hyaluronic acid (Restylane, Perlane)

Restylane is a gel of hyaluronic acid produced by bacteria and used for treating facial wrinkles and folds. It is classified as a medical device. Hyaluronic acid is a substance that is normally produced by the body; it is what gives skin its volume and fullness. The hyaluronic acid in Restylane is called non-animal stabilized hyaluronic acid (NASHA) because it is not derived from animal sources. When Restylane is injected into wrinkled skin it adds fullness and reduces the prominence of the wrinkles in the previously wrinkled area. Hyaluronic acid also attracts and binds water, and this also helps maintain fullness in the area of injection. The benefit of hyaluronic acid may last for six months or longer. Restylane was approved by the FDA in December 2003.

What brand names are available for hyaluronic acid?

Restylane, Restylane-L, Perlane

Is hyaluronic acid available as a generic drug?

No

Do I need a prescription for hyaluronic acid?

Yes

The most common side effects of hyaluronic acid are reactions at the site of injection such as:

• bruising,
• redness,
• pain,
• itching,
• tenderness, and
• swelling.

Vitamin E supplements, St. John's Wort, aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) such as Aleve and Motrin may increase bruising or bleeding after injection of hyaluronic acid. Therefore, patients should stop these drugs at least one week before the injections.

Post marketing adverse effects that have been reported include:

• infection,
• allergic
• reactions,
• necrosis (death of tissue), and
• acne.

Hyaluronic acid is administered by injection only by a physician. The amount of hyaluronic acid that is administered depends on the site that is being treated but it should not be more than 1.5 ml per naso-labial fold or 6 ml per treatment. For lip augmentation the maximum volume is 1.5 ml per lip not to exceed 3 ml per session.

Drug interactions are not listed in the prescribing information. Hyaluronic acid is classified as a medical device.

Use of hyaluronic acid during pregnancy has not been evaluated.

Use of hyaluronic acid by nursing mothers has not been evaluated.

What preparations of hyaluronic acid are available?

Single use syringes

How should I keep hyaluronic acid stored?

Hyaluronic acid should be stored at room temperature up to 25 C (77 F).