Alpha hydroxy acid acne treatment

Alpha hydroxy acids are natural acids derived from fruit and milk sugars. They have been in use for a very long time. Women during earlier times used sour milk, lemon juice and other acidic products coming from fruits to have glowing skin. It is reported that Cleopatra used a bath of sour milk for her flawless skin. Sour milk contains lactic acid which comes from bacterial fermentation of milk sugars. The most effective products are glycolic acid and lactic acid because they are backed up by a lot of research. Some manufacturers sell products that contain several different types of alpha hydroxy acids.

Major Types of Alpha-Hydroxy Acid

Glycolic acid (Sugar Cane)
This is the most common alpha hydroxy acid that you can find in most products. Glycolic acid has a small molecule which enables this product to have a rapid penetration ability on the skin. The rapid penetration characteristic of glycolic acid makes it the most irritating acid in the group.

Lactic acid (Sour Milk)
Lactic acid have the ability to moisturize the skin. It is a natural humectant that attracts and holds water in the skin. The moisturizing property of lactic acid makes it ideal for treating dry skin. It is less irritating than glycolic acid because of its large molecule size. Since lactic acid is naturally occurring inside the human body, this product is unlikely to cause allergic reaction. Lactic acid would also be ideal for sensitive and allergic skin.

Malic acid (Apple)
This product have an antioxidant property which is not present in other AHA. It also posses moisturizing properties.

Mandelic acid (Bitter Almond)
This product has a natural antibacterial property. Mandelic acid is stronger than Glycolic acid but is less irritating because of its large molecular structure. The antibacterial property of mandelic acid makes it also ideal for treating acne.

Citric acid (Citrus Fruits)
This is the naturally occurring acid in citrus fruits.

Tartaric acid (Grapes)
This is the main acid that can be found on wine. Tartaric acid also posses antioxidant properties.

II. How does Alpha Hydroxy Acid works on acne?

The peeling or exfoliating action of alpha-hydroxy acid on the skin helps unclog blocked pores. This prevents the accumulation of sebum and dead skin cells which provide a good environment for the bacteria that causes acne. Basically, it affects the topmost layer of the skin (epidermis) and the upper layer of dermis. Alpha hydroxy acids work by dissolving the glue that holds the dead skin cells together allowing them to peel off. The new and younger exposed layer of the skin would have better texture, appearance and color. It is best to use Alpha-hydroxy acids for dry/sun damaged skin without acne breakouts.


  • Ability to reduce fine lines and wrinkles and reduce the signs of aging.
  • Ability to make the skin smooth and glowing due to new and younger skin cells.
  • Can improve the appearance of dry, thickened, sun-damaged skin.
  • Exfoliation process also unclogs skin pores.


Can cause deep burns at higher concentrations or uncontrolled conditions.

Alpha hydroxy acids are water soluble and they would have a hard time penetrating oily skin. Oily skin should be cleaned first with soap and water to allow better penetration of alpha hydroxy acids.

Once you stop using them, your skin returns to its original condition. AHA and BHA do not produce long lasting results and should be used regularly.


Alpha-Hydroxy Acid works best at concentrations of 5% to 10% with an acidity level of pH 3 to 4.As the pH increases or their acidity decreases, the effectiveness of beta-hydroxy acids decline.
(Source: Cosmetic Dermatology, October 2001, pages 15–18).

The glycolic acid and salicylic acid peels were similarly effective. The salicylic acid peel had sustained effectiveness and fewer side effects. alpha- and beta-Hydroxy acid peels both offer successful adjunctive treatment of facial acne vulgaris.
(Source: Comparison of alpha- and beta-Hydroxy Acid Chemical Peels in the Treatment of Mild to Moderately Severe Facial Acne Vulgaris.Kessler E, Flanagan K, Chia C, Rogers C, Anna Glaser D.
Saint Louis University School of Medicine, St Louis, Missouri, USA.)

Glycolic acid chemical peels are an effective treatment for all types of acne, inducing rapid improvement and restoration to normal looking skin.
(Source: L. Atzori, M.A. Brundu, A. Orru, P. Biggio (1999) Glycolic acid peeling in the treatment of acne
Journal of the European Academy of Dermatology and Venereology 12 (2), 119–122.)

III. Forms, Dosage and Administration

Topical solutions and creams. 5% to 15% concentration. Higher concentrations are more irritating. Concentrations of 20% to 30% should be administered only by a trained cosmetologists. Doctors are able to use alpha hydroxy acid products that can have a concentration of 50% to 80%.

IV. Precautions

Do not use over wounds. Abrasive soaps. Products with high alcohol content and other products with peeling agents. Pregnant women should avoid salicylic acid. It is best to use alpha hydroxy acid levels of 10% or less and see the reaction of your skin. If there is minimal irritation, you can use higher concentration levels later. For people with sensitive skin the best product would be Mandelic acid because it is the least irritating alpha hydroxy acid. Darker skin types must avoid using Glycolic acid with greater than 10% concentration because of the risk of hyper pigmentation. Hyper pigmentation occurs in darker skin types if it undergoes irritation and inflammation. Use of alpha hydroxy acid will cause sun sensitivity. Use a minimum of SPF15 sunscreen before going out to the sun. Best sunscreen is SPF30.

V. Side Effects

Itching, redness, swelling, may cause sun sensitivity. Product may sting and cause a burning sensation after initial application.

References ( By David Maillie last update 5/26/2006 ) ( ( By David Maillie last update August 2006 ) ( Mariusz J. A. Sapijaszko, MD FRCPC last updated August 20, 2007)

Hydroxy acids and retinoids in cosmetics. Clinics in Dermatology, Volume 19, Issue 4, Pages 460-466 M. Ramos-e-Silva

Desai A, Moy LS. The role of -hydroxy acids in the treatment of photoaging. Photoaging. Marcel Dekker, 2004: 117-140.

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