Salicylic acid is listed among active products to treat acne (26,27). However, clearcut evidence for a significant benefit at low concentration in well-controlled experimental and clinical trials is scanty. Similarly, medium concentrations of AHAs, such as glycolic acid, lactic acid, and mandelic acid, are employed twice daily to improve mild acne (12). Such a treatment awaits validation by independent controlled studies. In our experience, the lower AHA concentrations present in some cosmetic products have no effect whatsoever on acne and comedones.
Another modality of acne treatment has been proposed using high concentrations of glycolic acid in an office setting (12). The procedure has to be repeated weekly or so. Improvement has been reported to be precipitous while patients were also taking tetracyclines (12). Discomfort, mild diffuse erythema, and fine scaling are often experienced by patients. In addition, there is a risk for stronger irritation leading to a papular and perifollicular erythema that can persist for a few weeks.
Pseudofolliculitis is another related disorder that can be improved by topical AHA treatment (28).
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