Uses of Ammonium Lactate in Dermatology
Ammonium lactate is primarily indicated for the treatment of dry, scaly skin (xerosis) and ichthyosis vulgaris, and for temporary relief of itching associated with these conditions. 1
Primary Indications
- Xerosis (dry skin): Ammonium lactate is highly effective for treating moderate to severe dry skin conditions
- Ichthyosis vulgaris: FDA-approved for this genetic skin condition characterized by dry, scaling skin
- Pruritus: Provides temporary relief from itching associated with dry skin conditions
Efficacy in Treating Xerosis
Ammonium lactate works through several mechanisms:
- Hydration: Increases water content in the stratum corneum
- Keratolytic effect: Helps remove dead skin cells by breaking down keratin
- Humectant properties: Attracts and retains moisture in the skin
Research demonstrates that 12% ammonium lactate lotion is significantly more effective than lower concentrations (5% lactic acid lotion) in reducing the severity of xerosis, with benefits persisting even after discontinuation of treatment 2. When compared to other moisturizing agents, ammonium lactate shows comparable efficacy to pure lanolin for moderate to severe foot xerosis when used twice daily for 4 weeks 3.
Special Applications
Corticosteroid-Induced Skin Atrophy
Ammonium lactate 12% has been shown to minimize cutaneous atrophy produced by potent topical corticosteroids by:
- Increasing epidermal thickness
- Enhancing dermal glycosaminoglycans
- Sparing atrophy in both epidermis and dermis without affecting the corticosteroid's anti-inflammatory properties 4
Atopic Dermatitis
In patients with atopic dermatitis, 12% ammonium lactate emulsion significantly:
- Reduces dryness, desquamation, and pruritus
- Increases skin hydration (measured by electrical capacitance)
- Improves skin barrier function
- Enhances skin surface topography 5
Comparative Efficacy
When compared to other treatments for xerosis:
- 40% urea cream shows faster improvement than 12% ammonium lactate lotion at 14 days of treatment for skin roughness, fissure reduction, thickness, and dryness 6
- 12% ammonium lactate demonstrates superior efficacy to 5% lactic acid lotion for moderate to severe xerosis 2
Application Guidelines
- Apply to affected areas 1-2 times daily
- Best applied to slightly damp skin after bathing
- May cause mild stinging or irritation upon initial application
- Avoid application to broken or inflamed skin
- Continue use even after improvement to maintain results
Potential Side Effects
- Transient stinging or burning sensation
- Mild irritation
- Erythema
- Contact dermatitis (rare)
Clinical Pearls
- Ammonium lactate products should not be used with other keratolytic agents unless directed by a healthcare provider
- Patients should avoid sun exposure after application as it may increase sensitivity to UV radiation
- The medication may destabilize when combined with certain topical corticosteroids or salicylic acid 7
- For optimal results in severe xerosis, consistent twice-daily application is recommended
Ammonium lactate represents an effective first-line therapy for xerosis and ichthyosis vulgaris, with demonstrated efficacy in clinical trials and a favorable side effect profile.