Hyaluronic acid is well tolerated and can be used safely in patients with comorbidities. Hyaluronic acid is a molecule that is naturally produced by the human body, and is present in the skin, the joints and the tendons. As a result, adverse reactions to hyaluronic acid are rare. The most common side effects are localised inflammation or swelling, which subside within a short period of time.6,7,11Biofermented hyaluronic acid of non-animal origin has a better safety profile than hyaluronic acid derived from animal products. Hyaluronic acid from animal sources, such as rooster combs, comes with a higher risk of adverse reactions such as swelling and inflammation.13