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In another study by Atzori et al, 70% GA was used in comedonic acne, papulopustular, and nodular/cystic acne. While comedones improved rapidly, papulopustular acne improved after six peel sessions, and nodulocystic lesions required ten sessions at three-week intervals. A significant improvement of coexisting post-acne superficial scarring was noted. Patient tolerance and compliance were both found to be excellent. 22 Glycolic acid actively helps to combat active acne inflammations at the exact same time as it works to reduce previous acne scarring. This one-two punch makes it a favourite of acne sufferers the world over.
The most common chemical agents currently used for medium-depth peeling are 70% glycolic acid and 35 to 50% TCA, with or without adjuvant combination products (e.g., Jessner’s solution [comprising 14g resorcinol, 14g salicylic acid, 14mL lactic acid in ethanol constituted to 100mL] or solid carbon dioxide [CO2]). 2 , 3 , 5 , 7 – 9 , 15 , 19 – 23 In addition, multiple layered applications of 20 to 40% salicylic acid and pyruvic acid are also used for medium-depth peeling, though not traditionally considered medium-depth peels. Typically, OTC o As glycolic acid is a highly concentrated acid, it’s frequently used in at-home exfoliating treatments; most popularly in chemical peels. Benefits of glycolic acid Glycolic acids greatest asset is its ability to help remove the uppermost layer of our skin by breaking down the bonds that bind dead cells together. It essentially works to ‘unglue’ skin cells from each other. Breaking this bond creates a chain reaction that, in turn, boosts the cell renewal and turn over, that leaves your skin feeling clean and looking bright. Using glycolic acid in your exfoliation routine helps to keep your skin's pH level balanced, fade any lingering acne scars and unclog your pores. It’s a truly turbo-charged chemical exfoliant that ensures that your skin reveals itself to be soft and supple.
After neutralization, the skin may be rinsed or cleansed gently. Following application, an initial erythema might become red and is often accompanied by edema. Stringy or patchy light frosting (Level I) might subsequently develop, indicating epidermolysis with separation of the epidermis from the underlying dermis. Development of frank or uniform frosting (≥Level II) indicates deeper destruction into the dermis and is not desirable, as this is meant to be a relatively superficial peel. Exfoliation typically occurs over several days, and reepithelialization is complete within 7 to 10 days. 1 , 2 , 7 , 8 , 9 , 21 In a study by Sarkar et al, 20 Indian patients received serial GA peels (30% GA for the first three sittings; 40% GA for the next three sittings), combined with the modified Kligman’s formula (2% hydroquinone, 0.025% tretinoin, and 1% mometasone). A further 20 Indian patients received only the modified Kligman’s formula, with no peeling. In both groups, a significant decrease in the MASI score was observed from baseline to 21 weeks ( P< 0.001). However, the GA peel group showed more rapid and greater improvement ( P< 0.001). 30
Self-precipitation of the peeling agent accounts for little penetration and a good safety profile, thus reducing the risk of postpeel hyperpigmentation, especially in the darker skin types.[ 16] These features have made salicylic acid peel superior to glycolic acid peel in comparative studies conducted earlier in dark-skinned individuals. Studies have also shown beneficial effect of salicylic acid peel in postinflammatory pigmentation in dark-skinned individuals.[ 16, 17] Similar effect on postinflammatory hyperpigmentation was noted in this study. Salicylic acid decreases postacne hyperpigmentation by its anti-inflammatory effects. Ahn and Kim[ 18] found salicylic acid to have a whitening effect on the skin as well. Mandelic acid also has a beneficial effect in improving skin pigmentation. CONDITIONS OF USE AND IMPORTANT INFORMATION: This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on WebMD. You should always speak with your doctor or health care professional before you start, stop, or change any prescribed part of your health care plan or treatment and to determine what course of therapy is right for you. Sharad J. Combination of microneedling and glycolic acid peels for the treatment of acne scars in dark skin. J Cosmet Dermatol. 2011 Dec;10(4):317-23. View abstract. Glycolic acid has been praised throughout the skincare world for its many uses and effortless simplicity.The use of polarized filters with color photography was an excellent method of enhancing pigmentation in photographs of patients, as shown in Figure 3 and Figure 4. Ultraviolet reflectance photography is also a valuable tool to accentuate pigmentation; however, patients must wash and degrease the face before photography to prevent reflection from the skin surface, which obscures the assessment of pigmentation. The mexameter served as a reproducible, easy-to-use tool for the objective measurement of pigmentation.
Dr. Hartman advises against using glycolic acid with salicylic acid, vitamin C, retinol or benzoyl peroxide to minimize the risk of irritation. "You can use those ingredients in other parts of your routine, but not at the same time, on the same day," he explains. "For example, if you regularly apply a retinol serum at night, but want to try glycolic acid, apply the glycolic acid product and skip your retinol for a couple of nights. If you have sensitive skin, skip using any other kind of exfoliating product on the day you use glycolic acid." If you're new to glycolic acid, it's best to ease into using the chemical exfoliant. "Start using it slowly, with a lower concentration of 10 percent or less, or with a glycolic acid cleanser," says Corey L. Hartman, MD, board-certified dermatologist and founder of Skin Wellness Dermatology in Birmingham, Alabama. As your skin adjusts over time, you can start adding products with the sloughing acid into your regime in higher concentrations. We’ve already mentioned all the ways that glycolic acid works to slough off dead skin cells, but did we mention that it also helps to attract moisture from the air, coaxing it into the skin to increase hydration and minimise any additional dryness? Amazing, right? Not only that, but it’s a great product to use in the morning in the form a cleanser or serum because it helps to prep your skin for other product use. It sets your skin up for smearing on your favourite moisturiser and even smoothes your skin, ready for your makeup application.Lin and Tham studied the use of GA peels in ten Asian women. Concentrations of 20%–70% GA were administered every 3 weeks, either alone or in combination with a topical regimen of 2% hydroquinone plus 10% GA. There was significant improvement ( P< 0.06) in melasma and fine facial wrinkling in patients who received the combination of creams and peeling. 27 Kalla et al did a comparative study of 55%–75% GA versus 10%–15% trichloroacetic acid (TCA) peels in 100 patients with recalcitrant melasma. The peels were conducted at 15-day intervals in both groups. It was seen that the response to TCA was rapid, and produced better results than GA. However, relapse was more common in the TCA group (25%) than in the GA group (5.9%). 28 On its own, it’s unlikely to cause a severe reaction. However, you should take care when using glycolic acid – or indeed any AHAs – with other skincare products, as it may potentially irritate the skin. In another study, 10 patients with melasma were treated with a triple combination of tretinoin 0.05%, hydroquinone 4%, and mometasone furoate 0.1%. Serial GA peels were performed at three-weekly intervals, with application times from 2–6 minutes, depending on tolerance and erythema. Glycolic acid of 57% concentration, with 55% free acid, and pH 2.3 was used on the face in gradually increasing durations of application. Significant reduction in melasma was noted after four peels. One patient developed irritation and hyperpigmentation, while one developed persistent erythema. No other side effects were reported. 37 , 38
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