Photoaging results from chronic exposure to sunlight, leading to wrinkles, altered pigmentation, and reduced skin elasticity, which can also affect mental well-being. This systematic review assesses the effectiveness of topically applied hyaluronic acid (HA) in addressing facial photoaging. Electronic databases of PubMed, Web of Science, Cochrane Library, and CINAHL were searched from database inception up to July 2025 for controlled trials comparing topical HA with placebo in photoaged skin. We included seven studies involving 316 participants. These trials utilised a variety of subjective outcome measures, such as patient self-assessment questionnaires and visual inspections; thus, a meta-analysis was not feasible. Our findings suggest that HA may have beneficial effects in alleviating the signs of photoaging, specifically by reducing wrinkle depth and improving skin hydration and elasticity. However, these findings should be interpreted with caution due to the moderate to high risk of bias across studies. In conclusion, while topical HA shows potential benefits for managing facial photoaging, more rigorous research is needed to validate these findings and inform clinical practice.