Benefits and Risks of Mandelic Acid
By: Amy Niu
What is mandelic acid?
Mandelic acid is an alpha-hydroxy acid with a history of use in medicine due to its antibacterial properties [1]. Alpha-hydroxy acids like mandelic acid, salicylic acid and glycolic acid have been studied extensively for their potential to treat acne [2]. Mandelic acid in particular is derived from a compound called amygdalin, which is found in peaches, apricots and bitter almonds [3]. Sarkar et al. (2019) write, “Mandelic acid is one of the largest alpha hydroxy acid peels and penetrates the skin slowly and uniformly, making it an ideal peeling agent of choice in sensitive skin.” Rangarajaiah et al. (2023) note that mandelic acid can also be used to treat oily skin and skin that is prone to acne because it is more lipophilic than other alpha-hydroxy acids that are soluble in water.
Benefits associated with mandelic acid
According to Egner et al. (2023), mandelic acid has been studied for its antimicrobial activity and its uses in preventing skin issues such as acne and wrinkles. Mandelic acid, Egner et. al (2023) write, “acts as an antiseptic against various microbial pathogens such as Staphylococcus aureus, E. coli, Proteus sp., Pseudomonas sp.” Egner et al. (2023) prepared a hand sanitizing gel with mandelic acid and essential oils as an alternative to alcohol-based hand sanitizers, as frequent use of alcohol-based sanitizers can lead to skin irritation. The researchers note that the antimicrobial effects of mandelic acid depended on the concentration of it present in the sanitizing gel, and a 10% concentration “showed significant antimicrobial activity against all tested microorganisms,” including E. coli, which affects the digestive and urinary tracts, and S. aureus, which can cause skin infections [1]. In addition, mandelic acid enhanced the antimicrobial activity of prepared gels when it was added to them [1].
Egner et al. (2023) note that mandelic acid could be an effective treatment against bacterial skin infections — especially methicillin-resistant S. aureus, which represents significant mortality and morbidity rates in hospitals worldwide.
Mandelic acid can also be used in the treatment of acne, particularly for those with sensitive skin. Sarkar et al. (2019) compared the effectiveness of three different chemical facial peels in treating acne during the 12 week experimental period: one made with 35% glycolic acid, another composed of 20% salicylic acid and 10% mandelic acid and a final peel composed of phytic acid. The researchers noted statistically significant improvement (70.9%) in the experimental subjects’ pustules at 6 weeks after treatment with the salicylic acid and mandelic acid peel [2]. Additionally, the researchers noticed a statistically significant improvement in comedones at 62.4% 4 weeks after the treatment [2]. A statistically significant reduction in pustular lesions (95.84%) was noted after a single peel session for the salicylic acid/mandelic acid peel [2]. At the end of the treatment session, the researchers noticed a 74.14% reduction in acne score at the end of 12 weeks for the salicylic acid/mandelic acid peel, with statistically significant improvement at 2 weeks onward [2]. The baseline percentage of hyperpigmentation was 17.16% for the salicylic acid/mandelic acid peel and the post-treatment percentage was 3.1% [2]. Mandelic acid, Sarkar et al. (2019) write, has the added benefit of evening out skin pigmentation.
Overall, Sarkar et al. (2019) showed improvement for acne and hyperpigmentation upon treatment with a chemical facial peel composed of 20% salicylic acid and 10% mandelic acid, which holds implications for the use of mandelic acid on sensitive skin types and on individuals with darker skin hues [2]. It is important to note that all of Sarkar et al. (2019)’s experimental subjects were of Asian descent, as they note there is a lack of comparative studies on the effectiveness of chemical facial peels on Asian populations, so the results are only generalizable to individuals of Asian descent [2].
Risks associated with mandelic acid
Sarkar et al. (2019) write, “Overall, two patients (13.3%) in the glycolic acid and salicylic acid groups, respectively, reported burning, whereas none in the phytic acid group reported any burning sensation. One patient (6.7%) in the salicylic acid group reported postprocedural erythema that subsided within 2 days after prescribing a moisturizer.” Because the salicylic acid group in this experiment was the group treated with facial peels composed of 20% salicylic acid and 10% mandelic acid, it is possible that the burning sensation and postprocedural erythema are associated with mandelic acid, albeit the chances of experiencing such side effects are rare, as evidenced by the results of Sarkar et al. (2019).
Rangarajaiah et al. (2023) examined the side effects of 40% lactic acid chemical facial peels versus 40% mandelic acid peels in the treatment of periorbital melanosis. Every two weeks for three months, patients underwent a 40% lactic acid peel on the left side of their faces and a 40% mandelic acid peel on the right side [3]. The researchers report that 36.7% of the 30 patients in the study experienced a mild burning sensation on the side of their faces treated with mandelic acid, and 10% experienced severe burning. Burning sensations subsided a few minutes after treatment [3]. Additionally, 10% of patients experienced dryness as a side effect, one which decreased with the use of emollients [3].
Though mandelic acid is one of the alpha-hydroxy acids that is gentler on skin, individuals who are considering using mandelic acid facial peels or other products that include mandelic acid should be aware of the side effects associated with it.
Sources:
1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9961504/
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6785964/
[3]https://www.jcdronline.org/admin/Uploads/Files/64f59dbfe2b010.29343138.pdf
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