Date of Award

2014

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department Chair

John Cavenagh, PhD, PA-C

Abstract

OBJECTIVE: The objective of this selective EMB review is to determine whether or not the use of glycolic acid is effective in the treatment of inflammatory and non-inflammatory acne.

STUDY DESIGN: The review of three randomized, double-blind, controlled trials all published in English language between the years of 2008-2010.

DATA SOURCES: Three randomized, double-blind, controlled trails comparing glycolic acid to a visually matched placebo or pharmaceutical therapy in improvement of acne. All articles were found using PubMed and EBSCO.

OUTCOMES MEASURED: The improvement of inflammatory and non-inflammatory acne and tolerance/ safety of the intervention. Efficacy was measure via patients’ preference/ assessment, Wilcoxon signed rank test, number of lesions, and Paired T-Test.

RESULTS: Abels demonstrated a significant improvement in the appearance of acne with monotherapy of oil-in-water emulsion and 10% glycolic acid verum. The patient and physician subjects’ evaluations indicated the verum was both well tolerated and efficacious. The report showed no statistically significant difference between verum and placebo of oil-in-water emulsion without glycolic acid in reported adverse effects. I-LKNUR established a statistically significant decrease in the number of non-inflamed and inflamed lesions with glycolic acid peel. When compared to the amino acid fruit placebo peel, the report detailed a non-significant difference in improvement of non-inflamed and inflamed lesions. Kessler demonstrated glycolic acid peels as well as the visually matched therapy salicylic acid peels were significantly effective by the second treatment. Additionally, the differences in effectiveness between the two peels were found to be non-significant. The report detailed more adverse events reported with the glycolic acid peel.

CONCLUSIONS: The results of these three studies show conclusive evidence that the use of glycolic acid is effective in the treatment of acne. Each study demonstrated both a significant quantitative and qualitative improvement. Varying reports of tolerability and adverse effects are possibly due to differing preparations and applications between studies. Most commonly these included reports of desquamation and erythema. The results do not encourage future research since no significant efficacy was found between glycolic acid and the comparable placebo or pharmaceutical therapy.

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