Glycolic Acid, a solution for keratosis pilaris?

How does glycolic acid act on keratosis pilaris?

The keratosis pilaris is a hereditary skin condition affecting nearly 50 to 80% of adolescents and about 40% of adults. It results from a dysfunction in the keratinisation process, where an excess of skin cells accumulates around the hair follicles. This accumulation traps hairs under the skin, forming small rough bumps. Often, one can see hairs coiled under these bumps. They typically appear on the arms, thighs and legs and are more common during adolescence. In many cases, the condition can resolve itself over time without treatment.

Theglycolic acid, an alpha α-hydroxy acid (AHA), is renowned for its exfoliating effects. It breaks down the bonds between dead skin cells, enhancing cellular renewal and skin regeneration. This action could be effective against keratosis pilaris, as it would help to reduce the accumulation of keratin, leading to smoother skin. Glycolic acid also cleanses the pores by removing skin cells and excess sebum, and it promotes collagen production while accelerating melanin metabolism, resulting in brighter and clearer skin. Its ability to improve scars also makes it a viable option for the treatment of keratosis pilaris, particularly in areas prone to dryness and rough texture such as the legs.

Research insights into the effectiveness of glycolic acid.

In a clinical trial conducted in 2021 by TIAN and his colleagues, 25 individuals with confirmed keratosis pilaris participated in the study. The subjects exhibited typical symptoms of keratosis pilaris on their limbs, including peri-follicular erythema (redness occurring around the hair follicle), papules, and pigmentation. They had not received any other treatment in the preceding six months.

The treatment involved the application of a high-concentration glycolic acid solution over four sessions, spaced 20 days apart, and during a five-year follow-up. The application protocol included concentrations of 50% glycolic acid for 5 minutes and 7 minutes, then increased to 70% for 5 minutes and 7 minutes, with treatments on days 0, 20, 40, and 60. Each application was followed by a neutralising solution to minimise irritation, and participants were advised to avoid sun exposure for a week after the treatment.

The evaluation criteria of the study included:

Counting the number of keratotic papules (on days 0, 20, 40, 60 and 80);
Measurement of the melanin and haemoglobin content in skin erythema and pigmentation of the hair follicle opening;
Measurement of skin clarity using a spectrophotometer;
Global Aesthetic Improvement Scale, which the patients used for self-assessment.

Over the course of 80 days, the results have been promising. The glycolic acid treatment reduced the number of keratotic bumps over time. By the end of the treatment cycle (day 80), the average number of keratotic papules decreased from 52.12 to 22.16, a reduction of approximately 58%. The melanin content, which affects pigmentation, and haemoglobin levels, related to redness, also showed significant changes, indicating an improvement in skin tone and less inflammation. Measures of skin clarity also improved, reflecting an overall enhancement in the appearance of the skin.

These results suggest that glycolic acid could be effective not only for alleviating the physical symptoms of keratosis pilaris, but also potentially improving the appearance of the skin by brightening it and reducing redness. However, the study indicated that although treatments with glycolic acid showed a reduction in symptoms during the treatment period, these effects were not maintained in the long term.

Five years post-treatment, follow-up evaluations revealed that the number of keratotic papules, melanin and haemoglobin content, and skin clarity had returned to levels observed prior to treatment. This suggests that the beneficial effects of glycolic acid may only be present during and immediately after treatment. Without ongoing use, symptoms of keratosis pilaris appear to gradually re-emerge, highlighting the potential need for continuous treatment management. Further studies would be required to confirm these findings and to explore long-term efficacy.

How to use glycolic acid against keratosis pilaris?

If you are considering using glycolic acid for the management or reduction of symptoms of keratosis pilaris, it is important to take into account the following points:

Concentration Levels : Glycolic acid treatments for keratosis pilaris in a clinical setting have utilised concentrations ranging from 15% to 70%. Such high concentrations are significantly more potent than over-the-counter products and are designed to effectively break down the keratin that contributes to the condition.
Frequency of Application : Clinical studies suggest that regular application over several weeks is necessary to achieve noticeable improvements, and permanent results are not guaranteed.
UV Sensitivity: Glycolic acid increases the skin's sensitivity to UV rays. The daily application of a broad-spectrum sunscreen is essential to protect the skin and prevent the exacerbation of keratosis pilaris symptoms.
Hydration: Like all chemical peels, glycolic acid can dry out the skin or even cause erythema (redness), skin irritation and a burning sensation. In order to keep the skin hydrated and support the skin barrier, you should follow each application of glycolic acid with a soothing moisturising cream. Dermatologists recommend using an oil-free cream or ointment to avoid clogged pores.

Although glycolic acid offers a potential solution to reduce the appearance of keratosis pilaris, it requires careful application and may not guarantee permanent results. Those considering trying glycolic acid for keratosis pilaris should consult a dermatologist to tailor the treatment to their specific skin type and condition, ensuring the best possible outcome with limited side effects.