From the Guidelines
Alpha-hydroxy acids (AHA) can cause side effects such as itching, burning sensation, and irritation, particularly when applied to sensitive areas like the face, flexures, and areas of fissuring. These side effects are noted in the management of congenital ichthyoses, where AHAs are used as keratolytics to remove scales and hyperkeratosis 1. The use of AHAs, typically in concentrations of 5-12%, can lead to these adverse effects, which may necessitate tapering the application or discontinuing use. Key points to consider when using AHAs include:
- Itching and burning sensations are common side effects
- Irritation can occur, especially in sensitive areas
- Application on the face, flexures, and areas of fissuring is not recommended due to the risk of irritation
- Concentrations of AHAs can be adjusted, and application frequency can be tapered based on the response, as noted in the study published in the British Journal of Dermatology in 2019 1. When using AHAs, it is essential to be aware of these potential side effects to minimize their occurrence and ensure the best possible outcome in terms of morbidity, mortality, and quality of life.
From the Research
Side Effects of Alpha-Hydroxy Acid (AHA)
- The use of alpha-hydroxy acids (AHAs) in cosmetic products can lead to certain adverse reactions, including swelling, burning, and pruritus 2.
- High concentrations of AHAs can cause irritation, with studies suggesting that concentrations above 10% can lead to increased risk of adverse effects 3.
- Common side effects of AHA use include:
- Swelling
- Burning
- Pruritus (itching)
- Irritation, particularly at high concentrations
- The use of AHAs can also increase the risk of sunburn, with regulatory bodies recommending labeling of products with sunburn alerts 3.
- Studies have shown that AHAs can be effective in improving skin properties, such as increasing skin cell renewal and improving moisture content, but can also cause stinging and irritation, particularly in sensitive skin 4.
Concentration-Dependent Effects
- The effects of AHAs on the skin are concentration-dependent, with higher concentrations leading to increased risk of adverse effects 2, 3.
- Concentrations of AHAs above 10% are not recommended, with the Cosmetic Ingredient Review (CIR) Expert Panel suggesting a maximum safe concentration of 10% 3.
- Studies have shown that AHAs can be effective at concentrations as low as 0.5-1.15 m, with lactic and glycolic acids being the most effective 4.