Posts tagged with "Hyaluronic acid"

Take your best shot: Studies show that steroid injections worsen knee arthritis

November 30, 2022

Two studies comparing injections commonly used to relieve the pain of knee osteoarthritis have found that corticosteroid injections are associated with the progression of the disease. Results of both studies were presented this week at the annual meeting of the Radiological Society of North America (RSNA).

Indeed, EurekAlert reports, osteoarthritis is the most common form of arthritis—affecting 32.5 million adults in the United States. Knee osteoarthritis is a chronic, degenerative, and progressive condition with an estimated incidence of 800,000 patients each year. More than 10% of patients with knee osteoarthritis seek noninvasive treatment for pain relief through corticosteroid or hyaluronic acid injections.

Researchers in both studies chose cohorts from the Osteoarthritis Initiative, a multicenter, longitudinal, observational study of nearly 5,000 participants with knee osteoarthritis currently in its 14th year of follow-up.

In the first study, researchers at the University of California-San Francisco included 210 Osteoarthritis Initiative participants, 70 of whom received intraarticular injections, and a control group of 140 who did not receive injections during a two-year period. Of the 70 patients who received injections, 44 were injected with corticosteroids; 26 were injected with hyaluronic acid. The treatment and control groups were matched by age, sex, body mass index, pain, physical activity scores, and severity of disease.

MRI was performed on all patients at the time of the injection and two years before and after. The MRI scans were assessed using whole-organ magnetic resonance imaging score (WORMS), a grading system for knee osteoarthritis that focuses on the meniscus, bone marrow lesions, cartilage, joint effusion and ligaments. The researchers identified osteoarthritis progression by comparing the imaging scores from the initial scans and two-year follow-up scans.

“This is the first direct comparison of corticosteroid and hyaluronic acid injections using the semi-quantitative, whole-organ assessment of the knee with MRI,” said Upasana Upadhyay Bharadwaj, M.D., a research fellow in the Department of Radiology at University of California-San Francisco.

Statistical analysis showed that corticosteroid knee injections are significantly associated with the overall progression of osteoarthritis in the knee—specifically, in the lateral meniscus, lateral cartilage, and medial cartilage.

Hyaluronic acid knee injections were not significantly associated with the progression of osteoarthritis in the knee. Compared to the control group, the group who received hyaluronic injections showed a decreased progression of osteoarthritis, specifically in bone marrow lesions.

“While both corticosteroid and hyaluronic acid injections are reported to help with symptomatic pain relief for knee osteoarthritis, our results conclusively show that corticosteroids are associated with significant progression of knee osteoarthritis up to two years post-injection and must be administered with caution,” Dr. Upadhyay Bharadwaj says. “Hyaluronic acid, on the other hand, may slow down progression of knee osteoarthritis and alleviate long term effects while offering symptomatic relief.”

In the second study, researchers at the Chicago Medical School of Rosalind Franklin University of Medicine and Science conducted a case-control study comparing the radiographic progression of osteoarthritis in patients who received injections of corticosteroids and hyaluronic acid.

“While these injections provide some patients with short-term pain relief, the effects of the injections on the progression of the disease are unknown,” said researcher and medical student Azad Darbandi.

Darbandi’s team selected a cohort of 150 patients with similar baseline characteristics from the Osteoarthritis Initiative database—including 50 patients who received corticosteroid injections, 50 who received hyaluronic acid injections, and 50 who were not injected over a 36-month time period. The groups were matched by sex, body mass index and X-ray findings.

Patients underwent X-ray imaging of the knee at baseline and two years later. The researchers analyzed the X-ray imaging, including joint space narrowing, formation of bone spurs, and bone thickening around the knee cartilage.

Compared to patients who received an injection of hyaluronic acid or no treatment at all, patients injected with corticosteroids had significantly more osteoarthritis progression, including medial joint space narrowing, a hallmark of the disease.

