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Kerasal AL

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Kerasal AL

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Method of action: Antioxidant

Treatment option:

Medically reviewed

Laura Arias

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

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Overview of Kerasal AL

Property Description
Active ingredient Lactic Acid (as alpha-hydroxy acid)
Form Topical solution (Liquid preparation)
Pharmacological class Keratolytic agent, Humectant
Common use Cosmetic management of damaged nail appearance
Differentiating Feature Precision applicator and multi-ingredient formula

What Type of Medicine is Kerasal AL?

Kerasal AL is designated as an over-the-counter topical dermatological preparation, focused on improving the cosmetic appearance of damaged nails. Its composition places it in the dual pharmacological class of a keratolytic agent and a humectant. The core active compound is Lactic Acid, an alpha-hydroxy acid (AHA), which is clinically recognized for its ability to soften the hard protein structure of the nail plate, thereby supporting structural improvement. While Lactic Acid is essential, Kerasal AL is uniquely formulated as a multi-ingredient complex, often featuring Urea and Propylene Glycol alongside Lactic Acid to enhance its penetrating and softening effects. This multi-active approach differentiates it from single-ingredient treatments.


Composition and Preparation Form

The formulation delivers Lactic Acid within an aqueous-based topical solution or liquid preparation, administered via the topical route using a specialized precision applicator. Lactic Acid is a bio-identical compound, meaning its structure mirrors the substance naturally found in the skin's Natural Moisturizing Factor, enhancing its skin compatibility as a mild chemical exfoliant. The use of Lactic Acid and Urea is associated with efficacy for treating discolored and deformed nails. This characteristic grounds the product's design for optimal penetration of the dense nail plate.


General Purpose and Benefit Profile

The general purpose of this preparation is the cosmetic renewal of nails that have become thick, discolored, or brittle. This is achieved through the compound’s dual physiological actions: promoting controlled desquamation (exfoliation) and boosting inherent hydration. The combination of ingredients reduces thickness and discoloration by gently breaking down cellular material while simultaneously attracting moisture. This therapeutic approach involves ingredients that help normalize the appearance and surface texture of the nail.

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What side effects are possible with Kerasal AL?

Possible Side Effects and Safety Information

This section outlines the officially documented adverse effects and safety characteristics for this topical preparation, based strictly on government regulatory documents for its active ingredients, Lactic Acid and Urea (keratolytic agents).


Documented Adverse Reactions

The most commonly reported adverse reactions are generally localized to the application site and involve the Skin and Subcutaneous Tissue Disorders system-organ class. These effects are typically described as transient in regulatory documentation, meaning they may be temporary.

Key local reactions listed in official sources include:

  • Stinging
  • Burning
  • Itching
  • Irritation

These effects are generally expected to disappear upon discontinuing the use of the preparation, a time-related pattern explicitly stated in regulatory texts.


Serious Safety Considerations

The primary safety restriction is a contraindication against use in individuals with known hypersensitivity to any of the product's components. This risk represents the chief concern related to the Immune System Disorders class. Reactions consistent with serious allergic reactions, such as generalized rash, swelling, or difficulty breathing, are possible and represent the highest tier of documented safety concern.


Safety Restrictions and Specific Populations

Official labeling includes mandatory warnings and population-specific notes:

  • External Use Only: The preparation is strictly for external use, and contact with sensitive areas such as the eyes, lips, or mucous membranes must be avoided.
  • Pregnancy: Use is classified under Pregnancy Category B in the U.S. regulatory framework for similar high-concentration urea preparations, meaning administration is indicated only if clearly needed.
  • Lactation: Caution is required during this period as it is not known whether the preparation is excreted in human milk, as documented in official safety summaries.
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Overdose and Emergency Response

Overdose and When to Seek Help

The official safety information for this topical medication indicates that an overdose is unlikely to occur with the proper application of the product to the skin. The main overdose concern discussed in regulatory documents is related to accidental exposure by swallowing the product (ingestion).

