A small study has found inflammatory lesions worsen with the use of topical hyaluronic acid, and the solution can cause wound deterioration in residents with conditions such as scleroderma.

Italian researchers followed 79 patients with 106 ulcers, whose wounds did not respond to typical wound dressings. They were then treated with four different HA-based products already on the market.

While just over half of the wounds healed without side effects, more than one-third of patients developed erythema or pain and saw their wounds grow. 

“Hyaluronic acid in wound dressings has certainly helped to expand the therapeutic arsenal in the context of wound care,” the team reported in the March issue of Wounds. “However, like any innovation, HA must be placed in the right context … Clinicians must be aware that this glycosaminoglycan plays a role in the pathogenesis of some diseases.”

In sclerodermic skin, chronic inflammation affects the connecting tissue and leads to progressive fibrosis, and patients with scleroderma overproduce hyaluronan, collagen and fibronectin.

Researchers discouraged broad-scale HA use.