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Ácido hialurônico: os riscos e contraindicações do produto que virou hit contra rugas

Nas últimas décadas, a busca por um rosto livre de rugas e outros sinais de envelhecimento ganhou um grande aliado: o ácido hialurônico, uma substância que pode ser aplicada nas camadas internas da pele para promover hidratação, fazer um preenchimento e dar os contornos desejados no queixo, bochechas, lábios e pálpebras.

Uma das estrelas da popular “harmonização facial“, o ingrediente virou sinônimo de produto de beleza e hoje aparece nos rótulos de muitos cremes e nas propagandas de clínicas de estética ou consultórios.

Mas será que ele pode ser usado por todo mundo mesmo? Existem contraindicações e efeitos colaterais? E qual a diferença entre os cremes vendidos nas lojas e as injeções aplicadas em consultórios?

Entenda em cinco pontos as principais questões relacionadas a esse produto.

O que é ácido hialurônico?

O ácido hialurônico é uma substância fabricada pelo nosso próprio organismo e o de muitos animais.

Ele tem a função de manter a hidratação natural das células que compõem as camadas internas da pele, além de ajudar a sustentar e preencher esse tecido.

“Com o passar dos anos e o processo de envelhecimento, a gente vai perdendo a matriz extracelular da pele, que se torna mais fina e solta“, explica a médica Alessandra Grassi Salles, coordenadora do Grupo de Cirurgia Estética, Cosmiatria e Laser da Faculdade de Medicina da Universidade de São Paulo (USP).

Essa “matriz extracelular” que a especialista menciona corresponde justamente a todas as substâncias que fazem o “recheio” da pele e mantém as células cutâneas unidas.

Com o passar dos anos e a diminuição natural desses compostos, é normal que a camada superficial do nosso corpo fique flácida, ganhe rugas e acabe se tornando menos espessa.

É aí que entram as aplicações de ácido hialurônico: o objetivo é repor ou aumentar a quantidade dessa substância, de modo a manter a pele com a espessura desejada.

Qual a diferença entre os cremes e as injeções?

“A grande questão é que o ácido hialurônico que nós produzimos naturalmente tem uma meia vida muito curta. Ele é absorvido pelo corpo em menos de 48 horas”, diz o médico Daniel Boro, da Sociedade Brasileira de Cirurgia Plástica.

“A indústria então desenvolveu versões desta substância que são bem mais resistentes e permanecem no organismo por meses.”

Atualmente, o ácido hialurônico injetado nos procedimentos estéticos é obtido por meio de um processo de fermentação de alguns micro-organismos.

Já os cremes carregam versões sintéticas desse ingrediente.

Durante o processo de envelhecimento, a pele perde conjunto de substâncias que dá apoio e firmeza à camada superficial

Além da fabricação, os dois tipos de produtos trazem diferenças fundamentais no mecanismo de ação.

“A função básica do creme é promover uma hidratação bem superficial da pele. Já os injetáveis têm o papel de preencher, dar suporte e rejuvenescer partes do rosto”, resume a médica Alessandra Ribeiro Romiti, assessora do Departamento de Cosmiatria Dermatológica da Sociedade Brasileira de Dermatologia.

Os especialistas explicam que o creme traz moléculas grandes, que não conseguem ultrapassar as primeiras camadas da pele. Com isso, não há possibilidade de o ácido hialurônico que faz parte da formulação se aprofundar e preencher a matriz extracelular, mencionada anteriormente.

Um efeito parecido de hidratação, aliás, é observado em cápsulas que também trazem esse ingrediente.

Porém, antes de começar a usar qualquer um desses itens, o ideal é buscar a orientação de um especialista.

“Se a pessoa tem pele oleosa e usa creme demais, há o risco de esse hábito entupir os poros da pele e causar acne“, explica Salles.

Para quem o ácido hialurônico é indicado?

De forma geral, não existe uma “receita de bolo“, ou uma recomendação geral que sirva para todas as pessoas.

“Nós podemos aplicar o ácido hialurônico como parte do processo de gerenciamento do envelhecimento da pele“, aponta Boro.

Na visão de Romiti, tudo vai depender do que o paciente busca e das características individuais dele.

