title: An Evaluation of Efficacy and Tolerability of Novel Enzyme Exfoliation Versus Glycolic Acid in Photodamage Treatment.
abstract: BACKGROUND
  Glycolic acid acts by chemical destruction of adhesions between skin cells to exfoliate superficial skin layers and excess pigmentation. It is well known to improve the appearance of photoaged skin, but is associated with varying degrees of skin irritation. Hydrolyzed salmon roe proteins destroy cell adhesions enzymatically with potentially less irritation than acid treatments. This double-blind prospective study assesses the efficacy and tolerability of hydrolyzed roe versus glycolic acid, and glycolic acid with citric acid.
  
  
  METHODS
  75 female subjects with mild to moderate photodamage, all skin types, and ages 31-70 years, were enrolled. In this 12 week study of twice daily self-treatments, patients were assigned to one of 3 groups; Group 1 (n-19) was assigned hydrolyzed roe cream, Group 2 (n=17), 4% glycolic acid, or Group 3 (n-16), 8% glycolic acid plus 2% citric acid. All patients used the same mild face wash and SPF 30 sunscreen throughout the study. Patients were evaluated at weeks 0, 8 and 12 for objective and subjective tolerability, improvement in photodamage by VISIA Complexion Analysis, modified Packman and Gans method, Visual Analog Scale (VAS), and answered an opinion questionnaire.
  
  
  RESULTS
  Group 1 improved in skin clarity from a VAS 44.1 to 55.7 (P=0.0317) at week 12. VISIA mean scores correlated with office evaluation showing improvement in brown spots from 453 to 417 (P = 0.0115) at 12 weeks. Group 2 improved in superficial fine lines at week 8 (-5.9, P=0.0428) and week 12 (-9.1, P=0.0019). Group 3 improved at week 12 in skin clarity (11.5, P = 0.0469) and skin roughness (-13.3, P = 0.0426), and in hyperpigmentation at week 8 (-9.4, P = 0.0462) and week 12 (-14.6, P= 0.0019).
  
  
  CONCLUSIONS
  Topical hydrolyzed roe protein used twice daily improves skin clarity. It has good tolerability with fewer instances of stinging and burning than the other glycolic acid containing creams. Patient's opinions of the 3 products were similar.
authors.forename: Maria
authors.initials: M
authors.lastname: Mekas
authors.forename: Jennifer
authors.initials: J
authors.lastname: Chwalek
authors.forename: Jennifer
authors.initials: J
authors.lastname: MacGregor
authors.forename: Anne
authors.initials: A
authors.lastname: Chapas
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D000818:Animals; D019343:Citric Acid / Q000008:administration & dosage / Q000009:adverse effects; D003879:Dermatologic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D004527:Egg Proteins / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006016:Glycolates / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D017495:Hyperpigmentation / Q000188:drug therapy; D008875:Middle Aged; D011446:Prospective Studies; D012474:Salmon; D015595:Skin Aging / Q000187:drug effects*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D003879:Dermatologic Agents; D004527:Egg Proteins; D006016:Glycolates; C031149:glycolic acid; D019343:Citric Acid