved injectable Restylane and Hylaform, respectively, for use in filling in wrinkles around the nose and mouth. Restylane is extremely useful since its effects last longer than collagen’s—four to six months, compared to collagen’s three.
Moreover, treatments with collagen require previous allergy tests. Hylaform has similar effects, though it doesn’t always last as long as Restylane.
Joshua Fox, director of Advanced Dermatology in Roslyn, New York, and a spokesperson for the American Academy of Dermatology, claims that “It’s good for someone who doesn’t have a lot of sagging and doesn’t need a lot of volume added. And for some people, it provides a more natural look than collagen.”
Theodosakis states that you should be wary of any HA cream or lotion whose label claims it can do the same thing for that an injection would. “They’re not going to reduce your wrinkles any more than any other type of moisturizer. Using these creams topically makes as much scientific sense as putting your head on a dictionary to read it. The active ingredient can’t be absorbed—its molecules are too big.”- he adds.
Patients, use and risks
This treatment is suitable for those who want a safe wrinkle-reducer with longer-lasting results than you can get from collagen. Insurance companies would not cover the expenses, however.
Users must find a cosmetic surgeon who regularly uses Restylane in the practice, and should take a day or two out of the public eye in case redness or swelling appears. Moreover, users ought to stop taking Saint-John’s-Wort, Ginkgo Biloba, or high doses of vitamin E before a treatment because of their blood-thinning effects.
Naomi Lawrence, a dermatologic surgeon at Cooper University Hospital in Camden, New Jersey, says that “Many people don’t realize these cause more bruising.” Lawrence adds that aspirin can do the same as well, so one should stop taking it two weeks before the treatment, unless medically necessary. One shot is most often enough, and it costs about $600.
Side effects usually disappear in less than a week, and about 25 to 50 percent of patients experience some tenderness, redness, and/or swelling at the injection sites.
It was several years ago when the FDA approved hyaluronic acid for treating arthritis of the knee, when it gained its popularity. It bolsters the joint’s natural cushioning, which is something conventional arthritis treatments cannot offer. Most other medicinal treatments, at least—target the inflammation that occurs (and causes pain) when the bones of the joint rub against each other. Cortisone shots work the same way as well.
Dennis Wen, a physician and associate professor of family and community medicine at University of Missouri Columbia Medical School claims that “With osteoarthritis, the fluid in the knee that normally provides cushion and support thins out. HA appears to add thickness to that fluid and therefore helps the knee move with less friction and pain.”
Nevertheless, this does not mean all knee pain sufferers should get HA shots. The best candidates are people who have pretty much exhausted traditional arthritis remedies, don’t respond to supplements, and want to avoid surgery. Still, some potential HA users may first need to have surgery to clean out any loose bits of cartilage or bone chips that may be causing trouble.
People who do well with the arthritis supplements glucosamine and chondroitin don’t seem to derive any further benefit from HA, according to Theodosakis.
He further on says that there is still an unknown issue concerning the pain relief and the reason it lasts much longer than the HA actually stays in your knee. Namely, the hyaluronic acid goes away within days, or even hours, but the pain stays away for six to 12 months. However, this treatment gives positive results in about half of sufferers.
In addition, patients can quickly determine whether this treatments works effectively in their cases, which is not the case with other types of arthritis therapy. “If it’s going to help, you should start to feel better within a couple of weeks,” says Theodosakis.
HA Treatment: Patients, Use, Risks
These treatments should be done in patients suffering of osteoarthritis of the knee who aren’t getting relief from other methods. They are typically given three or five weekly injections of one of three formulas: Synvisc (the synthetic version of HA), Hyalgan (the natural variety)), and the most recently approved Orthovisc (also natural). Medicare and most insurance companies cover the expenses, which are about $1,000 to $1,500.
If arthritis causes pain in other joints than the knee, the patients may still be the injections, But insurance won’t cover the cost, since it’s an off-label use. The orthopedic surgeon Robert Nirschl, in Arlington, Virginia, who’s given the shots in shoulders and thumbs adds that “a joint is a joint,” , however.
This treatment does not cause common complications or side effects. Theodosakis claims that in rare instances, some patients have a severe inflammatory reaction to Synvisc, and the joint swells, most often after the second or third injection. Usually ice and an anti-inflammatory will ease the flare-up, but if an infection develops, antibiotics might be required.