“Não existe uma idade certa para iniciar o tratamento. Tem gente que começa a trabalhar as olheiras com 25 anos, outros buscam corrigir certos aspectos do rosto após uma cirurgia bariátrica ou querem uma abordagem mais global quando chegam aos 50 ou 60 anos“, afirma.

Salles acrescenta que, além das possibilidades de modificar certos aspectos do rosto com novas tecnologias estéticas como o ácido hialurônico, o profissional de saúde precisa entender as motivações de cada pessoa.

“É um grande erro achar que a gente precisa ter um rosto de 30 anos para ser feliz. Se não trabalharmos o que está acontecendo dentro do paciente, ele pode até ficar com uma face rejuvenescida, mas nunca vai estar satisfeito de verdade“, ressalta.

Os resultados da aplicação são definitivos?

Não. O ácido hialurônico utilizado em procedimentos até dura mais tempo, mas aos poucos ele é absorvido pelo organismo. “Tudo depende do tipo de gel e da parte do rosto em que ele será aplicado“, responde Boro.

“Em linhas gerais, ele permanece nas camadas da pele por cerca de um ano, mas esse tempo costuma variar entre seis e 18 meses.”

Vale explicar aqui que nem todo ácido hialurônico é igual: existem formulações mais consistentes e outras mais maleáveis.

O profissional seleciona o tipo adequado de acordo com a parte do rosto e o efeito desejado — no queixo ou na mandíbula, por exemplo, pode ser necessário um gel mais firme, enquanto que, nos lábios ou nas pálpebras, é melhor aplicar um produto flexível e elástico, que vai permitir uma movimentação mais natural da boca ou dos olhos.

Cremes com ácido hialurônico até ajudam a hidratar a pele, mas não alcançam camadas mais profundas

Além da consistência, outro fator que interfere na duração do ácido hialurônico é a movimentação das estruturas da face. A tendência é que ele se esgote rapidamente em áreas que se movem com muita frequência, como os lábios e os olhos, e permaneça por um tempo extra em partes que são menos móveis, como a mandíbula.

Mas é claro que os especialistas não esperam que o ácido hialurônico acabe completamente para indicar novas aplicações.

“Nós realizamos um acompanhamento periódico e temos protocolos para fazer reposições, de acordo com a necessidade”, diz Boro.

Há o risco de efeitos colaterais depois do procedimento?

Eventos adversos podem acontecer, e é importante que tanto especialistas quanto pacientes saibam identificá-los para agir rápido e conter os danos.

Um dos perigos mais temidos ocorre quando o produto é injetado na parte errada do rosto. Com isso, o ácido hialurônico pode parar dentro dos vasos sanguíneos que irrigam a face, onde vai provocar um entupimento que leva à morte de tecidos de partes do nariz, dos lábios ou até um quadro de cegueira.

“Para minimizar esse risco, é importante fazer esse procedimento com profissionais que tenham muita experiência e anos de treinamento”, diz Salles.

“Isso não é algo que se aprende em um curso de final de semana. São anos de estudos para entender todas as variações anatômicas do rosto e onde provavelmente estão as veias e as artérias. E mesmo os especialistas mais experientes podem cometer erros e injetar sem querer a substância dentro de um vaso.”

Para minimizar os danos, é possível utilizar uma enzima chamada hialuronidase, que tem a função justamente de absorver o ácido hialurônico aplicado de forma inadequada

Mas esse “antídoto” também não pode ser usado em qualquer situação: existem pacientes que têm alergia à hialuronidase e desenvolvem reações graves.

Além do entupimento de artérias e veias, outros efeitos colaterais possíveis são reações inflamatórias, marcadas por vermelhidão e inchaço, e a formação de nódulos no local da aplicação.

A boa notícia é que, como o produto é absorvido pelo organismo, esses problemas costumam ser passageiros.

Por fim, Salles considera que a aplicação excessiva de ácido hialurônico — e os resultados estéticos indesejados disso — também podem ser vistos como um evento adverso em algumas situações.

“Há casos em que se injeta 10 a 20 mililitros de ácido hialurônico e você vê transformações impressionantes”, observa.

“Mas isso pode afetar a movimentação do rosto e a pessoa deixa de ter um sorriso ou uma expressão natural. É preciso encontrar um equilíbrio para que a pessoa se sinta bem e consiga reconhecer o próprio rosto no espelho.”

Fonte: BBC Brasil

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    References:
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    References:
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    References:
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