What is the difference between cross-linked hyaluronic acid and non-cross-linked hyaluronic acid?

The differences between cross-linked and non-cross-linked hyaluronic acid is a common question that patients ask aesthetic medicine doctors. What are the differences and what are they used for? Let's clarify the doubts.

Key Information

One molecule of hyaluronic acid can bind up to 250 water molecules
Non-crosslinked acid acts briefly (1–2 days) and is mainly used for skin hydration
Crosslinked acid is used for wrinkle filling and volumetry
After crosslinked acid, the application sites are visible longer than after non-crosslinked acid
The duration of action of both forms is also influenced by lifestyle and the individual's metabolism

What is Hyaluronic Acid?

Hyaluronic acid is an organic chemical compound that is produced by mammals and bacteria. In humans, it is found in many parts of the body, but it is most often discussed in the context of skin and joints. It is a major component of synovial fluid, which makes procedures using hyaluronic acid so common in orthopedics.

As for the skin, it is a component of the intercellular matrix of the dermis. Due to its enormous water-binding properties (one molecule of hyaluronic acid can bind as many as 250 water molecules!), it is responsible for proper hydration and (together with collagen and elastin fibers) maintaining skin firmness.

In what procedures is hyaluronic acid used in aesthetic medicine?

Hyaluronic acid is the most widespread and almost ubiquitous substance in aesthetic medicine treatments. It is used to fill lips, perform mesotherapy, volumetry, and fill wrinkles. It is also used in anti-aging treatments and as an ingredient in specialized cosmetics.

What is the difference between crosslinked and non-crosslinked hyaluronic acid?

Non-crosslinked hyaluronic acid is a molecule with relatively short chains and a rapid breakdown period. Its half-life in the skin is about 1-2 days and it is quickly metabolized in the liver to water and carbon dioxide. It has rejuvenating and revitalizing effects, which is desirable, for example, in rejuvenating mesotherapy.

During mesotherapy, this acid is injected rather shallowly under the skin and has moisturizing, rejuvenating, and anti-aging effects. It effectively protects the skin from moisture loss and the appearance of wrinkles.

Crosslinked hyaluronic acid differs in that the hyaluronate chains are cross-linked. Thanks to this process, HA metabolizes much longer and can remain in the application site for a longer time. This type of hyaluronic acid (or its mixture with non-crosslinked acid) is most commonly used for wrinkle filling, volumetry, and deep mesotherapy.

When selecting the appropriate acid for mesotherapy, it is worth knowing these differences. Non-crosslinked acid will act shorter, but the characteristic "beads" at the application site disappear immediately or within a few hours after the procedure. In contrast, the duration of action of hyaluronic acid is longer and more intense, but the visibility of the application sites is also longer.

It is also important to remember that other factors, such as lifestyle and the individual's metabolic characteristics, also affect the effect and duration of the treatment.

Which hyaluronic acid will you choose?