Clinical Medicine Reviews in Therapeutics

Hyaluronic acid (HA) is a linear naturally occurring polysaccharide formed from repeating disaccharide units of N-acetyl-D-glucosamine and D-glucuronate. HA is omnipresent in the human body but highest amounts are found in soft connective tissues. HA is involved in several key processes, including wound repair, regeneration, and matrix organization. To increase stability, modifications of HA like various crosslinking substances and technologies have been developed. In recent years, most HA-fillers are of bacterial origin which ensures very low protein contaminations. HA fillers are temporary fillers, which can easily be digested by hyaluronidase, usually lasting for 6 to 9 months. They are safe for volumizing procedures when used with the appropriate technique and indications. Various types of clinical application are discussed. Best data are available for facial rejuvenation, in particular for nasolabial folds and the periocular region. Combining HA dermal fillers with other techniques allows an individualized treatment. In addition, HA fillers are useful to improve medical conditions such as scars and HIV-associated lipodystrophy as well. This review will provide an overview on the potential of this class of filler substances.