Can Glycolic Acid Eliminate Keratosis Pilaris?

In a clinical trial conducted in 2021 by TIAN & al. 25 individuals with confirmed keratosis pilaris participated in the study. The subjects had typical keratosis pilaris symptoms on their limbs, including perifollicular erythema (redness occurring around the hair follicle), papules, and pigmentation and they had not received any other treatments in the previous six months.

The treatment involved applying a high-concentration glycolic acid solution across four sessions spaced 20 days apart and at a five-year follow-up. The application protocol included concentrations of 50% glycolic acid for 5 minutes and 7 minutes, and later increased to 70% for 5 minutes and 7 minutes, with treatments on days 0, 20, 40, and 60. Each application was followed by a neutralizing solution to minimize irritation, and participants were advised to avoid sunlight exposure for a week post-treatment.

The study’s evaluation criteria included:

• counting the number of keratotic papules (on days 0, 20, 40, 60 and 80);

• measuring melanin content and skin hemoglobin of the erythema and pigmentation of the hair follicular opening by a pigment measuring instrument;

• measuring skin lightness by a spectrophotometer;

• the global aesthetic improvement scale, which patients used for self-assessment.

Over the 80 day period, the results were promising. The treatment with glycolic acid 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, which is approximately a 58% reduction. The melanin content, which affects pigmentation, and the hemoglobin levels, related to redness, also showed significant changes, indicating an improvement in skin tone and less inflammation. Measurements of skin lightness improved as well, reflecting an overall enhancement in the skin's appearance.

These findings suggest that glycolic acid may be effective not only in reducing the physical symptoms of keratosis pilaris but also in potentially enhancing the cosmetic appearance of the skin by lightening it and reducing redness.

However, the study indicated that while glycolic acid treatments showed a reduction in symptoms during the treatment period, these effects were not sustained long-term. Five years post-treatment, follow-up assessments revealed that the number of keratotic papules, melanin and hemoglobin content, and skin lightness had reverted to levels observed before the treatment. This suggests that the beneficial effects of glycolic acid might only be present during and immediately after the treatment. Without continuous use, the symptoms of keratosis pilaris appear to gradually re-emerge, highlighting the potential need for ongoing management of the condition. Further studies would be necessary to confirm these findings and to explore long-term efficacy.

If you are considering the use of glycolic acid for management or reduction of keratosis pilaris symptoms, it's important to consider the following:

• Concentration Levels: Glycolic acid treatments for keratosis pilaris in clinical settings have utilized 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.

• Application Frequency: Clinical studies suggest that regular application for several weeks is necessary to achieve noticeable improvements, and permanent results are not guaranteed.

• UV Sensitivity: Glycolic acid increases skin sensitivity to UV rays. Daily application of a broad-spectrum sunscreen is essential to protect the skin and prevent exacerbation of keratosis pilaris symptoms.

• Moisturize: Like all chemical peels, glycolic acid can leave the skin dry 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 moisturizer. Dermatologists recommend using an oil-free cream or ointment to prevent clogged pores.

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