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Glycolic Acid
Glycolic Acid
Glycolic Acid
Gabriella Fabbrocini, Maria Pia De Padova, Antonella Tosti
2
The author has no financial interest in any of the products or equipment mentioned in this chapter.
a b
a b
Fig. 2.2a, b. Lateral view of the same patient before and after peeling
16 Gabriella Fabbrocini et al.
Fig. 2.3.
Melasma of the forehead
Glycolic Acid Chapter 2 17
a b
b
Glycolic Acid Chapter 2 19
repetitive glycolic acid peels (at least six times) the outcome of the peel [17]. Complications of
at 70% concentration are necessary to obtain glycolic acid peel like hyperpigmentation and
evident improvement. Long-term daily use of infection are rare. Chemical peel with glycolic
low-strength products may also have some use- acid may cause sensible irritation symptoms,
ful effects on scars and may be recommended characterized by stinging, burning and itching.
for patients who cannot tolerate the peeling A substance capable of counteracting sensory
procedure [13] (Fig. 2.7a, b). irritation is strontium nitrate at 20 % concen-
Patients of varying skin types (I–V) having tration, which applied topically with 70% gly-
striae distensae alba on the abdomen or thighs colic acid, potently suppresses the sensation of
can apply topical 20% glycolic acid daily to the chemically induced irritation [18].
entire treatment area. In addition, these pa- Moreover, some studies have demonstrated
tients apply 10% L-ascorbic acid, 2% zinc sul- that glycolic acid could cause an increase in the
fate, and 0.5% tyrosine to half of the treatment level of skin damage in a dose- and time-de-
area and 0.05% tretinoin emollient cream to pendent manner. Lower doses (1 and 3 mg/cm2)
the other half of the treatment area. The creams of glycolic acid caused erythema and eschar at
are applied on a daily basis for 12 weeks. Im- most, whereas higher doses (5 and 7 mg/cm2) of
provement is evaluated at 4 and 12 weeks with glycolic acid caused redness, edema and ne-
increased elastin content within the reticular crotic ulceration.
and papillary dermis [14]. Glycolic acid also increased the thickness of
Pseudofolliculitis barbae is a foreign-body the epidermal layer, reduced the organization
inflammatory reaction surrounding ingrown of the stratum corneum and eventually de-
facial hair, which results from shaving. Topical stroyed some parts of the epidermal layer at
application of glycolic acid lotion is an effective 7 mg/cm2. UVB caused redness and edema and
therapy and allows the patient to resume a dai- also reduced the integrity of the stratum corne-
ly shaving regimen [15]. um. Glycolic acid enhances UVB-induced skin
In patients with scalp psoriasis a combina- damage without accompanying PGE (2) pro-
tion of a 10% glycolic acid scalp lotion is used duction or COX-2 protein expression. There-
as well as a 0.1% betamethasone scalp applica- fore, caution should be exercised by those using
tion, applied twice daily without any bandage glycolic acid chronically or in excessive
for a period of 8 weeks [16]. amounts. Moreover, people with photosensitive
skins and those particularly exposed to the sun
should be particularly careful. However, this
photosensitivity could be reversed within a
2.9 Post-peeling Care week after terminating treatments [19].
and Complications Laboratory investigations have rarely shown
a complex I deficiency in the mitochondrial ox-
Following the peel the skin is carefully observed idative phosphorylation of patients who had re-
for any complications such as hyperpigmenta- current episodes characterized by nausea, vom-
tion and infection. Results are maintained with iting, and signs of dehydration necessitating
serial peels and by using at-home tretinoin or admission to the hospital. In these patients gly-
glycolic acid, as well as by sun avoidance. colic acid was detected in blood and they were
diagnosed as having ethylene glycol intoxica-
tion [3].
2.10 Disadvantages
Through the patient’s history and physical ex- 2.11 Side Effects
amination, the physicians will identify any spe-
cific factor such as medications, prior proce- Side effects, such as temporary hyperpigmenta-
dures and medical conditions that can affect tion or irritation, are not very significant.
20 Gabriella Fabbrocini et al.