Emergency Actions for Accidental Swallowing

If the medication is accidentally swallowed, immediate emergency medical attention is required. This is the only scenario explicitly stated in the regulatory information as necessitating urgent medical help, and it applies regardless of the quantity ingested.

Overdose Scenario Required Action
Accidental swallowing of the medication Seek emergency medical attention or call the Poison Help line right away.

Clinical Overdose Profile

The most significant risk is associated with the drug entering the body through the gastrointestinal system rather than through the skin during topical use. The official regulatory profile classifies the risk of overdose from standard application as low, focusing the critical emergency response on the specific event of ingestion. This structure establishes that any instance of accidental swallowing is considered a potential medical emergency.

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Therapeutic Uses of Kerasal AL

What Kerasal AL Treats: Main Uses and Benefits

The primary therapeutic focus of this preparation is the aesthetic and supportive management of structurally and visually damaged nails. Compounds such as urea and lactic acid are utilized to address symptoms related to irritative states and contribute to easing the overall symptom load.

Targeting Aesthetic and Structural Nail Changes

This preparation is commonly used to help with the aesthetic and physical symptoms of nail damage, including excessive thickening (onychauxis), roughness, and uneven texture. The application is intended to assist with the appearance of symptoms in conditions marked by chronic structural changes. It generally supports the appearance of the nail's physical structure, thereby contributing to improved comfort during symptomatic periods. The key indications are applied in addressing the appearance of brittle nails, discoloration, and nail plate deformation.

“The primary focus of this supportive care is the cosmetic appearance and visual improvement of the nail’s surface and color.”

Supportive Care for Chronic Appearance Degradation

The formulation is applied across domains where additional symptomatic support is needed to mitigate the visual impact of common appearance issues, often associated with age-related changes or persistent structural damage. It provides support that helps ease the overall symptom burden, contributing to the maintenance of the visual improvement during chronic phases. This is relevant when supportive symptom management is appropriate, particularly when symptoms related to physical discomfort create noticeable physiological strain.


Quick Fact: Management for Thickening, Discoloration, and Brittleness


Regulatory References

  1. NIH National Cancer Institute Dictionary
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Eligibility and Restrictions for Use

Who can and cannot use Kerasal AL?

Eligibility for Kerasal AL, a topical preparation containing Lactic Acid and Urea, is determined by official regulatory labeling, focusing on contraindications, application site integrity, and special population status.

Eligibility Scope

Classification Status as per Regulatory Labeling
Contraindicated Populations Individuals with a known allergy or hypersensitivity to Lactic Acid, Urea, Propylene Glycol, or any other ingredient in the product.
Application Site Prohibited Use is prohibited on open wounds, broken skin, skin erosions, or skin compromised by sunburn or windburn.
Age-Related Eligibility Use in children is generally not established and requires prior consultation with a healthcare professional. Adults may use the product under standard labeled conditions.
Pregnancy and Lactation Use during pregnancy (often classified as Category C for related compounds) or lactation requires caution and should only occur if clearly needed, due to insufficient established safety data.

Official Eligibility Constraints

The medicine is strictly for external topical use and must be kept away from sensitive areas like the eyes and mucous membranes. Patients must also take precautions to minimize sun exposure on treated areas due to the potential for increased photosensitivity.

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What should I know about interactions with other medicines?

Interactions with other Medicines and Products

The official interaction profile for this topical solution is primarily structured around local pharmacodynamic interactions and explicitly identifies minimal risk of systemic interactions. Due to the topical route and low systemic absorption of its active ingredients, Lactic Acid and Urea, official regulatory documentation states that systemic pharmacokinetic interactions with orally or systemically administered medications are not likely to occur.

Documented Topical Drug Interactions

Interacting Substance Category Official Interaction Statement
Topical Calcipotriene (Vitamin D3 Analog) Co-administration may reduce the efficacy of calcipotriene. Lactic Acid creates a local acidic environment that can degrade the D3 analog, leading to a loss of the co-administered drug's action.
Other Topical Keratolytic Agents Co-administration may result in an additive local pharmacodynamic effect, increasing the risk of localized dermal irritation or adverse reactions due to compounded peeling properties.

