©2018 WebMD, Inc. All rights reserved. eMedicineHealth does not provide medical advice, diagnosis or treatment. See Additional Information.

Alpha Hydroxy Acids

What other names is Alpha Hydroxy Acids known by?

Acide 2-hydroxypropionique (Acide Lactique), Acide Alpha-Hydroxyéthanoïque, Acide Citrique, Acide de Pomme, Acide Dihydroxysuccinique (Acide Tartrique), Acide Glycolique, Acide Hydroxyacétique (Acide Glycolique), Acide Hydroxycaprylique, Acide Hydroxypropionique, Acide Hydroxysuccinique, Acide Lactique, Acide Malique, Acides Alpha-Hydroxylés, Acidos Alfa-Hydroxi, AHA, Alpha Hydroxy Acides, Alpha-Hydroxyethanoic Acid, Apple Acid, Citric Acid, Dihydroxysuccinic Acid (Tartaric Acid), Gluconolactone, Glycolic Acid, Hydroxyacetic Acid (Glycolic Acid), Hydroxycaprylic Acid, Hydroxypropionic Acid, Hydroxysuccinic Acid, Lactic Acid, Malic Acid, Mixed Fruit Acid, Monohydroxysuccinic Acid (Malic Acid), 2-hydroxypropionic acid (Lactic Acid).

What is Alpha Hydroxy Acids?

Alpha hydroxy acids are a group of natural acids found in foods. Alpha hydroxy acids include citric acid (found in citrus fruits), glycolic acid (found in sugar cane), lactic acid (found in sour milk), malic acid (found in apples), tartaric acid (found in grapes), and others.

Some people take malic acid by mouth with magnesium for treating pain and tenderness associated with fibromyalgia.

Various alpha hydroxy acids are applied to the skin (used topically) for moisturizing and removing dead skin cells, for treating acne and improving the appearance of acne scars, for improving the appearance of photo-aged skin, and firming and smoothing skin.

Alpha hydroxy acids are also used topically to treat extremely dry skin (xerosis), an inherited disease marked by dry, scaly skin (ichthyosis), and a condition that causes darkening of the skin (melasma). When this condition develops in pregnant women, it is sometimes called “the mask of pregnancy.”

Not all cosmetics that contain alpha hydroxy acid have the concentration information on the label. For safety's sake, it's best to use products that identify the concentration of active ingredients.

Is Alpha Hydroxy Acids effective?

When applied directly to the skin as a lotion or cream, alpha hydroxy acids can help treat sun-damaged skin and dry skin. But the alpha-hydroxy skin peels do not seem to work for this use.

There is some evidence that a alpha hydroxy acids lotion or cream might help improve acne when applied to the skin. Although some people try alpha hydroxy acids as a skin peel to treat sun-damaged skin, it does not seem to be effective for this use

There is also some evidence that taking one alpha-hydroxy acid called malic acid with magnesium hydroxide by mouth might help reduce pain and tenderness related to fibromyalgia.

Likely Effective for...

  • Treating sun damage when applied to the skin in a cream or lotion, but alpha hydroxy skin peels do not seem to work for this use.
  • Treating dry skin when applied to the skin in a cream or lotion.

Possibly Effective for...

  • Acne when applied to the skin in a cream or lotion.
  • Acne scars when applied to the skin in a facial peel or lotion. Applying glycolic acid, an alpha hydroxy acid, as a facial peel or lotion seems to improve the appearance of acne scars. Applying 70% glycolic acid in a series of peels seems to work better than using 15% glycolic acid lotion daily. However, 15% glycolic acid lotion seems to be moderately effective in people who cannot tolerate facial peels.
  • Reducing pain and tenderness caused by fibromyalgia when a specific alpha hydroxy acid, called malic acid, is used in combination with magnesium.
  • Reducing the pigmentation associated with a skin disorder called melasma. Applying 10% glycolic acid as a lotion for 2 weeks followed by a facial peeling program using 50% glycolic acid every month for 3 consecutive months seems to reduce unwanted skin coloration in people with two of the three types of melasma, epidermal-type and mixed-type melasma. However, glycolic acid facial peels don't seem to work for the third type of melasma, dermal-type melasma.

SLIDESHOW

Skin & Beauty: Anti-Aging Tips & Secrets to Look Younger See Slideshow

Insufficient Evidence to Rate Effectiveness for...

  • Treating an inherited skin disorder that causes dry, scaly skin (ichthyosis).
  • Other conditions.
More evidence is needed to rate alpha hydroxy acids for these uses.

How does Alpha Hydroxy Acids work?

Alpha hydroxy acids seem to work by removing the top layers of dead skin cells. They can also increase the thickness of deeper layers of skin, promoting firmness.

Are there safety concerns?

Alpha hydroxy acids at a concentration of 10% or less as a lotion or cream are LIKELY SAFE for most people when applied to the skin appropriately and as directed. In some people, alpha hydroxy acids can make the skin extra sensitive to sunlight. Be sure to use a sunscreen while using alpha hydroxy acid products.

Alpha hydroxy acids can also cause mild skin irritation, redness, swelling, itching, and skin discoloration.

Facial peels, lotions, and creams with a concentration greater than 10% should only be used under the supervision of a dermatologist. Facial peels can cause moderate to severe skin irritation, redness, and burning. Facial peels left on the skin for periods longer than recommended can cause severe burns to the skin.

When taken by mouth, the alpha hydroxy acid called malic acid is POSSIBLY SAFE when used short-term. Some people can have side effects including diarrhea, nausea, and general stomach discomfort.

Special Precautions & Warnings:

Pregnancy and breast-feeding: Alpha hydroxy creams at a concentration of 10% or less are LIKELY SAFE when applied to the skin during pregnancy and breast-feeding. But don't take malic acid (the form of alpha hydroxy acids that is generally taken by mouth). Not enough is known about the safety of malic acid during pregnancy and breast-feeding.