“Even though imaging findings for all patients were similar at baseline, the imaging hallmarks of osteoarthritis were worse two years later in patients who received corticosteroid injections compared to patients who received hyaluronic acid injections or no treatment at all,” Darbandi says. “The results suggest that hyaluronic acid injections should be further explored for the management of knee osteoarthritis symptoms, and that steroid injections should be utilized with more caution.”

“Knowing the long-term effects of these injections will help osteoarthritis patients and clinicians make more informed decisions for managing the disease and the pain it causes,” Dr. Upadhyay Bharadwaj adds.

Research contact: @EurekAlert

What’s the difference between a $7 hyaluronic acid and one that costs $300?

January 15, 2020

Hyaluronic acid is a skin care ingredient that is said to hydrate, plump, and protect the skin from moisture loss. Its moisturizing properties have been widely promoted—and it is trending as the key ingredient in products from drugstore and budget-friendly face cream brands like Neutrogena ($21) and cult favorite The Ordinary ($7); to prestige lines like Dr. Barbara Sturm, a brand that sells a 30 ml bottle of hyaluronic acid serum for $300.

But because you can pick it up, literally, at thousands of outlets, consumers are find it challenging to understand which products give the best results, The Huffington Post reports.

What’s a skincare junkie to do?

First, says HuffPost, consult such online beauty communities as Reddit and Makeup Alley, as well as the Sephora message boards, where buyers share what is and isn’t working for them.

One of the top questions on the message boards discussing hyaluronic acid is, “Is it worth it?” Does it really make a difference whether you purchase a $7 product or upgrade to a $300 serum? HuffPost talked to dermatologists to find out.

“Hyaluronic acid is a natural sugar found in our skin,”  Joshua Zeichner, director of Cosmetic and Clinical Research in Dermatology at Mount Sinai Hospital in New York City, told the news source. “It is what provides bounce and plumpness to the skin. Think of it like the stuffing in your mattress. As a humectant, hyaluronic acid is essentially a sponge that binds to 1,000 times its weight in water.”

But, even though the humectant is a powerhouse, that doesn’t mean it can do it all.

When it comes to fully moisturizing and plumping your skin, “hyaluronic acid alone might not do the job,” Victoria Fu, who is half of the chemist duo at skin care brand Chemist Confessions told HuffPost. “Look for products that pair with other types of hydrators such as glycerin, glycols, urea, panthenol, [or] sodium PCA. One ingredient won’t solve all your moisturizing troubles—skin hydration is a team effort.”

What drives up the cost of hyaluronic acids? A few thing—among them: molecular weight, added ingredients, and product packaging.

“There are some studies that suggest smaller molecular weight HA can penetrate somewhat better and can have long-term anti-aging benefits on top of hydration,” Fu said. The Ordinary’s $7 HA formula combines low, medium, and high molecular weight hyaluronic acid, while Dr. Sturm’s $300 HA uses short- and long-chain molecules (low and high weight).

For those of us who weren’t paying attention in chemistry class, Zeichner kindly breaks the science down for us. “Smaller molecules can better penetrate through the outer skin layer to give more of a plumping effect,” the doctor told HuffPost, explaining that the smaller molecules can go farther into the skin.

“Long-chain HA, because of its large size, does not penetrate well through the skin and provides a hydrating effect to the outer skin’s layer.” Zeichner says many over-the-counter products stick to high and medium molecular weights because “there is some data that low molecular weight HA may actually promote inflammation in the skin.”

Fu told HuffPost that molecular size “can certainly drive up the cost of the product. However, it also heavily depends on concentration, support ingredients or any sort of special testing that was done on the HA product.”

Does the percentage of HA in a product play a role in pricing, like it does with retinol, glycolic acid. and vitamin C?

“It’s hard for us personally to shell out $300 for a hyaluronic acid serum,” Lu and Fu told HuffPost. Speaking to the Dr. Barbara Sturm product, they said, “While having exotic antioxidants like purslane can certainly make it more effective than the average economical HA product, we’re just not sure it’s $300-worth effective.”

