Evaluation of the Effects of Different Crosslinking Technologies on Hyaluronic Acid Behavior-study of Five Hyaluronic Acid Gels Available in Iran Market

Background The rheologic, mechanical, and pharmacological characteristics of hyaluronic acid (HA) gels vary in terms of their specific crosslinking technologies. Objective To evaluate the various characteristics of selected HA gels available in Iran, using simple, inexpensive, and reproducible experimental tests are necessary to better understand their appropriateness for specific indications. Methods The HA gels produced by various crosslinking technologies were evaluated by three experiments, including cohesivity, resistance to stretch, and microscopic examination. The gels subjected to these experiments in this study included Neuramis, Desirial, Belotero, Restylane, and Juvéderm. Results We found that cohesivity was different among the gels so that Desirial was the least cohesive and Belotero was the most cohesive gel. Other HA gels were observed as partially cohesive. The resistance to stretch test confirmed the cohesivity results and Belotero had the most significant resistance. Microscopic examination of the HA gels showed HA particles of varying distribution and size. Belotero and Desirial were the gels with no particles visible under the microscope. Conclusion Simple and inexpensive laboratory tests help to understand the way that they can affect the specific gel performance, and may be beneficial for physicians to decide on the best product for a particular therapeutic indication.