Cutaneous Irritation Due to Repeated Topical Application of Alpha Hydroxy Acid

Lee, Ji Young; Park, Chun Wook; Lee, Cheol Heon

Abstract

BACKGROUND: Alpha hydroxy acid (AHA) is known to diminish corneocyte cohesion at the innermost levels of the stratum corneum and has been used in the treatment of various disorders of keratinization. However, its effect on skin barrier function and irritant potential are not fully elucidated. Recently, cutaneous irritation reactions after 24 hours patch test or after repeated topical application of AHA on normal human skin have been reported. OBJECTIVE: This study was done to evaluate the skin irritation reactions after chronic cumulative application of 10% AHA solution. METHODS: Each aqueous 10% solution of lactic acid and of glycolic acid were applied on volar forearm skin in 30 normal healthy subjects for 13 days. Erythema indices (E-indices) and transepidermal water loss (TEWL) values were measured at before, 6th day, and 13th day after open application of test solutions. RESULTS: 1. Eight persons (26.7%) dropped out due to severe skin irritation reactions such as erythema, pruritus and bullae formation. 2. There were significant increases in E-indices among before, 6th day values, and 13th day values in both lactic acid and glycolic acid treated groups. E-indices were statistically increased compared to control group at 13th day in both lactic acid and glycolic acid treated groups. Increase of E-indices were more prominent in lactic acid treated group than glycolic acid treated group. 3. There were significant increases in TEWL values among before, 6th day values, and 13th day values in both lactic acid and glycolic acid treated groups. TEWL values were statistically increased compared to control group at 6th day and 13th day in both lactic acid and glycolic acid treated groups. Increase of TEWL values were more prominent in lactic acid treated group than glycolic acid treated group. CONCLUSION: E-indices and TEWL values were increased after repeated application of 10% AHA solutions on normal human skin and these findings suggest that repeated topical applications of the products containing 10% AHA can cause irritant contact dermatitis.