WORDS BY — Sophia Ruiz, Founder, Integrative Esthetician, + Dermatology Researcher

Walk down any beauty aisle or open your social feeds and it’s there: hyaluronic acid.

The holy grail of skin hydration. It’s in serums, creams, masks, and mists, promising plump, dewy, glass-like skin.

But, the truth is: sometimes even the most celebrated ingredients don’t love us back.

A core tenet of my skin philosophy is skin intuition — listening to your skin above all. Embracing the trends that work and not forcing the ones that don’t. And sometimes, that means questioning the skincare status quo.

When “good” ingredients go rogue: is hyaluronic acid really safe for acne-prone skin?

Hyaluronic acid is an incredible, biocompatible ingredient.

A naturally occurring molecule, it cushions joints, protects skin cells, and binds up to a thousand times its weight in water. It’s in nearly every hydrating formula for a reason: it works to deliver plump, glowing skin.

But here’s the twist: recent research shows that acne-causing bacteria — specifically, Cutibacterium acnes (previously known as Propionibacterium acnes) — may actually use hyaluronic acid to drive acne.

For me, this research is personal.

No matter the formula, hyaluronic acid serums have consistently broken me out. Despite a pristine skincare routine otherwise, a week of using a hyaluronic acid serum would consistently trigger deep, red, cystic pimples somewhere on my face – a characteristic sign of bacterial overgrowth.

And I wasn’t alone – dozens of women echoed the exact same story. 

Recognizing this pattern is what prompted me to go looking for this research – and what I found convinced me hyaluronic acid wasn’t right for me. If you struggle with stubborn acne, it might be the case for you, too.

How might hyaluronic acid contribute to breakouts?

Science has known for years that C. acnes bacteria creates an enzyme called hyaluronidase. This enzyme specifically targets and breaks down hyaluronic acid.

Hyaluronidase produced by C. acnes helps the bacteria live on the skin. It does this in two key ways: 

• As C. acnes breaks down hyaluronic acid, the skin becomes easier to access (and live on).

• C. acnes also breaks down hyaluronic acid into simpler sugar molecules that it can use as fuel for growth.

This isn’t a bad thing – after all, C. acnes isn’t always the villain. Some strains are commensal – peacekeepers of the skin microbiome, even. Hyaluronidase helps these good C. acnes strains colonize the skin microbiome, supporting healthy skin.

Instead, the real problem is the type of C. acnes that live in acne-prone microbiomes.

Hyaluronic acid, hyaluronidase, and the acne-prone skin microbiome

In a 2023 study published in Nature Communications, researchers found that some C. acnes strains, specifically ones linked to acne, might metabolize hyaluronic acid differently.

Researchers found two distinct metabolic profiles among C. acnes bacteria:

• Strains that break down hyaluronic acid into disaccharides (complete degradation)

• Strains that break down hyaluronic acid into large hyaluronic acid fragments (partial degradation)

This metabolic shift makes a difference. While HA-derived disaccharides are anti-inflammatory and calm acne, hyaluronic acid fragments are majorly pro-inflammatory and drive acne.

What’s more: in a preclinical acne model, altering the metabolism of hyaluronic acid determined the severity of acne. When hyaluronic acid was fully-degraded to disaccharides, researchers observed a decrease in acne severity. When only partially degraded to HA fragments, acne severity increased.

But, here’s the real kicker. The strains that only partially degrade hyaluronic acid? They’re the strains primarily found on acne prone skin.

In plain terms: acne-prone skin is distinctly different. Part of this difference is that the acne-prone microbiome uses hyaluronic acid differently. Instead of pure hydration support, hyaluronic acid becomes the fuel that drives acne and inflammation.

This doesn’t make hyaluronic acid the villain. It just means it’s not the right nourishment for every skin ecosystem.

How do I know if hyaluronic acid breaks me out?

There’s no easy way to tell if hyaluronic acid is contributing (or will contribute) to your breakouts, barring a casual genomic sequencing of your skin microbiome.

But, there are two ways to make a good guess:

• Patch test a hyaluronic acid serum. If it causes breakouts? Hyaluronic acid might not be a right fit for you. Although, this isn’t a perfect science. Other ingredients in a product could be a culprit, too.

• Assess your breakouts. Do you have deep, inflamed, and/or cystic breakouts? This is a sign of bacterial acne, which may be more prone to potential hyaluronic acid breakouts.

Hyaluronic acid is in everything, how do I avoid it?

It’s true, hyaluronic acid is in literally almost everything.

(Except, you won’t find it in our products *wink*).

But, just because an ingredient list contains hyaluronic acid (or its derivatives: sodium hyaluronate, hydrolyzed hyaluronic acid, hydroxypropyltrimonium hyaluronate, etc.), doesn’t mean it’s included at relevant concentrations.

The major culprits are hyaluronic acid toners, serums, mists, or moisturizers – leave-on formulas that typically contain 1% or more hyaluronic acid. If you’re sensitive to hyaluronic acid causing breakouts, you might benefit from avoiding these products.

Rinse-off formulas (like cleansers or polishes) or formulas you’ve used and loved for years without issues are far less of a problem. If you’re ever unsure, you can always patch test.

Smart hydration: acne-safe alternatives to hyaluronic acid

Good hydration is essential for healthy, glowing skin. Period.

Besides hydration from the inside, like plenty of water and electrolytes, skincare can be an immensely effective tool towards this end.

Hyaluronic acid is one of them – and a good one at that. But, if hyaluronic acid isn’t the right fit for your skin, there are plenty of great alternatives:

• Glycerin — a skin-identical humectant that draws in moisture for lightweight hydration. Our cleansers contain a healthy dose of glycerin to infuse hydration as you cleanse.

• Linoleic acid — a ceramide-boosting omega fatty acid that repairs the skin barrier and prevents moisture loss. (Pssst, find it in abundance in our lipid serums here.)

• Electrolytes — electrolytes like sodium and potassium are a component of the natural moisturizing factors (NMFs), proven to be essential for skin hydration

• Antioxidants — to protect the skin’s native hydrators, like chondroitin and dermatan sulfate, which naturally support collagen and elasticity.

The verdict: nuance matters

The longer I live, the more I realize leading a successful life is about embracing nuance. We are all living beautifully unique lives, each one deserving of precise attention to our unique paths and purposes. 

Our skin is no different. And sometimes that means leaving behind skincare trends and trusting your intuition.

When it comes to hydration, it’s not one-size-fits-all. It’s a dialogue — between your skin, your products, and your intuition. When we learn to listen, we can curate our skincare routines to meet our unique hydration needs and beyond.