From the Guidelines
Ammonium lactate is a recommended treatment for xerosis cutis, as it helps to improve skin hydration and reduce dryness. According to the guidelines of care for the management of atopic dermatitis in adults with topical therapies 1, moisturizers, such as ammonium lactate, play a crucial role in reducing signs, symptoms, and inflammation in atopic dermatitis (AD) by minimizing transepidermal water loss and improving stratum corneum hydration.
When using ammonium lactate for xerosis cutis, I recommend applying a 12% lotion or cream to affected areas once or twice daily. The medication should be massaged into the skin until fully absorbed, and treatment typically continues until skin condition improves, often within 2-4 weeks, though it can be used safely for longer periods.
- Key benefits of ammonium lactate include:
- Gentle exfoliation through its alpha-hydroxy acid properties
- Restoration of the skin's pH balance
- Humectant properties that draw moisture into the skin
- For best results, apply after bathing when skin is slightly damp, avoid application to broken or irritated skin, and expect possible mild stinging upon initial application which typically subsides with continued use. If irritation persists or worsens, discontinue use and consult a healthcare provider. As noted in the guidelines 1, moisturizers like ammonium lactate are integral to nearly all AD management plans, and their use can lead to improved AD severity and increased time between AD flares.
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. Ammonium lactate is indicated for the treatment of xerosis cutis (dry, scaly skin) 2.
- The lotion may provide temporary relief of itching associated with xerosis cutis.
- The exact mechanism of action is not fully understood, but it is thought to involve the humectant properties of lactic acid and its ability to decrease corneocyte cohesion 2.
From the Research
Ammonium Lactate for Xerosis Cutis
- Ammonium lactate is used in the treatment of xerosis cutis, with varying degrees of success 3, 4, 5, 6.
- A study comparing 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 3.
- Another study comparing salicylic acid and urea versus ammonium lactate for the treatment of foot xerosis found no statistically significant difference between treatment groups, but both treatments resulted in reduction in the severity of xerosis after 4 weeks of therapy 4.
- A double-blind clinical trial comparing the efficacy and safety of pure lanolin versus ammonium lactate 12% cream for the treatment of moderate to severe foot xerosis found that both treatments were effective, but no differences were statistically significant 5.
- A study comparing 12% ammonium lactate lotion and 5% lactic acid lotion in the treatment of moderate to severe xerosis found that 12% ammonium lactate lotion was significantly more effective than 5% lactic acid lotion in reducing the severity of xerosis 6.
Treatment of Xerosis Cutis
- Xerosis cutis is generally diagnosed on clinical grounds, and treatment involves avoiding possible trigger factors, adequately treating comorbidities, and using suitable skin care products to improve skin hydration and restore its barrier function 7.
- Suitable skin care products should contain both rehydrating and lipid-replenishing components, with the choice of ingredients based on a patient's individual symptoms, such as scaling, fissures, erythema, and pruritus 7.
- Ingredients or combinations thereof with good clinical evidence should be preferentially used, with urea having the best evidence for efficacy in the treatment of xerosis 7.