The Alpha-Hydroxy-Acids (AHAs)

Retin-A is not the only new topical anti aging cream. The hydroxy-acids (AHAs) are now attracting a great deal of attention. Although their pharmacological roots are ancient, the AHAs became the new wonder drug of the 1990s. Because they showed some success with some of the same skin problems treated successfully with Retin-A, comparisons have been inevitable.

A very interesting comparison between the two has to do with the striking similarities in how long it took each of them to become acknowledged as an anti aging wrinkle agent. Retin-A, was first introduced in the early 1960s for the treatment of acne but didn’t get recognized as a savior for wrinkled faces until twenty
five years later. Similarly, the AHAs were being used for dry skin for a period of almost twenty years before their effects on wrinkled skin became widely known.

This kind of delay is not unfamiliar in medicine. A drug can be in use for a while for one purpose, and, later, its beneficial effects for another ailment will emerge. Research must then be conducted on its safety and effectiveness for this new use. The rigorous, scientific testing that is required and the publication of the results of these studies can take years. Then the FDA has to approve that same drug for its safety and effectiveness in treating the new problem, in this case as an anti wrinkle cream. This slow, conservative, painstaking process is one that increases the likelihood that the results will be sound and reliable. Sometimes, when treatments or drugs are approved more quickly – as with some drugs for AIDS – it stirs controversy.

The question arises: Was enough care given to determine their safety and/or effectiveness?

The AHAs have one advantage over Retin-A in the treatment of wrinkles and age spots. They are natural. They can be found in the human body and in many other plant sources, such as sugar cane and lemons. In our day and age of artificial everything, a naturally occurring treatment is quite welcome.

The AHAs are a group of several different acids that bear certain chemical similarities. Some of these acids are quite familiar to all of us. Citric acid is found in citrus fruits, such as oranges and lemons. Another one that is common is lactic acid. Less well known is malic acid, found in apples. Two more AHAs are tartaric acid and glycolic acid. Old wine is rich in tartaric acid, and it has been claimed that the women of the European nobility used old wine on their faces to smooth out their skin.

Before the introduction of cortisone creams in the 1950s, natural remedies were the mainstay of topical dermatologic treatment. You may remember wrinkle creams, lotions, and ointments containing mercury, such as Mercurochrome. Iodine, a common natural ingredient in seafood, continues to be a popular topical skin disinfectant to this day. Compounds with sulfur were also demonstrated to have therapeutic value.

With the 1950s came the synthetic age. In addition to cortisone creams for treating wrinkles, newer antibiotics, both oral and topical, were introduced. The natural remedies for aging skin and wrinkle treatment were becoming a threatened species. But “natural” decided to make a comeback. The use of natural remedies is well accepted in modern day dermatology. The 1970s saw the emergence of interest in aloe vera. Aloe is a plant species that is widely grown. The ancient Chinese used extracts of the aloe plant over two thousand years ago to treat stomach disorders. The South American and Central American Indians still use aloe gel in the treatment of skin diseases. Thus, the use of the natural AHAs as a treatment has historical precedent.

In early 1990, research from a major California medical center announced some impressive results with glycolic acid, the foremost AHA. One hundred and fifty patients were treated for wrinkles, age spots, and other unto-toward effects of sun and aging. Those that were treated with glycolic acid showed marked improvement. A senior member of the research team, reported that a high concentration of glycolic acid was applied to the face for a few minutes and then it was washed off. The application caused some burning or stinging. Following this treatment, over the next few days, the dry skin dissolved and the skin assumed a less wrinkled, rosy color. The patients maintained this improvement by then using a lower concentration of glycolic acid at home. It was also recommended that higher concentrations of glycolic acid were to be reapplied in the dermatologist’s office from every few weeks in some cases up to every few months in others.

As if wrinkles weren’t enough to claim benefits pores became unplugged, whiteheads and blackheads we expressed, or “spurt out,” and a better complexion resulted.