Aplikasi pelembab salah satunya golongan humektan telah lama diketahui dapat

menurunkan TEWL.9 Humektan bekerja dengan cara mengikat air baik dari dermis ke
epidermis maupun dari lingkungan eksternal. Salah satu jenis humektan yang paling
banyak digunakan adalah kelompok alpha hydroxy acid (AHA).9 Alpha hydroxy acid
termasuk di dalamnya asam glikolat, asam laktat, asam sitrat dan asam malat telah lama
digunakan dalam bidang dermatologi sebagai moisturizer maupun tatalaksana pada akne,
mengurangi kerutan, melasma dan hiperpigmentasi.10 Efektifitas AHA dipengaruhi oleh
pH, konsentrasi dan waktu paparan. Alpha hydroxy acid pada konsentrasi yang tinggi
(>20%) sering digunakan sebagai agen peeling karena memiliki efek merusak ikatan
korneosit sedangkan pada konsentrasi yang rendah AHA memiliki efek sebagai
humektan.11,12

Based on the log regression test by Kligman (2), a clinical evaluation of the effects of 12% ammonium
lactate (pH 4.4) and 8% glycolic acid (partially neutralized at pH 4.4) was conducted in ten subjects
with moderate to severe ichthyosis/xerosis of the lower legs. Product treatment consisted of a
previous two-week rest period followed by three weeks of product applications (twice daily) with a
one-week recovery period. Acceptable levels of TEWL were observed, indicating little to no change in
the SC barrier function, as also shown histologically by the normalization of the classical SC basket
weave picture (3). In a meeting with the SCCNFP, CTFA provided data to demonstrate no
compromise in the skin barrier after either short or longer term skin applications of AHA, as
measured by TEWL. In all cases, it was demonstrated that AHA do not compromise the integrity of
the skin barrier (4-6).

Whilst the SCCNFP agreed previously that available data showed no increase in TEWL or dermal
penetration of reference compounds after long-term use of AHA (up to 10 % at pH 3.5), concerns
were raised over effects potentially occurring after short-term uses prior to adaptive changes of the
skin. Considering skin renewal rate, a maximum effect (if any) on skin barrier function should be
visible between 8-14 days.

Berardesca E, Distante F, Vignoli GP, Oresajo C, Green B (1997). Alpha hydroxy acids modulate
stratum corneum barrier function. Br J Dermatol 137: 934-938.

Low molecular substances in majority, with capability to attract water into stratum corneum. Frequently used
with other compounds which may retain the water content

Many humectants also possess emollient properties. Natural moisturizing factors, consist of
low molecular weight soluble hygroscopic substances mixture, play a major role for stratum
corneum hydration (for example: lactic acid, pyrolidone carboxylic acid, and amino acids).6
Humectants can also enhance trans-epidermal water loss by increasing water absorption from
dermis into epidermis, where it easily evaporates; therefore combination with occlusives is
frequently required to help enhancing epidermal barrier function and hydration.9 Honey,
sorbitol, glycerin, panthenol, urea, gelatin, hyaluronic acid, alpha hydroxy acids (glycolic
acid, lactic acid, sodium pyrrolidine, carboxylic acid), propylene glycol and butylene glycol
are examples of humectants.
Humectants, such as 10% urea, have been shown to reduce trans-epidermal water loss in atopic
patients.2 Urea also reduce skin irritation from sodium lauryl sulfate exposure in both atopic and
normal skin. In mouse models of atopic dermatitis, application of glycerin-based moisturizer
demonstrated a rapid hydration effect compared to untreated skin. 32 Alphahydroxy acids are also
effective treatment for dry skin. While lactic acid, particularly the L-isomer of lactic acid, stimulates
ceramide synthesis, resulting in a higher production of stratum corneum ceramide and promoting a
superior skin lipid barrier and dry skin resistance. 9
Purnamawati S, Indrastuti N, Danarti R, Saefudin T. The Role of Moisturizers in Addressing Various
Kinds of Dermatitis: A Review. Clin Med Res. 2017;15(3-4):75-87. doi:10.3121/cmr.2017.1363

epeated application of AHA

did not induce perturbation of the skin barrier, and
might therefore enhance skin resistance to irritant
substances. Our study also showed no increase and no
difference in TEWL between skin following the 2-week
AHA (5%, pH 3·8) application in hairless mice, and
skin with a vehicle-only application

In conclusion, our study showed functional and

morphological evidence that low concentrations of AHA
could improve the skin barrier by inducing enhanced
desquamation and increasing the number and secretion of LB without increasing TEWL; therefore, it may
be useful as a therapeutic agent for xerotic skin, hand
eczema, irritant contact dermatitis, atopic dermatitis
and ichthyosis

Kim, T-H & Choi, Eung Ho & Kang, YC & Lee, S & Ahn, S. (2001). The effects of topical α‐hydroxyacids
on the normal skin barrier of hairless mice. The British journal of dermatology. 144. 267-73.
10.1046/j.1365-2133.2001.04011.x.

Known beneficial effects of AHA (glycolic, lactic, gluconolactone) at low concentrations (4 to 8%)
include improvement in xerosis [24

The present study showed that a 4% glycolic acid formulation (pH 3.8), applied twice daily, neither
increases the TEWL values as an indicator of a barrier disruption as discussed previously [32] nor
decreases the thickness of the human SC