Aprile Vol.2 N° 1 - 2006 - Salute per tutti

Figure 1a.
Patient with mild papulopustular
acne before
treatment.
Figure 1b.
The same patient
showed a complete
remission of cutaneous
lesions after treatment
with pyruvic acid.
Although pyruvic acid vapours are non-toxic,
they are pungent and can irritate the lining of
the upper respiratory tract and ocular mucosae.
To avoid irritation, the chemical peeling procedure
should be performed in a well-ventilated
area, and patients must be instructed to keep
eyes closed during the whole procedure.
atients and Methods
P
Papulo-pustular acne
Peeling with pyruvic acid is very effective in the
treatment of patients with mild to moderate
papulo-pustular acne (Figure 1), used either
alone or in association with traditional therapies.
The efficacy of pyruvic acid is essentially
due to its keratolytic effects, associated with a
high capacity to penetrate into sebaceous
glands, with a sebostatic and antimicrobic
action. In a recent study, we demonstrated a
good improvement in cutaneous lesions of
patients with papulo-pustular acne treated with
pyruvic acid. In addition, in these patients we
observed an important decrease of seborrhoea
after peeling treatment, without a simultaneous
reduction of cutaneous hydration (1). The
reduction of seborrhoea is important in the
treatment of acneic patients, because it results
in evident improvement in the oily skin that is
characteristic of these patients. The simultaneous
lack of reduction in cutaneous hydration
differentiates pyruvic acid from other peeling
1a. 1b.
The use of chemical peeling with pyruvic acid in the treatment of different dermatological diseases
agents, such as salicylic acid, that cause dryness
and desquamation of the treated areas (10).
Patients with acne are generally treated with
medium concentrations of pyruvic acid: 40%
strong or 50%, based on skin reactivity, with
medium times of application (2-4 minutes).
During peeling, in sites of acneic lesions it can
be observed the quick onset of white frost, that
indicates dermo-epidermal separation. This
event should be considered perfectly normal
and favours a rapid improvement of cutaneous
lesions. Treatments can be repeated every two
weeks and during the intervals patients can use
specific local therapies.
Acne scars
Acne scars and other kind of superficial skin
scars can be treated with pyruvic acid. In these
patients the aim of peeling is to obtain a keratolityc
effect, associated with a stimulation of an
increased production of collagen, elastic fibres
and glycoproteins. For this reason, acne scars
are generally treated with medium-high concentrations
of pyruvic acid (50-60%) and
longer times of application (4-5 minutes). In
fact, dermoplastic properties of pyruvic acid are
more evident using higher concentrations.
Based on the high concentrations employed,
generally peeling are repeated every 3-4 weeks.
Seborrhoeic dermatitis
Recently, the use of pyruvic acid has been proposed
also in patients with mild to moderate seborrhoeic
Journal of Plastic Dermatology 2006; 2, 1
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