Guide
Hyaluronic acid side effects
The oral hyaluronic acid trials we reviewed reported no adverse events attributed to it, though the trials were short (8-12 weeks) and small (20-128 people), which limits what they could detect. An animal-derived source, such as one extracted from rooster comb, is a separate consideration for anyone with a poultry allergy.
The oral hyaluronic acid trials we reviewed reported no adverse events attributed to it over 8-12 weeks of daily use. That's a reassuring pattern, but the trials behind it were small and short, which limits what they could detect — and anyone using an animal-derived form has a separate, source-specific question worth checking.
What the trials reported
A 2021 trial of 40 adults taking 120 mg a day for 12 weeks stated directly that there were no adverse events attributable to hyaluronic acid intake (PMID 34203487). A 2025 trial of 60 women taking 60 mg a day for 12 weeks reported no serious adverse events associated with the product tested (PMID 40498387). A third trial, of 128 women taking 100 mg or 200 mg a day for 12 weeks, didn't report on adverse events either way in its published results — a gap in what was measured or disclosed, not evidence that nothing happened (PMID 38009035). Taken together, the pattern across these trials is good tolerability, without a documented side effect specific to hyaluronic acid.
A limit worth naming: small and short
These trials ran 8-12 weeks with 20 to 128 people. That's enough to catch a side effect that's both common and appears quickly, but not enough to rule out something rarer, or something that only shows up after months or years of daily use. None of the sources we reviewed for this page followed people on hyaluronic acid beyond 12 weeks.
Source matters: animal-derived versus fermentation-derived
Hyaluronic acid supplements are made two ways — bacterial fermentation, or extraction from animal tissue such as rooster comb (PMID 36961510). One small pilot trial specifically tested a chicken-comb-derived extract (PMID 18208600). If a product's hyaluronic acid comes from an animal source and you have a poultry or egg allergy, that's a reasonable thing to check on the label or with the manufacturer before taking it — a consideration that doesn't apply to a fermentation-derived product. More on checking a label in how to choose a good hyaluronic acid supplement.
What we didn't find
No case reports of serious harm — liver injury, for example — from oral hyaluronic acid turned up in the sources we reviewed for this page, unlike some other herbal or supplement ingredients with a documented history of individual case reports. That's an absence in what we found, not a formal safety conclusion covering every possible use or dose.
Questions people ask
Does hyaluronic acid have side effects?
The trials we reviewed found no adverse events attributed to it, but they were short (8-12 weeks) and small (20-128 people), so a rare or slow-developing effect wouldn't necessarily show up.
Can hyaluronic acid affect the liver?
We found no case reports or trial data linking oral hyaluronic acid to liver problems. If you have existing liver disease or take other medications processed by the liver, ask a doctor before adding any new supplement.
What are the risks of taking a hyaluronic acid supplement?
Based on the trials we reviewed, the main documented consideration is a possible allergy if the source is animal-derived (such as rooster comb) rather than fermentation-derived. No other specific risk was reported across the trials.
Can you be allergic to hyaluronic acid?
General allergic reactions to any supplement ingredient are possible. If the hyaluronic acid is sourced from animal tissue, a poultry or egg allergy is a specific reason for caution. Stop taking it and see a doctor if you notice hives, swelling, or difficulty breathing.
Related reading: who should not take hyaluronic acid?, hyaluronic acid and medications: what to check, and how much hyaluronic acid should you take a day?
Sources
- Oral administration of hyaluronic acid to improve skin conditions via a randomized double-blind clinical test A 2023 industry-funded trial of 128 women found 100 mg or 200 mg/day of a 300 kDa hyaluronic acid improved skin hydration within 2-8 weeks, skin tone within 4-8 weeks, and epidermal thickness by 12 weeks; the trial did not report on side effects.
- Oral Supplementation with a New Hyaluronic Acid Matrix Ingredient Improves Skin Brightness, Hydration, Smoothness, and Roughness: Results from a Randomized, Double-Blinded, Placebo-Controlled Study A 2025 industry-funded trial of 60 women found 60 mg/day of a hyaluronic acid-and-collagen matrix ingredient improved skin wrinkles, smoothness, hydration and brightness over 12 weeks versus placebo, with no serious adverse events.
- Oral Hyaluronan Relieves Wrinkles and Improves Dry Skin: A 12-Week Double-Blinded, Placebo-Controlled Study A 2021 trial of 40 adults found 120 mg/day of hyaluronic acid for 12 weeks significantly improved wrinkle scores, skin water content, water loss through the skin, and elasticity versus placebo, with no adverse events attributed to it.
- Effect of a natural extract of chicken combs with a high content of hyaluronic acid (Hyal-Joint) on pain relief and quality of life in subjects with knee osteoarthritis: a pilot randomized double-blind placebo-controlled trial A 2008 pilot trial of 20 people with joint pain found 80 mg/day of a chicken-comb-derived hyaluronic acid extract for 8 weeks produced no significant difference from placebo on the main pain measure (p=0.943); some quality-of-life scores moved more in the hyaluronic acid group, but the trial was too small to draw a firm conclusion.
- Tapping on the Potential of Hyaluronic Acid: from Production to Application A 2023 review of hyaluronic acid manufacturing describes bacterial fermentation, using Streptococcus bacteria, as a major modern production method, alongside continued extraction from animal tissue such as rooster comb.
*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.