Michelle Wong, a chemist behind the blog Lab Muffin, uses her social media platforms to share the science behind product development while giving tips on which products are worth buying. Wong agrees that “hyaluronic acid products do not need to be very expensive,” adding, “the pricing of almost all beauty products are based on marketing and consumer perception rather than the actual cost of ingredients.”

But Lu recommends that readers “[look] … for products that have gone through actual clinical testing” if you are in the market for a prestige-priced HA. “Clinical testing means that a brand paid to test their product on a group of subjects with a third party clinic and take measurements to show actual efficacy. We think this is a great and meaningful way to substantiate marketing claims,” Fu told HuffPost.

Research contact: @HuffPost

‘Getting jaded’ could be good for you: The new face roller craze

December 12, 2018

Instagram seems to be “on a roll” when it comes to skin care: Forget the high-tech masks, the “friendly bacteria,” and the dry-brush exfoliation. The latest (ahem) “wrinkle” in style is jade rollers—not for your body, but for your face.

According to a December 10 report by Prevention magazine, “Jade rollers are not a skin care necessity, like face wash or moisturizer. However, if you enjoy pampering yourself and want to give your complexion a little TLC, jade rollers can be a helpful addition to your daily routine, especially if you deal with puffy skin.” Others praise the rollers for firming the skin, increasing circulation, and decreasing inflammation.

For the uninitiated, a jade roller is a small beauty tool that looks like a miniature paint roller—except it’s made of stone and owning one is viewed as chic and upscale In the same way that your muscles feel more relaxed after a nice massage, the skin on your face can experience a release of tension when you use a jade roller properly, according to the fanbase on Instagram.

Prevention informs us: “Take one look through the 30,000 posts tagged #jaderoller on Instagram and you’ll find countless women massaging their face with the tool, often after applying a sheet mask or serum.

The use of the gemstone jade plays a vital role here, Prevention notes—thanks to its ability to maintain a cool temperature, despite being exposed to body heat. In fact, one of the ways to tell if it’s really jade in the first place is to place the stone in the palm of your hand. If it warms up, then it’s not jade.

How exactly does it improve your facial skin? “We do know that fluid tends to accumulate in the soft tissue of the face and around the eyes, which can worsen with allergies, rosacea, high blood pressure, and hormonal changes, and it can start to change the texture of the skin on the face if left there for prolonged periods of time,” Dr. Erum Ilyas, a dermatologist at Montgomery Dermatology in Pennyslvania, told Prevention in a recent interview. “Aside from medications, the use of a jade roller to gently work this excess fluid back into the lymphatic system can help control the effects of this swelling.”

If your goal is to reduce puffiness under the eyes and mitigate dark circles, it’s best to keep your roller in the refrigerator prior to use, Dr. Ilyas advises.

“A desired eye and face serum must be applied to clean skin prior to rolling as well, ideally one containing hyaluronic acid, which holds up to 1,000 times its weight in water,” Bobbi Del Balzo, lead medical aesthetician at the Deep Blue Med Spa in New York, told the magazine. Another handy hint: You can apply a hydrating sheet and use the jade roller over it.

For lymphatic drainage, it’s all in the technique, says Dr. Ilyas, and should take a few minutes at most:

  • Start with the bottom of the face—specifically the center of the chin—and work your way up, rolling outward across the jaw and up toward the ear. Follow this same pattern all the way out towards the cheek.
  • Next, start adjacent to the nose and roll outward over your cheek towards your ears.
  • Using the smaller stone end of your jade roller, work from the inner lower eyelid over the gentle skin under the eye and outward to the temple.
  • Place the roller between your eyebrows and roll out over each eyebrow, again slightly above this area, then straight up towards the hairline.

If you are intrigued, the cost is not too high. Many face rollers are under $20, and most are under $100.

Just how trendy are these face rollers? Even Gwyneth Paltrow’s Goop has one for sale—a doo-hickey that is made of rose quartz and, the website claims, will “wake up your entire face” for just $45.

Research contact: @jennsinrich