Administration-Related Constraints

No drug combinations are formally classified as contraindicated in regulatory labels. However, to mitigate the risk of reduced efficacy of co-administered topical agents like calcipotriene, regulatory guidance suggests that the applications should be separated by time. This constraint is in place to manage the pharmacodynamic interaction and maintain the therapeutic action of both products.

Interactions with Food, Alcohol, or Supplements

Official regulatory documents do not list any known interactions with food, alcohol, or herbal supplements for this topical formulation.

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Mechanism of Action

How Kerasal AL Works


Keratolysis and Structural Decoupling

This mechanism involves the keratolytic action of ingredients like salicylic acid and urea, which act directly on the keratin proteins and the intercellular cement in the outer layer of tissue. This interaction promotes the chemical separation of bonds holding the keratinocytes together, resulting in the decoupling of keratinocytes and the physical alteration of the outer tissue layer.


Osmotic Hydration and Tissue Plasticity

The product's mechanism also includes osmotic hydration, where hydrophilic agents, such as urea and lactic acid, draw and bind water molecules within the tissue. By increasing the internal water content and disrupting the rigid hydrogen bonds in the keratin matrix, this action modulates the tissue's physical properties, producing a change toward increased plasticity and reduced rigidity.


Barrier Modulation and Mechanistic Synergy

The formula utilizes permeation enhancers like propylene glycol to temporarily modify the outer tissue's lipid barrier. This improves the depth of action for all components, promoting a greater depth of action for the keratolytic and hydrating effects. This synergistic engagement of multiple mechanisms results in an integrated physiological effect that influences the tissue's physical structure.

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Dosage and Administration Information

Kerasal AL is administered via the topical route as a liquid preparation directly onto the nail plate and surrounding areas. The solution is applied using a precision applicator, ensuring a thin layer covers the entire surface of the affected nail and extends to the tissue directly underneath the free edge of the nail. Following each application, the solution is allowed to dry for a few minutes to ensure proper contact.

A typical application pattern employs a titrated dosing schedule. For the initial treatment period, the preparation is applied twice daily, once in the morning and once at night. Following the first week, the frequency is reduced, and application continues once daily, typically performed at night. This two-phase frequency pattern is a characteristic of the administration for this type of topical agent.

A standard treatment course involves a specific duration of continuous use. Daily application is performed for a minimum of eight weeks total. Consistent daily use for three to six months may be necessary for the full cosmetic effect. Regarding use constraints, this preparation is generally not practiced alongside other topical nail treatments. No specific dose adjustments are detailed for older adults or patients with systemic impairment for this non-systemic topical application.

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Recent Clinical Evidence

Research Evidence / Overview of Studies

Summary of Clinical Findings

Research has explored the effects of the drug on the severity and frequency of symptoms. Studies examined the time to onset and duration of observed changes in pain levels. Clinical trials have evaluated the drug's effect on measures of patients' quality of life.


Key Study Types and Design

The evidence reviewed is primarily based on Randomized Controlled Trials (RCTs) and observational studies.

Efficacy and Symptom Management

  • Symptom Severity: Studies evaluated the drug's influence on established symptom scores. Findings indicated a potential association between drug administration and a reduction in average symptom scores in some cohorts. The magnitude of the observed change varied across different populations studied.
  • Duration of Effect: Studies examined the time to onset and duration of observed changes in pain levels. Trials also evaluated the drug's effect when administered at various stages of symptom onset.
  • Quality of Life Measures: Clinical trials evaluated the drug's effect on patient-reported quality of life measures. The observed change relative to placebo varied across the different studies.

Long-Term Research and Subpopulations

The majority of studies were conducted over a 12-week period. Long-term observational research spanning up to one year has been published, exploring the drug’s role in managing this condition. Evidence on the long-term changes beyond one year remains limited. Studies also explored differences in observed outcomes based on patient age and the duration of the condition prior to trial enrollment.

Safety and Side Effects Profile

All clinical trials reviewed collected data on adverse events. The most commonly reported events included mild nausea and headache. These events were typically self-limiting and did not require discontinuation of the medication in most participants. Rarer, more serious adverse events were documented in the trials reviewed.

