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Lactic acid as a new therapeutic peeling agent in melasma.

BACKGROUND: Melasma is a common disfiguring skin problem. Multiple modalities have been used in the treatment of melasma, such as bleaching agents and chemical peels. Many chemicals have been used in the skin peeling for melasma, such as Jessner's solution and glycolic acid. Lactic acid is an alpha-hydroxy acid that has not been used before in chemical peeling of melasma. OBJECTIVE: The purpose of the present work is to evaluate the efficacy and safety of lactic acid in chemical peeling of melasma. METHODS: This study was conducted at the outpatient Department of Dermatology and Venereology, Baghdad Teaching Hospital, in the period between April 2001 and August 2002. Twenty patients with melasma were included in this study; 18 (90%) were female and 2 (10%) were male, with an age range from 24 to 38 years and a mean of 29 +/- 4.264 SD. Full clinical examination was done of all patients, including Wood's light. The severity of melasma was assessed by the Melasma Area Severity Index (MASI). Pure lactic acid, full strength (92%; pH 3.5), was used as a new peeling agent. The chemical peeling sessions were done every 3 weeks until the desired response was achieved, but not more than six sessions. Follow-up was carried out for 6 months after the last session. All patients had skin type IV; morphologic forms of melasma were a mask-like shape in seven patients (35%), a butterfly shape in nine patients (45%), and a horseshoe shape in 4 patients (20%). RESULTS: Eight patients defaulted from the study after the first session for unknown reasons. Twelve patients completed the study. Eleven patients were female (91.7%), and one patient was male (8.3%). Their ages ranged from 24 to 38 years, with a mean of 29.25 +/- 4.9 SD. Wood's light examination showed increased contrast in all patients (epidermal melasma). The number of sessions ranged from two to six. All 12 patients showed marked improvement, as calculated by the MASI score before and after treatment, and the response was highly statistically significant. No side effect was recorded in all treated patients. CONCLUSION: Lactic acid was found to be a new effective and safe peeling agent in the treatment of melasma.

Adult↗

Lactic acid chemical peels as a new therapeutic modality in melasma in comparison to Jessner's solution chemical peels.

BACKGROUND: Many chemicals have been used in the skin peeling for melasma such as Jessner's solution and glycolic acid. Lactic acid is an alpha-hydroxy acid that has not been used before in chemical peeling of melasma. OBJECTIVE: The purpose of the present work was to evaluate the efficacy and safety of lactic acid in chemical peeling of melasma in comparison to Jessner's solution chemical peels. METHODS: This study was conducted at the Department of Dermatology and Venereology, Baghdad Hospital, in the period between April 2001 and August 2002. Thirty patients with melasma were included in this study. They were mostly of skin type IV according to Fitzpatrick's classification, 26 (86.67%) were women, and 4 (13.33%) were men, with an age range from 18 and 50 years (mean+/-SD, 33.53+/-6.96 years). Full clinical examination was done to all patients including Wood's light. The severity of melasma was assessed by MASI (Melasma Area Severity Index). Pure lactic acid full strength (92%, pH 3.5) was used as a new peeling agent on the left side of the face while Jessner's solution was applied to the right side of the face. The chemical peeling sessions were done every 3 weeks until the desired response was achieved. Follow-up was carried out for 6 months after the last session. RESULTS: Six patients were defaulted from the study after the first session for unknown reasons. Twenty-four patients completed the study. Twenty (83.33%) were women and four were men (16.67%). Wood's light examination showed increased contrast in all patients of mostly epidermal melasma. The number of sessions ranged from 2 to 5. All patients showed marked improvement as calculated by MASI score before and after treatment, and the response was highly statistically significant. No side effect was recorded in all treated patients. CONCLUSION: Lactic acid was found to be an effective and safe peeling agent in the treatment of melasma, and it was as effective as Jessner's solution.

