مندلیک اسید یک آلفا هیدروکسی اسید آروماتیک است. در آب نسبتاً محلول و در اتانول و ایزوپروپیل الکل کاملاً محلول است. از آنجایی که از هیدرولیز آمیگدالین (عصاره بادام تلخ) بدست میآید؛ نام آن از Mandel (بادام به زبان آلمانی) مشتق شده است. به شکل پودر کریسالی سفید رنگ بوده و همانطور که در شکل میبینید ساختار شیمیایی بزرگتری نسبت به گلیکولیک اسید داشته و دمای ذوب بالاتری نیز دارد.
در دهه اخیر تحقیقات گستردهای روی اثرات درمانی آن روی چین و چروکهای پوست ناشی از آفتاب، هایپرپیگمانتاسیونهای غیرطبیعی و آکنه انجام گرفته است به طوریکه آن را کاندید مناسبی برای جایگزینی گلیکولیک اسید معرفی نموده است.
مندلیک اسید خواص آنتی بیوتیکی نیز دارد درگذشته از آن به طور خوراکی در درمان عفونتهای مجاری ادراری استفاده میکردند. از همین اثرات آنتی بیوتیکی در درمان آکنه و پیشگیری از عفونتهای گرم منفی پس از لیزر درمانی استفاده میشود.
غلظتهای ۲ تا ۱۰ درصد مندلیک اسید به عنوان AHA (آلفا هیدروکسی اسید) کاربرد دارد. مزیت آن نسبت به گلیکولیک اسید که به طور معمول به عنوان AHA در محصولات کازمسیوتیک بکار میرود؛ اثرات ملایم تر و عوارض کمتر میباشد. فرآوردههای حاوی AHA در درمان افتادگی، خطوط و چین و چروکهای پوستی و همچنین در درمان هایپرپیگمانتاسیون پوست که اغلب خود را به شکل لکههای پوستی و لک و مک نشان میدهد؛ با خاصیت لایه برداری کاربرد دارند. AHA های مورد استفاده در فرآوردههای ضدچروک شامل لاکتیک اسید، سیتریک اسید، گلیکولیک اسید و مندلیک اسید میباشد. در این بین مندلیک اسید به دلیل اثرات لایه براداری ملایم و ایجاد تحریکات پوستی کمتر ارجحیت نسبی دارد.
برای لایه برداری سریع پوست یا Peeling معمولاً از غلظتهای ۲۵ تا ۷۰ درصد گلیکولیک اسید استفاده میشود. بر اساس مطالعاتی که اخیراً صورت گرفته مندلیک اسید وقتی با غلظت ۳۰تا۵۰ درصد برای Peeling بکار میرود؛ اثرات ملایم تری داشته و عوارضی که به شکل قرمزی و تحریک ایجاد میشود ملایمتر و قابل پیشبینیتر میباشد. کمتر سبب ایجاد تاول و سوختگی پوست شده و سلولهای اپیدرم رشد بهتری دارند.
مندلیک اسید با خواص دوگانه ضد میکروبی و لایه برداری در درمان آکنه کمک کننده است. در آکنه رزاسه و آکنه بزرگسالان کاربرد دارد. در آکنههای پاپولار و پوسچولاری که به درمانهای موضعی معمول مقاوم شدهاند؛ اثرات مطلوبی دارد. در لوسیونها و ژلهای پاککننده پوست برای برطرف کردن جوشهای سر سیاه در غلظت ۲ درصد بکار میرود.
پس از لیزر درمانی احتمال عفونت با باکتریهای گرم منفی وجود دارد. نشان داده شده که مصرف مندلیک اسید ۲تا ۴ هفته قبل از درمان با لیزر ریسک این عفونتهای گرم منفی را کاهش داده و اریتم و تحریک کمتری را سبب میگردد.
ملاسما به تغییرات رنگ پوست اطلاق میشود که در شرایطی همچون بارداری، شیردهی،تغییرات هورمونی، افزایش سن و مصرف داروهای ضدبارداری و برخی داروهای ضدتشنج در نواحی از پوست که در معرض نور آفتاب است، رخ میدهد. این تغییر رنگ معمولاً به شکل لکههای پوست و کک و مک بروز میکند. ملاسما یک مشکل شایع است بطوری که در ۱۰ درصد از زنان باردار دیده میشود. درمانهای مختلفی برای آن توصیه میگردد مانند مصرف محصولات حاوی هیدروکینون، ترتینوئین، گلابریدین، عصارههای گیاهی روشن کننده و غیره
معمولاً درمان ملاسما طولانی مدت بوده و چندین دارو و فرآورده پوستی به کار میرود. یکی از مهمترین این درمانها مصرف طولانی مدت فرآوردههای حاوی AHA است. کاربرد مندلیک اسید به طور تنها یا همراه با داروهای روشن کننده و ضد لک دیگر مثل کوجیک اسید و هیدروکینون در درمان ملاسما بخصوص در افرادی که دارای پوستهای حساس و نازک میباشند؛ ایدهآل است. در یک مطالعه مشاهده شده مندلیک اسید با غلظت ۱۰ درصد در طول مدت ۶ ماه روی ملاسما مقاوم به درمانهای دیگر، موثر بوده است. البته در طول درمان با هر داروی ضد لک و لایه بردار دیگر اعم از مندلیک اسید باید حفاظت در برابر نور خورشید مورد توجه ویژه قرار گیرد. درمان لکها و چین و چروکهای پوست بدون توجه به اثرات مضر نور خورشید امکانپذیر نخواهد بود. این حفاظت شامل خودداری از قرار گیری جلوی نور آفتاب در ساعات ۱۰ تا ۱۶ بخصوص در فصول بهار و تابستان و استفاده از ضد آفتابها متناسب با نوع پوست میباشد. بنابراین در طول زمان مصرف مندلیک اسید حتماً توصیه میشود که در طول روز از ضد آفتاب مناسب استفاده شود تا از هایپر پیگمانتاسیون ثانویه (تیرگی پوست مجدد بعد از استفاده از ضد لکها و لایه بردارها) ممانعت گردد.
بنابراین مندلیک اسید را میتوان یک AHA نسبتاً نوظهور با عوارض کمتر و ایمنی بیشتر نسبت به مشتقات ترتینوئین نامید که میتوان آن را محصولات کارخانهای و فرآوردههای ترکیبی در داروخانهها در درمان کمکی آکنه، پیرپوستی، افتادگی و چروک پوست، لیزر درمانی و ملاسما بکار رود.
منابع:
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Garg VK, Sinha S, Sarkar R.”Glycolic acid peels versus salicylic-mandelic acid peels in active acne vulgaris and post-acne scarring and hyperpigmentation: a comparative study.”Dermatol Surg. ۲۰۰۹ Jan;35(1):59-65. Epub 2008 Dec 8.
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Mandelic Acid: A Revolution in Skin Care.skincarerx.org/rx_article.html
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Roan AM. “The chemistry of alpha-hydroxy acids” Cosmet dermatol. ۱۹۹۴;۷ (suppl 10):4.
-
Taylor MB. “Summary of Mandelic Acid for the Improvement of Skin Conditions” www.nucelle.com/article.pdf
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