Water works: How hyaluronic acid supports youthful skin

Ageing often slips in quietly – not with sudden deep lines, but with subtle shifts that surface over time. Dr Low Chai Ling, founder and medical director of SW1 Clinic, recalled treating a patient in her early 40s who felt her skin looked tired all the time.

“A combination of dullness, uneven texture and slight laxity – the big three signs of ageing skin – added years to her appearance,” said Dr Low.

These changes affect more than looks alone. Dr Low recounted a patient in her 50s who avoided video calls because she felt self-conscious about her skin. After treatment, she appeared fresher and began turning her camera on more often, even volunteering to present at meetings. “Sometimes it’s not just about the skin, but how renewed confidence impacts daily life,” Dr Low noted.

HYALURONIC ACID: A HYDRATION ESSENTIAL

One factor behind visible signs of ageing is the skin’s declining ability to stay hydrated, a challenge made worse in Singapore’s air-conditioned environment.

Hyaluronic acid helps replenish lost moisture, shared Dr Low. A naturally occurring substance in the body’s tissues, it acts like the skin’s water reservoir. “It can hold up to 1,000 times its weight in water, making it essential for hydration,” she explained. “Well-hydrated skin looks plumper, more radiant and functions better as a barrier.”

According to Dr Low, hyaluronic acid creams and serums hydrate the skin’s surface, providing a temporary plumping effect. This approach, she added, works best for prevention and maintenance, particularly for younger individuals or those not ready for injectables.

Injectables, on the other hand, deliver hyaluronic acid deeper into the skin. “This can improve structure and stimulate collagen and is more suitable for those already noticing volume loss or significant texture changes,” she said.

STIMULATING SKIN TO REJUVENATE ITSELF

Injectable hyaluronic acid works beneath the skin’s surface to tackle concerns beyond hydration. In this form, it is available in different molecular weights, each working at a different level. Said Dr Low: “High-molecular-weight hyaluronic acid locks in moisture and reduces water loss on the surface, while the low-molecular-weight version penetrates deeper to hydrate at a cellular level.”

According to Dr Low, unlike traditional dermal fillers that use chemical crosslinking agents to hold their shape and provide lift in a targeted way, hyaluronic acid injectables are softer and spread more evenly, enhancing skin quality and firmness in a more natural way.

Beyond hydration, these injectables stimulate fibroblasts – the ‘skin’s factories’, as Dr Low describes them – to produce collagen that strengthens skin and elastin that restores bounce. “As we age, production of both collagen and elastin drops dramatically,” she said. “Restimulating them helps restore resilience so the skin doesn’t just look better in the short term, but also ages more naturally.”

To bring these benefits together, Dr Low recommends the Youth Preserve Structura treatment, which leaves skin supple with a subtle lifting effect that doesn’t alter facial contours. “Patients who want to look fresher without looking ‘done’ often prefer this.”

For a more balanced approach, patients from their mid-30s onwards can combine injectables with topical care. “They complement each other,” Dr Low explained. “Skincare is daily maintenance; energy-based solutions like ultrasound or radiofrequency are like the gym; injectables are your structural engineering.”

KEEPING SKIN IN THE PINK

According to Dr Low, the effects of hyaluronic injectables last around six to 12 months, depending on the product and one’s skin condition. Patients usually require two maintenance sessions a year. “Side effects are generally mild – some redness, swelling or bruising, which typically resolve within a few days,” she said.

To maintain a more youthful appearance, Dr Low highlighted the importance of sun protection, diet and sleep. “UV damage accelerates ageing faster than anything else while antioxidants from fruits and vegetables help combat oxidative stress,” she said. “Last but not least, proper rest allows skin to repair itself.”

In Singapore’s hot climate, Dr Low advised cutting back on dehydrating habits such as excessive alcohol or caffeine intake and maintaining proper cleansing to prevent sweat¹ and pollution² from triggering inflammation. “Your skin ages inside and out, so a holistic approach makes all the difference in how gracefully you age,” she said.

Learn more about how SW1 Clinic’s treatment options can support radiant skin.

Results may vary depending on individual skin type, lifestyle and other factors.

1. Shiohara T, Mizukawa Y, Shimoda-Komatsu Y, Aoyama Y. Allergology Int. 2018 Oct; 67(4):1323-8930, doi: 10.1016/j.alit.2018.07.010.

2. Araviiskaia E, Berardesca E, Bieber T, Gontijo G, Sanchez Viera M, Marrot L, Chuberre B, Dreno B. J Eur Acad Dermatol Venereol. 2019 Apr 26;33(8):1496-1505. doi:10.1111/jdv.15583.