Glycolic acid side effects

Water-in-oil (w/o/w) emulsion systems combining glycolic acid, strontium nitrate, and dex-panthenol might optimize glycolic acid cosmetic effects and decrease its side effects [305]. 

The safety and efficacy of a series of glycolic acid facial peels were investigated in 25 Indian women with melasma [16]. Patients were treated with 50% glycolic acid peels monthly for 3 months. Improvement was noted in 91% of patients with maximal clearing occurring in patients classified with epidermal melasma. Side effects were observed in one patient who developed brow hyperpigmentation. 

Jessner s solution contains 14% resorcinol, 14% salicylic acid and 14% lactic acid. Jessner s solution has been used alone for superficial peeling, or in combination with TCA 35% to achieve a medium-depth peel. Increasing the number of coats applied to the treated area increases the depth and reaction induced by the Jessner s peel. These peels are well tolerated with minimal side effects in the author s practice. As with glycolic acid and salicylic acid peels, Jessner s peels are most commonly used as adjimctive therapy for moderate to severe facial dyschromias, acne, oily skin, texturally rough skin, fine wrinkles, and pseudofolliculitis barbae. 

Lawrence et al. [21] compared the efficacy of Jessner s solution and 70% glycolic acid in a split-face study of 16 patients. Of the total group, five were skin type IV, three were skin type V, and one was skin type VI. There was no statistically significant difference in improvement between the two groups. The investigator did not report an increased frequency of side effects in patients of skin types IV-VI. 

Azelaic acid is a non-phenolic derivative (1,7-hep tanedicarboxylic acid) used at concentration of 10-20% twice a day to treat melasma with minimal side effects (allergic reactions). It acts to disturb the tyrosinase synthesis and can be used as a bleaching agent in patients sensitive to hydroquinone. Better results are obtained if a glycolic acid cream is applied sequentially to azelaic acid treatment. 

Superficial chemical peels, including salicylic and glycolic acids, and Jessner s peels target the stratum corneum to the papillary dermis. These agents can be safely used to facilitate the resolution of PIH (Figs. 16.2,16.3,16.4 and 16.5). To assess for variability in response and limit further PIH, when possible, chemical peels should be initiated at the lower concentrations and titrated to higher concentrations if necessary to increase efficacy while minimizing side effects (see Darker Skin Section). 

This group of compounds has both peripheral and central properties. It is known from ancient literature that atropine has psychotomimetic effects (extracts from Atropa belladona were used to induce hallucinations in wizards ). Central effects increase when the compounds are considered in the following rank atropine, scopolamine, benactyzine, Ditrane, and, finally, BZ and other esters of glycolic acid (Albanus, 1970). BZ was originally studied for the therapy of gastrointestinal diseases. But even in small doses it produces side effects, such as confusion and hallucinations. Therefore, BZ was withdrawn from commercial studies and turned over to the US Army as a possible candidate for incapacitating... 

Retinoids induce neoangiogenesis, whereas AHAs act on the dermis without necessarily going through a phase of inflammatory reaction. We can therefore assume that their combined effects can produce better results at the same time as reducing the incidence of side-effects thanks to the use of lower doses of each of these two potential irritants. For example, if there is resistance to (daily or twice daily) monotherapy with tretinoiff at 0.1%, applying an 8-10% glycolic acid gel beforehand helps the retinoid to penetrate more efticiently. Tretinoin and AHAs can be applied separately, but they can also be mixed in the same gel. 

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