Fruit Acids
Scientific Name(s):Alpha hydroxy acids, malic acid, lactic acid, gluconolactone
Common Name(s): Fruit acids
Clinical Overview
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Uses of Fruit Acids
Fruit acids are used for cleansing, moisturizing the top layers of skin and for treating acne.
Fruit Acids Dosing
There are no recent clinical studies of fruit acids to provide a basis for dosage recommendations.
Contraindications
Hypersensitive individuals and those with irritated skin should use alpha hydroxy acids with caution.
Pregnancy/Lactation
Information regarding safety and efficacy in pregnancy and lactation is lacking.
Fruit Acids Interactions
None well documented.
Fruit Acids Adverse Reactions
Dryness, scaling, burning and similar effects may occur in sensitive individuals or with prolonged use.
Toxicology
No data.
As the name indicates, these acidic organic compounds are derived primarily from fruit sources. Juices and fruit pulps may be rich in malic and lactic acids, although other sources may be used for commercial production of these acids (ie, starch, glucose or other sugars).
History
Organic acids such as lactic acid have long been used in dermatologic preparations as humectants to improve the moisturization of the top skin layers. Organic acids have also been used to remove hair from and to tan animal hides. 1
Most organic acids can be caustic in sufficiently high concentrations. As agents that modify the keratinization process (see Pharmacology), alpha hydroxy acids may be useful for the treatment of acne and other skin disorders. 2 Since they help debride dead cells from the skin, they have been added to a variety of skin cleansers.
A number of cosmetic companies are marketing products that contain alpha hydroxy acids for their anti-aging effects on the skin. While the fruit acids have the ability to promote the sloughing of outer skin layers, there is no evidence that the use of these products, particularly over a long period of time, can “rejuvenate” the skin or alter the basic aging-related changes of the skin. It is possible, however, that removal of top skin layers may enhance the appearance of the skin.
Chemistry
The “fruit acids” are a group of organic acids that share a common chemical structure consisting of a hydroxyl group positioned at the alpha-carbon position. Consequently, these compounds are often referred to as “alpha hydroxy acids.” Common fruit acids include lactic and malic acids. Because of the structural configuration of these acids, they are optically active and only certain forms of the isomers are obtained from natural sources. For example, only (-)malic acid is obtained from fruit juices. 3
Fruit Acids Uses and Pharmacology
Dermatological effectsLactic acid (in concentrations of approximately 1% to 2% in creams or lotions) has been reported to be an effective naturally occurring skin humectant, having beneficial effects on dry skin and also in severe hyperkeratotic conditions.
Hyperkeratinization appears to play a role in the development of acne and is often the result of decreases in the rate of skin cell sloughing, which itself is due to an increase in the cohesion of cells known as corneocytes. 4 Alpha hydroxy acids may decrease the cohesiveness of corneocytes by weakening intracellular bonding, 5 thereby freeing skin cells and permitting more efficient cell removal and skin cleansing. 6
Animal dataResearch reveals no animal data regarding the use of fruit acids for dermatological effect.
Clinical dataOne fruit acid component, gluconolactone, has been found to be as effective as benzoyl peroxide in the treatment of acne. 4 In a double-blind trial of 150 patients, a 14% solution of gluconolactone was compared with benzoyl peroxide 5% lotion and to a placebo vehicle.
Both active treatments significantly reduced the number of inflamed lesions (compared to baseline) during the 12–week study. While there was no significant difference between active treatments during the first 4 weeks, the benzoyl peroxide was significantly better in reducing the number of inflamed lesions by weeks 8 and 12 than was the alpha hydroxy acid. Both groups were similarly effective in reducing the total number of inflamed and noninflamed lesions, but dryness was reported by significantly more patients treated with benzoyl peroxide.
Overall, 50% of the benzoyl peroxide-treated patients reported adverse events, compared to 24% of those treated with gluconolactone and 10% of the placebo-treated patients. Dryness, scaling and burning were the most commonly reported events.
Dosage
There are no recent clinical studies of fruit acids to provide a basis for dosage recommendations.
Pregnancy/Lactation
Information regarding safety and efficacy in pregnancy and lactation is lacking.
Interactions
None well documented.
Adverse Reactions
Depending on the concentrations used, alpha hydroxy acids can cause severe skin irritation, burning and sloughing. Hypersensitive individuals and those with irritated skin should use alpha hydroxy acids with caution.
Toxicology
Research reveals little or no information regarding toxicology with the use of this product.
Bibliography
1. Windholz M, ed. The Merck Index , ed. 10. Rahway, NJ: Merck & Co., 1983.2. Van Scott EJ, Yu RJ. Arch Dermatol . 1974;110:586.
3. Morrison RT, Boyd RN. Organic Chemistry , ed. 3. Boston: Allyn and Bacon, Inc., 1973.
4. Hunt MJ, Barnetson RS. Australas J Dermatol . 1992;33:131.
5. Van Scott EJ, Yu RJ. J Am Acad Dermatol . 1984;11:867.
6. Van Scott EJ, Yu RJ. Cutis . 1989;43:222.
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