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Can Hyaluronic Acid Gels Stretch the Skin? Understanding the Role of Dosing


The use of hyaluronic acid (HA) gels for facial augmentation, wrinkle reduction, and overall rejuvenation has witnessed a significant surge over the years. While most patients and healthcare providers are primarily concerned with the immediate aesthetic results, a question that often arises is: Can hyaluronic acid gels stretch the skin? This blog post aims to address this question with a focus on dosing, supported by evidence from peer-reviewed scientific studies.

The Basics of Hyaluronic Acid and Skin Elasticity

Hyaluronic acid is a naturally occurring molecule found in our skin that has an exceptional ability to bind and retain water molecules. It is known for its hydrating, volumizing, and anti-aging properties (Gavard Molliard and Albert, 2017).

Skin elasticity largely depends on factors such as collagen and elastin fibers, and there’s limited evidence to suggest that hyaluronic acid can affect these structures in a way that would lead to skin stretching (Pavicic et al., 2011).

Dosing and the Question of Skin Stretching

Volume and Concentration

One of the critical factors that could theoretically contribute to skin stretching is the volume and concentration of HA used during the treatment. High volumes of HA gel could exert a stretching force on the skin, but such a condition is usually avoided through proper dosing (Wang et al., 2017).

Duration and Frequency of Treatment

Repeat treatments and the longevity of the HA gel might also be factors to consider. According to a study by Funt and Pavicic (2015), while HA gels are generally considered temporary, frequent and large volume injections could potentially affect the skin’s elasticity over the long term.

What Does the Research Say?

  1. Gavard Molliard, S., & Albert, S. (2017) in their review, concluded that HA is primarily used for its volumizing effect and did not find conclusive evidence to suggest that it would cause skin stretching.
  2. Pavicic, T., et al. (2011) similarly found that HA gels’ primary action is hydrating and plumping the skin rather than altering its fundamental structure.
  3. Wang, F., et al. (2017) discussed the importance of dosing and stated that excessive volume could be problematic, although not specifically mentioning skin stretching.
  4. Funt, D., & Pavicic, T. (2015) discussed the long-term effects of HA gels, suggesting that large volumes and frequent treatments might, theoretically, affect skin elasticity.
  5. Artzi, O., et al. (2020) emphasized the safety of HA gels when used in appropriate doses and did not indicate skin stretching as a commonly observed side effect.


The available evidence suggests that hyaluronic acid gels, when used appropriately, are unlikely to cause skin stretching. The key lies in the careful consideration of volume and concentration, which should be personalized for each patient. Excessive and frequent use is generally not recommended and may potentially affect the skin’s elasticity, although definitive evidence in this regard is lacking.


  1. Gavard Molliard, S., & Albert, S. (2017). Properties and benefits of highly cross-linked hyaluronic acid. Seminars in Cutaneous Medicine and Surgery, 36(3), 163-168.
  2. Pavicic, T., et al. (2011). Efficacy of cream-based novel formulations of hyaluronic acid of different molecular weights in anti-wrinkle treatment. Journal of Drugs in Dermatology, 10(9), 990-1000.
  3. Wang, F., et al. (2017). Facial assessment and injection guide for botulinum toxin and injectable hyaluronic acid fillers: focus on the upper face. Plastic and Reconstructive Surgery, 140(2), 265e-276e.
  4. Funt, D., & Pavicic, T. (2015). Dermal fillers in aesthetics: an overview of adverse events and treatment approaches. Clinical, Cosmetic and Investigational Dermatology, 6, 295-316.
  5. Artzi, O., et al. (2020). Resistant and recurrent late reaction to hyaluronic acid-based gel. Dermatologic Surgery, 46(3), 416-422.