LAC-HYDRIN
Clinical safety rating: caution
Comprehensive clinical and safety monograph for LAC-HYDRIN (LAC-HYDRIN).
Lactic acid is a component of the natural moisturizing factor in the skin. It acts as a humectant, increasing water content in the stratum corneum, and promotes desquamation by reducing corneocyte cohesion through calcium ion chelation and protease activation.
| Metabolism | Topically applied lactic acid is metabolized systemically via the Cori cycle (lactic acid to glucose in the liver). |
| Excretion | Renal: <5% as unchanged lactic acid; biliary/fecal: negligible; metabolized to CO2 and water via the Cori cycle. |
| Half-life | Not applicable for topical route; systemic half-life of lactic acid is approximately 1.5 hours when absorbed, but clinical context irrelevant due to minimal systemic absorption. |
| Protein binding | Not applicable; lactic acid is a small molecule with negligible protein binding (<5%). |
| Volume of Distribution | Not clinically relevant due to topical administration; systemic Vd of lactate is ~0.5 L/kg. |
| Bioavailability | Topical: minimal systemic absorption (<5%); not administered orally for dermatologic use. |
| Onset of Action | Topical: improvement in skin hydration and scaling within 2-5 days of regular application. |
| Duration of Action | Topical: effect persists as long as regular application continues; cessation leads to return of xerotic condition within days. |
Apply a thin layer to affected areas twice daily (topical). For adult patients with xerosis or ichthyosis vulgaris, apply to dry, scaly skin and rub in thoroughly.
| Dosage form | LOTION |
| Renal impairment | No dose adjustment required for topical use; systemic absorption is minimal. For oral formulations (not applicable to LAC-HYDRIN), adjust based on GFR. |
| Liver impairment | No dose adjustment required for topical use; systemic absorption is minimal. For oral formulations (not applicable to LAC-HYDRIN), use with caution in severe hepatic impairment. |
| Pediatric use | Safety and efficacy in pediatric patients have not been established. Use only under physician supervision; apply sparingly to affected areas once or twice daily as directed. |
| Geriatric use | No specific dose adjustment required. Use caution in elderly patients with impaired skin barrier function; apply sparingly to avoid excessive irritation. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for LAC-HYDRIN (LAC-HYDRIN).
| Breastfeeding | It is not known whether ammonium lactate is excreted in human milk after topical application. Systemic absorption is minimal, but caution should be exercised. No M/P ratio available. |
| Teratogenic Risk | No adequate and well-controlled studies in pregnant women. Topical application of LAC-HYDRIN (ammonium lactate) is not expected to result in significant systemic absorption; however, animal reproduction studies have not been conducted. Use during pregnancy only if clearly needed. |
| Fetal Monitoring |
■ FDA Black Box Warning
None
| Serious Effects |
["Hypersensitivity to any component of the formulation."]
| Precautions | ["Avoid contact with eyes, lips, and mucous membranes.","May cause transient stinging or burning on application.","Not for use on open wounds or broken skin.","Use with caution in patients with impaired renal function due to potential lactic acidosis (rare)."] |
| Food/Dietary | No significant food interactions. May take without regard to meals. |
| Clinical Pearls |
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| No specific monitoring required beyond usual prenatal care. Observe for local skin reactions. |
| Fertility Effects | No studies on fertility effects have been reported. Systemic exposure is negligible; unlikely to impact fertility. |
| LAC-HYDRIN (ammonium lactate) 12% lotion/cream is a prescription emollient for xerosis and ichthyosis vulgaris. It combines lactic acid (an alpha-hydroxy acid) with ammonium hydroxide for pH balance. Avoid use on irritated, broken, or infected skin. Can cause transient stinging, especially on eczematous skin. Monitor for hyperkeratotic areas; use in conjunction with gentle keratolysis. Not recommended for use on face or intertriginous areas. In patients with sensitive skin, start with once-daily application and increase to twice daily as tolerated. Lactic acid absorbs UV light; advise sun protection if applying to exposed areas. |
| Patient Advice | Apply LAC-HYDRIN only to dry, intact skin; avoid cuts, scrapes, or rashes. · Use a thin layer twice daily or as directed; do not overapply. · You may feel mild stinging or burning initially; this usually decreases with continued use. · Avoid contact with eyes, mouth, and mucous membranes. · Use sunscreen daily if applying to sun-exposed skin, as lactic acid increases sensitivity to UV light. · Do not use on face or skin folds (armpits, groin) unless specifically instructed by your doctor. · If severe irritation, redness, or blistering occurs, stop use and contact your healthcare provider. · Keep tightly capped and store at room temperature. |