Hyaluronic acid in the improvement of skin aging: optimal physicochemical characteristics, modifications, and personalized strategies

Hyaluronic acid (HA) is a key biopolymer in injection cosmetology, regulating processes of tissue regeneration, inflammation, and hydration. Its functional polymorphism, determined by variability in molecular weight (MW), spatial organization, and receptor interactions, defines the duality of its biological effects. This dichotomy positions HA as a central focus of research in biomedicine and cosmetology, where controlling its properties opens pathways to personalized therapeutic strategies. Modern injection cosmetology faces challenges related to limitations in the use of native hyaluronic acid and traditional cross‑linked HA fillers. Rapid biodegradation of native HA by reactive oxygen and nitrogen species, as well as hyaluronidases, further diminishes long‑term efficacy. Despite their ability to correct volume deficits, dermal fillers do not address the pathogenetic mechanisms of aging, and their application carries risks of adverse reactions due to residual cross‑linker content. These problems highlight the need for innovative approaches to polymer stabilization, MW control, and the integration of bioactive components to synergize volumetric correction with biochemical impact. Solid‑phase modification methods for HA hold promise – specifically, mechanochemical cross‑linking with bio‑regulators, which eliminates toxic reagents and ensures controlled delivery of active agents. The relevance of this work stems from the necessity to transition from symptomatic correction to pathogenetically‑grounded interventions in injection cosmetology. Despite the broad spectrum of existing preparations, the selection of optimal HA forms is often based on empirical data, leading to variable outcomes and complication risks. Systematizing current scientific evidence on the influence of HA molecular weight, post‑synthetic modifications, and receptor interactions on procedural efficacy is a crucial step towards establishing pathogenetically‑grounded protocols that minimize the risk of complications.

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