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  Vol. 132 No. 6, June 1996 TABLE OF CONTENTS
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Topical 8% Glycolic Acid and 8% L-Lactic Acid Creams for the Treatment of Photodamaged Skin

A Double-blind Vehicle-Controlled Clinical Trial

Matthew J. Stiller, MD; John Bartolone, PhD; Robert Stern, MD; Shondra Smith, MD; Nikiforos Kollias, PhD; Robert Gillies, PhD; Lynn A. Drake, MD

Arch Dermatol. 1996;132(6):631-636.


Abstract

Objective
To evaluate the efficacy and tolerability of 2 widely used topical {alpha}-hydroxy acids at low concentrations, 8% glycolic acid and 8% lactic (L-isoform) acid creams, in the treatment of photodamaged skin.

Design
A single-center, 22-week, double-blind, vehicle-controlled, randomized clinical trial assessed the overall severity of photodamage on the faces and forearms of volunteers, based on 7 individual clinical components of cutaneous photodamage.

Setting
The study was performed in an outpatient clinical research unit at the Massachusetts General Hospital, Boston.

Patients
Seventy-four women, aged 40 to 70 years, with moderately severe photodamaged facial skin were enrolled in the study. One subject withdrew from the study early because of skin irritation, and 6 subjects withdrew from the study for personal reasons.

Interventions
Glycolic acid, L-lactic acid, or vehicle creams were applied twice daily to the face and outer aspect of the forearms.

Main Outcome Measures
Improvement in {alpha}-hydroxy acid—treated photodamaged skin as determined by patient self-assessments and physician evaluations of efficacy and irritancy.

Results
The percentage of patients using either 8% glycolic acid or 8% L-lactic acid creams on the face achieving at least 1 grade of improvement (using a scale from 0 through 9) in overall severity of photodamage was significantly greater than with the vehicle cream (76% glycolic acid, 71% lactic acid, and 40% vehicle; P<.05). On the forearms, after 22 weeks, treatment with glycolic acid cream was superior to the vehicle in improving the overall severity of photodamage and sallowness (P<.05). L-Lactic acid cream was significantly superior to the vehicle in reducing the overall severity of photodamage (P<.05), mottled hyperpigmentation (P<.05), sallowness (P<.05), and roughness on the forearms (P<.05) at week 22.

Conclusions
Topical 8% glycolic acid and 8% L-lactic acid creams are modestly useful in ameliorating some of the signs of chronic cutaneous photodamage. These agents are well tolerated and available without prescription.

(Arch Dermatol 1996;132:631-636)



Author Affiliations

From the Dermatology Clinical Investigations Unit, Massachusetts General Hospital (Drs Stiller, Smith, Kollias, Gillies, and Drake) and the Department of Dermatology, Beth Israel Hospital (Dr Stern), Boston, Mass, and the Unilever Research Corp, Edgewater, NJ (Dr Bartolone).



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