In the last 10 years more studies and literature reviews have emerged that examine the role of alpha hydroxy acids in over-the-counter adult acne products. Alpha hydroxy acids are in wide in acne treatments, but are far less commonly used in over-the-counter-
Benzoyl Peroxide is a topical agent against acne-causing bacteria within the oil producing skin pores, or the sebaceous glands (follicles). It is considered safe and relatively effective but to many users it is irritating to the skin. Skin dryness, peeling, stinging or burning are common effects. The skin can become sensitized with frequent use worsening these side effects (Morelli, et al, 1989) . These side effects are particularly troubling for adult women, because these factors can accelerate skin aging.
Alpha hydroxy acids work differently than benzoyl peroxide. Alpha hydroxy acids are not bactericidal but instead tend to reduce the skin conditions that promote bacterial growth. That is, by promoting healthy skin conditions, alpha hydroxy acids make it more difficult for bacteria to grow and create the inflammation that causes acne. They are far less irritating, and tend to enhance the cosmetic appearance of the skin.
Specifically alpha hydroxy acids decrease acne, or adult acne, by two important mechanisms. One of the primary symptoms of acne is hyperkeratinization, or excess production of partially detached cellular tissue, particularly in the follicles or pores. Alpha hydroxy acids not only moderate this hyperkeratinization but also exfoliate this tissue (Van Scott, Yu, 2004). Alpha hydroxy acids thin out, or rather micro-decrease this outer layer of the skin, the stratum corneum, causing stiff, dry skin cells to shed faster and more normally. This exfoliation inhibits the growth of acne-causing bacteria because in part there is less fissured, less partially attached dead tissue to trap oils and harbor bacteria. Newer, more supple actively growing skin is closer to the surface, which in turn increases the flow of blood and oxygen to the outer layers of the skin. The skin is consequently softer and less dry. This exfoliation also levels out tiny creases in the skin which can distort newly emerging tissue into visible fine lines and wrinkles.
Secondly, alpha hydroxy acids stimulate the biosynthesis of collagen and hyaluronic acid (Bernstein et al, 2001). Hyaluronic plays a role in dispersing basal layer melanin, the pigmentation that results in age spots. Collagen underpins skin structure. For the adult acne sufferer this means that use of alpha hydroxy acids can lessen the skin discoloration and the scarring resulting from acne, and firm skin. In other words, anti-acne alpha hydroxy acids fade age spots , enhance skin firmness, and improve overall color and tone.
Alpha hydroxy acids are also humectants, and improve the ability of the skin to absorb moisture (Kneedler et al, 1998). One survey conducted by the National Health and Wellness Club, http://www.niora.com/
Research, thus, has documented that the same physiological factors that make alpha hydroxy acids an effective adult acne treatment, are the same mechanisms that make alpha hydroxy acids a desirable skin treatment for aging skin. Because alpha hydroxy acids improve aging skin, they are more likely to used regularly as an adult acne treatment than benzoyl peroxide and this may be an important factor in the effectiveness of alpha hydroxy acids as an adult acne care product.
The development of alpha hydroxy acids as an anti-aging acne treatment offers great potential to provide adult women with more appropriate over-the-counter therapies for adult acne. Combination therapies are being studied, for example alpha hydroxy acids, used in conjunction with Benzoyl peroxide may be useful in alleviating the irritation common with Benzoyl Peroxide (Berson, et al, 1995). As research continues more alternatives will become available that are more appropriate for adult acne.
references:
Morelli R. Lanzarini M. Vincenzi C, et al: Contact dermatitis due to benzoyl peroxide. Contact Dermatitis 20:238-239, 1989
Bernstein EF, Lee J, Brown DB, Yu R, Van Scott E: Glycolic Acid Treatment Increases Type I Collagen mRNA and Hyaluronic Acid Content of Human Skin. Dermatol Surg; 27:429-433, 2001
Van Scott EJ, YU RJ: Alpha-hydroxyacids and Carboxylic acids. Journal of Cosmetic Dermatology, 3, 76-87, 2004
Kneedler JA, Sky SS, Sexton LR: Understanding Alpha Hydroxy Acids. Dermatology Nursing, Vol 10(4), 247-262, 1998
Alpha Clear Adult Acne Treatment, An independent survey by the National Health and Wellness Club, (National Health and Wellness Alpha Clear Acne Treatment Survey), Nov 2000
Berson DS, Shalita AR:The treatment of acne: The role of combination therapies, J. Am Acad Dermatol 32: S31-S41, 1995