Sensitive skin: Alpha hydroxy acids can worsen skin conditions by causing skin irritation and removal of the top layer of skin cells.

Dosing considerations for Alpha Hydroxy Acids.

The following doses have been studied in scientific research:

APPLIED TO THE SKIN:

  • For treating skin wrinkled and aged by sunlight: Alpha hydroxy acid products containing lactic acid, tartaric acid, gluconolactone, or glycolic acid (GA) in 8% concentration are used. The alpha hydroxy acid gluconolactone has also been used in a 14% solution. These products are usually applied to the skin twice daily.
  • For improving the appearance of acne scars: glycolic acid (GA) facial peels are used. Peels of increasing strength of 20%, 35%, 50%, and 70% are applied every two weeks. Peels are applied first for 2 minutes and then for a longer time (up to 4-5 minutes) before applying the next stronger solution. Completing the series at least 6 times is usually needed before skin looks better. People who do not like facial peels often use 15% GA lotion daily long-term instead.
  • For lightening brown patches due to a condition called melasma: a 10% lotion of the glycolic acid (GA) is applied with a sunscreen to facial skin nightly for 2 weeks. Then a peeling program is done monthly for 3 months in a row. The peeling program features a 50% GA peel applied three times to the face and left on for a period of 2-5 minutes each time (first peel 2 minutes, second peel 4 minutes, and third peel 5 minutes).

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).

Health Solutions From Our Sponsors

Reviewed on 9/17/2019
References

Kligman AM. Topical treatments for photoaged skin. Separating the reality from the hype. Postgrad Med 1997;102:115-26. View abstract.

Anon. Alpha Hydroxy Acids in Cosmetics. July 31, 1997. FDA. www.fda.gov/opacom/backgrounders/alphabg.html.

Berardesca E, Distante F, Vignoli GP, et al. Alpha hydroxyacids modulate stratum corneum barrier function. Br J Dermatol 1997;137:934-8. View abstract.

Ditre CM, Griffin TD, Murphy GF, et al. Effects of alpha-hydroxy acids on photoaged skin: a pilot clinical, histologic, and ultrastructural study [see comments]. J Am Acad Dermatol 1996;34:187-95. View abstract.

Erbagci Z, Akcali C. Biweekly serial glycolic acid peels vs. long-term daily use of topical low-strength glycolic acid in the treatment of atrophic acne scars. Int J Dermatol 2000;39:789-94.. View abstract.

Fartasch M, Teal J, Menon GK. Mode of action of glycolic acid on human stratum corneum: ultrastructural and functional evaluation of the epidermal barrier. Arch Dermatol Res. 1997;289:404-9. View abstract.

Ghadishah D, Gorchynski J. Airway compromise after routine alpha-hydroxy facial peel administration. J Emerg Med 2002;22:353-5.. View abstract.

Hunt MJ, Barnetson R. A comparative study of gluconolactone versus benzoyl peroxide in the treatment of acne. Australas J Dermatol 1992;33:131-4. View abstract.

Javaheri SM, Handa S, Kaur I, Kumar B. Safety and efficacy of glycolic acid facial peel in Indian women and melasma. Int J Dermatol 2001;40:354-7. View abstract.

Kempers S, Katz HI, Wildnauer R, Green B. An evaluation of the effect of an alpha hydroxy acid-blend skin cream in the cosmetic improvement of symptoms of moderate to severe xerosis, epidermolytic hyperkeratosis, and ichthyosis. Cutis 1998;61:347-50. View abstract.

Kurtzweil P. Alpha-hydroxy acids for skin care: Smooth sailing or rough seas? FDA 1999. Available at: /www.fda.gov/fdac/features/1998/298_ahas.html (Accessed 18 August 2000).

Piacquadio D, Dobry M, Hunt S, et al. Short contact 70% glycolic acid peels as a treatment for photodamaged skin. A pilot study. Dermatol Surg 1996;22:449-52. View abstract.

Rawlings AV, Davies A, Carlomusto M, et al. Effect of lactic acid isomers on keratinocyte ceramide synthesis, stratum corneum lipid levels and stratum corneum barrier function. Arch Dermatol Res 1996;288:383-90. View abstract.

Russell IJ, Michalek JE, Flechas JD, Abraham GE. Treatment of fibromyalgia syndrome with Super Malic: a randomized, double blind, placebo controlled, crossover pilot study. J Rheumatol 1995;22:953-8. View abstract.

Smith WP. Epidermal and dermal effects of topical lactic acid. J Am Acad Dermatol 1996;35:388-91. View abstract.

Stiller MJ, Bartolone J, Stern R, et al. Topical 8% glycolic acid and 8% L-lactic acid creams for the treatment of photodamaged skin. A double-blind, vehicle-controlled clinical trial. Arch Dermatol 1996;132:631-6. View abstract.

Thueson DO, Chan EK, Oechsli LM, Hahn GS. The roles of pH and concentration in lactic acid-induced stimulation of epidermal turnover. Dermatol Surg 1998;24:641-5. View abstract.

Van Scott EJ, Yu RJ. Hyperkeratinization, corneocyte cohesion, and alpha hydroxy acids. J Am Acad Dermatol 1984;11(5Pt1):867-79.. View abstract.

Wehr R, Krochmal L, Bagatell F, Ragsdale W. A controlled two-center study of lactate 12 percent lotion and a petrolatum-based creme in patients with xerosis. Cutis 1986;37:205-7, 209. View abstract.

CONTINUE SCROLLING FOR RELATED SLIDESHOW

Health Solutions From Our Sponsors