Glycolic acid
Place in Therapy
Place in Therapy
Evidence supporting the use of low dose glycolic acid for the treatment of mild to moderate acne is scarce. The available prospective trials assess the use of glycolic acid as monotherapy, however these trials are small and either do not show a significant reduction in acne lesions, or assess the clinical improvement of acne in a subjective manner1,2. The chapter on acne in CPhA’s Patient Self-Care textbook does not include low-dose glycolic acid’s place in therapy, nor does it comment on potential interactions with other acne treatments.3 The available trials assessing the efficacy of glycolic acid forbid the concomitant use of other medicated acne products during the study1,2.The trial conducted by Abels et al. showed similar adverse event outcomes between the treatment and placebo groups; however the placebo drug had a similar pH to the study drug, and both groups did experience side effects – the fact that there was no difference between the two groups does not imply that treatments were side effect-free2. Despite this, authors do not report any participants stopping the trial due to side effects, and overall the dropout rate was very low2. The trial conducted by Erbagci et al. used a lower dose of glycolic acid combined with retinaldehyde but had a significant proportion of patients temporarily stop therapy due to side effects attributed to the study drug2. Although most patients who stopped therapy were able to resume and complete the trial, these trials suggest that low-dose glycolic acid is not inert, particularly in the first month of treatment1,2. Current evidence suggests that low-dose glycolic acid could be used as an alternative monotherapy for mild acne with good tolerability; however, combining 6-10% glycolic acid products with other medicated acne medications is not recommended due to the potential for side effects such as burning, redness, itchiness, dryness, and scaling of skin2. Overall, despite being well tolerated, 6% glycolic acid did not show efficacy, and is not recommended for the treatment of mild to moderate acne. Products with 10% glycolic acid show some efficacy and are safe, and therefore can be used in patients who are unable to tolerate other treatments.
References:
1. Erbagci Z, Akcali C. Efficacy and Safety of 0.1% Retinaldehyde/6% Glycolic Acid (Diacneal) for Mild to Moderate Acne Vulgaris. Int J Dermatol. 2000;39:789-794. Available from: PubMed. Accessed March 8, 2014.
2. Abels C, Kaszuba A, Knie U, et al. A 10% glycolic acid containing oil-in-water emulsion improves mild acne: a randomized double-blind placebo-controlld trial. J Cosmet Dermatol. 2011;10:202-209. Available from: PubMed. Accessed March 8, 2014.
Evidence supporting the use of low dose glycolic acid for the treatment of mild to moderate acne is scarce. The available prospective trials assess the use of glycolic acid as monotherapy, however these trials are small and either do not show a significant reduction in acne lesions, or assess the clinical improvement of acne in a subjective manner1,2. The chapter on acne in CPhA’s Patient Self-Care textbook does not include low-dose glycolic acid’s place in therapy, nor does it comment on potential interactions with other acne treatments.3 The available trials assessing the efficacy of glycolic acid forbid the concomitant use of other medicated acne products during the study1,2.The trial conducted by Abels et al. showed similar adverse event outcomes between the treatment and placebo groups; however the placebo drug had a similar pH to the study drug, and both groups did experience side effects – the fact that there was no difference between the two groups does not imply that treatments were side effect-free2. Despite this, authors do not report any participants stopping the trial due to side effects, and overall the dropout rate was very low2. The trial conducted by Erbagci et al. used a lower dose of glycolic acid combined with retinaldehyde but had a significant proportion of patients temporarily stop therapy due to side effects attributed to the study drug2. Although most patients who stopped therapy were able to resume and complete the trial, these trials suggest that low-dose glycolic acid is not inert, particularly in the first month of treatment1,2. Current evidence suggests that low-dose glycolic acid could be used as an alternative monotherapy for mild acne with good tolerability; however, combining 6-10% glycolic acid products with other medicated acne medications is not recommended due to the potential for side effects such as burning, redness, itchiness, dryness, and scaling of skin2. Overall, despite being well tolerated, 6% glycolic acid did not show efficacy, and is not recommended for the treatment of mild to moderate acne. Products with 10% glycolic acid show some efficacy and are safe, and therefore can be used in patients who are unable to tolerate other treatments.
References:
1. Erbagci Z, Akcali C. Efficacy and Safety of 0.1% Retinaldehyde/6% Glycolic Acid (Diacneal) for Mild to Moderate Acne Vulgaris. Int J Dermatol. 2000;39:789-794. Available from: PubMed. Accessed March 8, 2014.
2. Abels C, Kaszuba A, Knie U, et al. A 10% glycolic acid containing oil-in-water emulsion improves mild acne: a randomized double-blind placebo-controlld trial. J Cosmet Dermatol. 2011;10:202-209. Available from: PubMed. Accessed March 8, 2014.