In addition to topical antibiotics and retinoids, keratolytic agents provide another option for the topical treatment of acne. Keratolytic agents are available as both prescription medications (azelaic acid, glycolic acid) and in OTC formulations (salicylic acid, sulfur, benzoyl peroxide). They work by breaking down the highly keratinized outer layer of the epidermis, which can help open up pores plugged at the surface. In addition, they help remove older, damaged surface tissue and promote the generation new skin. Some of the keratolytic agents also have antibacterial properties.
A naturally occuring dicarboxylic acid, azelaic acid is a generally well tolerated treatment for mild to moderate acne. in addition to being a keratolytic agent, it has antibacterial and anti-inflammatory activities that are also helpful in resolving acne. However, because the action of azelaic acid is primarily at the surface of the skin, it is less effective at resolving nodular, cystic and inflammatory acne. It generally comes packaged as a 15-20% cream.
Glycolic acid is a member of the increasing popular family of alpha-hydroxy acids (AHA). Alpha-hydroxy acids are used extensively in the cosmetics industry as chemical peels designed to fight wrinkles and even out skin tone. Like other keratolytic agents, glycolic acid acts by helping to remove the outermost layer of the epideris, removing damaged tissue and promoting new growth. In acne treatment, it is primarily used to diminsh the appearance of acne scarsand even out skin tone, but can also be used as a general keratolytic agent to treat mild cases of acne.
Related Articles from The Science of Acne
What is Acne Vulgaris?
What Causes Acne?
Prescription Medications and Acne Vulgaris
Naturopathic Medicine and Acne Vulgaris
Light and Laser Therapies and Acne Vulgaris
Over the Counter Medications (OTC) and Acne Vulgaris
References and Sources
PDR Staff Writers. 2011. 2011 Physicians’ Desk Reference (PDR)
Habif. 2009. Clinical Dermatology
Goodheart. 2006. Acne For Dummies
Scientific Research Articles
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