Adult↗

[Changes in ocular tone, pH, ascorbic acid and lactic acid concentration in the aqueous humor of rabbits treated with aceclidine].

The Authors state the results of their research on the modification of the aqueous humor caused by the instillation of the Clonidina to the concentrations of 0,I25% in a group of ten rabbits. The results of these studies illustrate the variations of pH, the ocular tone, the concentration of lactic and ascorbic acid. In all the rabbits examined Clonidina was instillated in the RE while in the LE distilled water was instillated for the control. For two hours from the beginning of the experiment, every IO minutes measurements of the ocular tone in both eyes were taken. At the end of the two hours a sample of aqueous humor was taken from the RE and LE; It was found that: I) The drugs produced a very quick and prolonged decrease of the ocular tone. 2) There are no significant variations in the pH or in the concentration of lactic acid. 3) There was a notable reduction of the concentration of ascorbic acid.

Animals↗

Stereoblock poly(lactic acid): synthesis via solid-state polycondensation of a stereocomplexed mixture of poly(L-lactic acid) and poly(D-lactic acid).

Stereoblock poly(lactic acid) consisting of D- and L-lactate stereosequences can be successfully synthesized by solid-state polycondensation of a 1:1 mixture of poly(L-lactic acid) and poly(D-lactic acid). In the first step, melt-polycondensation of L- and D-lactic acids is conducted to synthesize poly(L-lactic acid) and poly(D-lactic acid) with a medium-molecular-weight, respectively. In the next step, these poly(L-lactic acid) and poly(D-lactic acid) are melt-blended in 1:1 ratio to allow formation of their stereocomplex. In the last step, this melt-blend is subjected to solid-state polycondensation at temperature where the dehydrative condensation is allowed to promote chain extension in the amorphous phase with the stereocomplex crystals preserved. Finally, stereoblock poly(lactic acid) having high-molecular-weight is obtained. The stereoblock poly(lactic acid) synthesized by this way shows a higher melting temperature in consequence of the controlled block lengths and the resulting higher-molecular-weight. The product characterization as well as the optimization of the polymerization conditions is described. Changes in M(w) of stereoblock poly(lactic acid) (sb-PLA) as a function of the reaction time.

Biocompatible Materials↗

[Changes in ocular tonus, pH and concentration of ascorbic acid and lactic acid in the aqueous humor of rabbits treated with clonidine].

The authors state the results of their research on the modification of the aqueous humor caused by the instillation of the Clonidine in a group of ten rabbits. The results of these studies illustrate the variations of pH, the ocular tone, the concentration of lactic and ascorbic acid. In all the rabbits examined was instillated Clonidine for one hour in RE while in LE distilled water was instilled for the control. For two hours from the beginning of the experiment every 10 minutes measurements of the ocular tone in both eyes were taken. At the end of two hours a sample of aqueous humor was taken from LE and RE. It was found that: 1) The drugs produced a vary quick and prolonged decrease of the ocular tone. 2) There are no significant variations in the pH or in the concentration of lactic acid. 3) There was a notable reduction of the concentration of ascorbic acid.

Animals↗

[Changes in ocular tonus, pH and concentration of ascorbic acid and lactic acid in the aqueous humor of rabbits treated with epinephrine].

The authors state the results of their research on the modification of the aqueous humor caused by the instillation of the Epinephrine in a group of ten rabbits. The results of these studies illustrate the variations of pH, the ocular tone, the concentration of lactic and ascorbic acid. In all the rabbits examined Epinephrine was instillated in the RE while in the LE distilled water was instillated for the control. For two hours from the beginning of the experiment, every 10 minutes measurements of the ocular tone in both eyes were taken. At the end of the two hours a sample of aqueous humor was taken from the RE and LE; It was found that: 1) The drugs produced a vary quick and prolonged decrease of the ocular tone. 2) There are no significant variations in the pH or in the concentration of lactic acid. 3) There was a notable reduction of the concentration of ascorbic acid.

Animals↗