Effectiveness of alpha-hydroxy acids in the treatment of acne vulgaris: A comparison of azelaic and pyruvic acids

Alpha-hydroxy acids (AHA) are widely used as a therapeutic agent in dermatology. The aim of the present study is to compare azelaic and pyruvic AHAs for their efficacy in the treatment of acne vulgaris. We treated 120 young women (mean age 22 years old) with six peeling sessions at two-week intervals. One group (n = 60, 50%) was treated using azelaic acid (AA), whereas second group participated in pyruvic acid (PA) sessions. We evaluated the patients clinically twice (before and after treatment), using the Scale of Hellegren-Vincent Severity Symptoms (SHVSS) to assess the acne diagnosis, and the Nati Analyzer to estimate the skin properties (oily skin, desquamation, porosity, and moisture). The clinical evaluation of the patients after the peeling sessions demonstrated a 50% reduction of acne severity symptoms in both the AA and PA groups. The effect was also found in terms of decreasing desquamation (p &lt; .05) and oiliness of the skin (p &lt; .001). PA showed a greater reduction of greasy skin than AA (p &lt; .05). In conclusion, after the six peeling sessions using AA and PA, all patients showed better skin parameters in reducing oiliness and desquamation. Both AA and PA peelings can be proposed as a safe and efficient treatment for mild acne, however side effects, skin properties and patients’ preferences should be taken into account in the selection of one of the two AHAs.α-羟基酸（Alpha-hydroxy acids, AHA）在皮肤病学领域被广泛用作治疗制剂。本研究旨在比较壬二酸（azelaic acid, AA）与丙酮酸（pyruvic acid, PA）这两种α-羟基酸治疗寻常痤疮的疗效。本研究共纳入120名年轻女性受试者（平均年龄22岁），每两周开展一次化学剥脱治疗，总计6个疗程。其中一组（n=60，占比50%）接受壬二酸剥脱治疗，另一组则接受丙酮酸剥脱治疗。研究分别在治疗前后对受试者进行两次临床评估：采用赫勒格伦-文森特严重程度症状量表（Scale of Hellegren-Vincent Severity Symptoms, SHVSS）评估痤疮病情，并使用Nati分析仪（Nati Analyzer）检测皮肤状态参数，包括油性皮肤状态、脱屑情况、毛孔状况及皮肤含水量。剥脱治疗后的临床评估结果显示，壬二酸组与丙酮酸组的痤疮严重程度症状均降低了50%。同时，两组受试者的脱屑情况（p<0.05）与皮肤油脂分泌水平（p<0.001）均得到显著改善。其中，丙酮酸组在改善皮肤油脂分泌方面的效果优于壬二酸组（p<0.05）。综上，经过6次壬二酸或丙酮酸剥脱治疗后，所有受试者的皮肤油脂分泌与脱屑情况均得到显著改善。壬二酸与丙酮酸剥脱疗法均可作为轻度寻常痤疮的安全有效治疗方案，但在选择两种α-羟基酸疗法时，需综合考虑不良反应、皮肤基础状态及受试者的个人偏好。