Barbara A. Green

Clinical and cosmeceutical uses of hydroxyacids

The hydroxyacids are represented by the alpha-hydroxyacids, beta-hydroxyacids, polyhydroxy acids, and bionic acids. Together, these ingredients form a class of compounds with unparalleled benefits to the skin and unprecedented usage in the cosmeceutical market in cosmetic and therapeutic formulations alike. The most commonly used hydroxyacid is glycolic acid, an alpha-hydroxyacid that has been used extensively in cosmetic antiaging formulations, moisturizers, and peels, and in treatment products to improve hyperpigmentation and acne. The newer polyhydroxy and bionic acids offer the benefits of alpha-hydroxyacids without irritation, making them suitable for use on sensitive skin, rosacea, and after cosmetic procedures. They also provide additional antioxidant/chelation, barrier strengthening, and moisturizing effects. Bionic acids inhibit matrix metalloproteinase enzymes in skin, providing a preventative antiaging benefit. The hydroxyacids as a class can be combined with therapeutically active materials and cosmetic procedures to increase therapeutic effects and improve tolerability and outcomes of medicinal agents and procedures.

An evaluation of a polyhydroxy acid skin care regimen in combination with azelaic acid 15% gel in rosacea patients

Rosacea is a common skin condition presenting with facial erythema, inflammatory papules and pustules, telangiectasia, and which is frequently associated with an increased facial sensitivity and irritability to a variety of topical products. 1 This is particularly problematic for women, who, on one hand, are socially embarrassed by the facial stigmata of rosacea, and on the other, are often unable to tolerate common skin care products for cleansing and moisturizing, or to improve the appearance of aged skin. A variety of topical prescription therapies are available for the treatment of rosacea, including azelaic acid (AzA), metronidazole, and sodium sulfacetamide. 2 However, because of the demographics of rosacea, i.e., typically after age 30, female rosacea patients desire not only to treat the clinical signs and symptoms of their rosacea, but also to improve the cosmetic condition of their skin. As a result, optimal cleansing and moisturizing products that are well tolerated on sensitive skin and provide cosmetic benefits such as antiaging effects are highly desirable. The aim of this study was to assess the tolerability and possible additional benefits of a skin care regimen containing the polyhydroxy acid (PHA), gluconolactone, compared to nonstandardized, individual skin care regimens during active treatment of rosacea with AzA 15% gel. The therapeutic efficacy of AzA 15% gel in papulopustular rosacea has been demonstrated in controlled studies. 3 Gluconolactone skin care was selected because it was previously demonstrated to provide cosmetic and adjunctive therapeutic effects. 4,5 It is a sixcarbon polyhydroxy acid (PHA) lactone that hydrolyzes to gluconic acid, an alpha-hydroxy acid (AHA), in the presence of water in a moisturizer formulation or in the skin. 6

After 30 years … the future of hydroxyacids

Alpha-hydroxyacids (AHAs) have transformed skin care and enjoyed huge commercial success since their introduction by dermatologist Dr Eugene J. Van Scott and dermatopharmacologist Dr Ruey J. Yu in the early 1970s. Thirty years have passed since the published introduction of AHAs, demonstrating their significant “normalizing” or corrective effects on severely dry skin and ichthyosis. 1 It was not until the mid-1990s, just 10 years ago, that the antiaging effects of AHAs became a prominent message in cosmetic dermatology, leading to a proliferation of AHA-containing antiaging products and skin care systems. Today, AHAs and related compounds, including the polyhydroxy acids (PHAs) and polyhydroxy bionic acids (bionic acids), are used manifold in dermatology – cosmetically to achieve smoother skin, adjunctively with topical and systemic medications, and as a complement or enhancing agent with cosmetic procedures. Many companies have marketed AHA-containing skin care products and, accordingly, consumer recognition of their beneficial effects is high. However, many of the important skin benefits of AHAs are not well understood by many consumers and other users of AHAs. Still viewed by many as simple exfoliants, the more significant effects of AHAs, including normalization of epidermal keratinization 1,2 and dermal remodeling, 2 are frequently overlooked. Moreover, the newer AHAs (such as benzilic and mandelic acids), polyhydroxy acids (PHAs, such as gluconolactone), and bionic acid compounds (such as lactobionic and maltobionic acids) are even less well understood. The polyhydroxy ingredients are not simply another AHA. They provide similar antiaging and skin smoothing effects of AHAs with the addition of other important benefits too, including gentleness and antioxidant effects – significant advantages over traditional AHAs. The newer, more lipophilic AHAs offer targeted treatment of oily and acne-prone skin, and appear to be less stinging than glycolic acid. Mandelic acid and benzilic acid – targeted skin benefits

A novel LCD (coal tar) solution for psoriasis does not discolor naturally light or color-processed hair in an exaggerated exposure test model

Background  Scalp psoriasis is reported to occur in 50–80% of psoriasis sufferers. Treatment of scalp psoriasis requires special consideration of product esthetics and staining potential due to the presence of hair.

A Cost-effectiveness Comparison of Liquor Carbonis Distillate Solution and Calcipotriol Cream in the Treatment of Moderate Chronic Plaque Psoriasis

be no personal or family history of typical chronic plaque psoriasis lesionselsewhereonthebody,nohistoryofatopic dermatitis, and no relevant positive findings on patch testing. Patients were considered to have palmoplantar psoriasis if they presented with well-demarcated, symmetric, indurated, and hyperkeratotic plaques on the palms with asharpcutoff at thewrist.Patientswereconsidered tohave typical chronic plaque psoriasis if lesions were distributed on the extensor elbows, knees, scalp, nails, or trunk. All patients had chronic disease present for at least 6 months and all had not had topical therapy for at least 2 weeks and systemic therapy for at least 4 weeks. Tissue samples were obtained by 4-mm punch biopsy specimens taken from lesional skin of patients with HHD (n=4), palmoplantar psoriasis (n=4), and chronic plaque psoriasis (n=6) and nonlesional skin of patients with psoriasis(n=6).Frozentissuesectionswereprepared,andslides were incubated in 10% methanol for 10 minutes, in 3% hydrogen peroxide for 10 minutes, and then in blocking solution for 1 hour. Antibodies directed against human IL-23 (Biolegend,SanDiego,California)werethenappliedataconcentration of 1:50 overnight at 4°C. Vectastain Elite ABCPeroxidasekitsandVectorVIPperoxidasesubstratekits(Vector Laboratories, Burlingame, California) were used for visualizingcells.Positivecellswerecountedin8high-power fields, and the average number of labeled cells was calculated.A1-way,between-subjectanalysisofvariancewasconducted to compare the expression level of IL-23 in the 4 groups. A paired t test was used in post hoc analysis to individuallycompareeachofthe4groupsagainstoneanother.