From the Guidelines
Ammonium lactate is a recommended treatment for derision cutis, also known as keratosis pilaris, due to its ability to hydrate and exfoliate the skin, improving its appearance and texture. The most recent and highest quality study, 1, published in 2023 in the Journal of the American Academy of Dermatology, highlights the importance of moisturizers in managing atopic dermatitis, which can also be applied to the treatment of keratosis pilaris.
Key Points to Consider
- Ammonium lactate works through dual mechanisms: the ammonium component helps maintain skin pH while the lactic acid (an alpha-hydroxy acid) exfoliates by breaking down the excess keratin that causes the rough, bumpy texture characteristic of the condition.
- It is essential to apply the product to clean, dry skin and to avoid application to broken, irritated, or sunburned skin.
- Sun protection is crucial while using this treatment as it may increase sun sensitivity.
- If skin irritation occurs, reducing application to once daily may help.
- Most patients see gradual improvement with consistent use, though complete resolution may not occur in all cases.
Application and Dosage
- I recommend using a 12% ammonium lactate lotion or cream, such as Amlactin, applied to affected areas twice daily.
- The medication should be massaged into the skin until fully absorbed, and treatment should continue for at least 4-6 weeks to see significant improvement.
- As noted in 1 and 1, moisturizers and topical agents are essential in managing skin conditions, and their application should be tailored to the individual's needs and preferences.
From the FDA Drug Label
Ammonium Lactate Lotion is indicated for the treatment of dry, scaly skin (xerosis) and ichthyosis vulgaris and for temporary relief of itching associated with these conditions.
The answer to the question about using ammonium lactate for derision cutis (which seems to be a typographical error, possibly meaning "dermatitis" or a specific skin condition) is not directly supported by the provided drug label information. However, given the indications for dry, scaly skin (xerosis) and ichthyosis vulgaris, ammonium lactate could be considered for conditions characterized by dryness and scaling, but derision cutis is not explicitly mentioned.
- Key Indications: Dry, scaly skin (xerosis), ichthyosis vulgaris, and temporary relief of itching associated with these conditions.
- Decision: Without clear information on derision cutis, a conservative approach would be to not recommend ammonium lactate for this condition based solely on the provided label, as it does not directly address derision cutis. 2
From the Research
Ammonium Lactate for Xerosis Cutis
- Ammonium lactate is used for the treatment of xerosis cutis, with studies showing its effectiveness in reducing the severity of xerosis 3, 4, 5.
- A randomized, double-blind, clinical study compared the efficacy of 5% salicylic acid and 10% urea ointment with 12% ammonium lactate lotion in treating mild-to-moderate xerosis, and found that both treatments resulted in significant improvement in the severity of xerosis after 2 and 4 weeks of treatment 3.
- Another study compared the efficacy of pure lanolin with 12% ammonium lactate cream in treating moderate to severe foot xerosis, and found that both treatments were effective in reducing xerosis scores after 2 and 4 weeks of treatment 4.
- A clinical evaluation of 40% urea and 12% ammonium lactate in the treatment of xerosis found that 40% urea cream was superior to 12% ammonium lactate lotion in most instrumental and clinical assessments on day 14 of treatment 5.
Comparison with Other Treatments
- A systematic review of moisturizers for the treatment of foot xerosis found that urea was the most researched active ingredient, with ammonium lactate being the next most researched 6.
- The review found that treatments containing urea as a primary active ingredient have been the most researched, but the poor quality of the literature precludes recommendation of any active ingredient over another 6.
- Ammonium lactate has been compared with other treatments, such as salicylic acid and urea, and has been found to be effective in reducing the severity of xerosis 3, 5.