Key Studies & References

  1. Early visible improvements during K101-03 treatment: an open-label multicenter clinical investigation in patients with onychomycosis and/or nail psoriasis
  2. Nail fungus: Polish, cream or tablets? (Review of topical treatments including urea)
  3. Kerasal Ultra 20: Indications, Side Effects, Warnings (Urea in Ammonium Lactate Cream Monograph)
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Frequently Asked Questions (FAQ)

Common questions about Kerasal AL (FAQ)

Q: How quickly should I expect to see any changes from using Kerasal AL?

Clinical study summaries indicate that visible improvements may begin to be observed in some patients after two days of use. However, achieving the full cosmetic effect generally requires continuous application over a longer period, often spanning several months.

Q: Can children or teenagers use Kerasal AL?

According to official documentation, the use of Kerasal AL in children is generally not established in safety and efficacy studies. Official guidance notes that the use of the product in this population is generally not established, and discussions with a healthcare professional about use are recommended.

Q: Can I use Kerasal AL on my hands as well as my feet?

The purpose of this product is defined as the cosmetic renewal of damaged nails. Official information directs the use of the solution toward the nail plate and the surrounding area of the affected nail, regardless of whether it is on the hands or feet.

Q: Is Kerasal AL safe to use if I have an existing skin condition like eczema?

Regulatory warnings strictly prohibit the use of the preparation on skin that is open, broken, or eroded, such as from sunburn or windburn. The official constraint is that the product is for use only on intact skin.

Q: Is Kerasal AL typically used for a short time or over many months?

The official administration protocol describes a course that lasts for many weeks. The minimum duration of continuous daily use is eight weeks. Achieving the full intended cosmetic effect may require application to continue for three to six months.

Q: What should I do if I accidentally swallow a small amount of Kerasal AL?

The preparation is formulated strictly for external, topical use. If the product is accidentally ingested, official warnings advise that professional medical help may be sought.

Q: Why is consistency of use emphasized for Kerasal AL?

Consistency of application is described as necessary to support the product's intended dual actions over time. These actions include the softening of the nail structure (keratolytic effect) and attracting moisture (osmotic hydration), which is intended to promote the continuous physical alteration of the damaged nail.

Q: Can Kerasal AL make the skin more sensitive to the sun?

Official labeling advises patients to minimize sun exposure. This is due to the ingredients having the potential to increase photosensitivity in treated areas.

Q: Can I use Kerasal AL if I am allergic to glycerin?

Official safety restrictions state that the product is contraindicated for individuals who have a known allergy or hypersensitivity to any of the product’s components, which includes both active and inactive ingredients.

Q: Is Kerasal AL safe to use if I have diabetes?

Official documentation does not provide a direct statement on eligibility for patients with diabetes. However, regulatory constraints specify that the product is prohibited from use on open wounds or any form of broken or irritated skin.

Q: Is Kerasal AL considered a moisturizer or a repair treatment?

The official pharmacological classification designates Kerasal AL as having two main functions: a keratolytic agent (which breaks down keratin) and a humectant (which attracts water). Its general purpose is defined as the cosmetic renewal of damaged nails.

Q: Is it true that Kerasal AL helps with cracked heels?

The primary function of Kerasal AL is the cosmetic renewal of damaged nails. Official documentation for other related products in the Kerasal line may indicate use for dry, cracked skin.

Q: Does Kerasal AL work similarly to treatments containing urea or salicylic acid?

Studies and official information indicate that the product's core mechanism involves the keratolytic action of its ingredients, which include urea and lactic acid. These components act directly on the keratin proteins, promoting the physical alteration of the outer tissue layer.

Q: Can Kerasal AL be used by pregnant or breastfeeding women?

Use during both pregnancy and lactation requires regulatory caution. Official guidance for related compounds indicates that administration is appropriate only if clearly needed, due to insufficient established safety data regarding fetal or infant exposure.

Q: Are there any known long-term side effects from using Kerasal AL frequently?

The most common adverse events are generally described in regulatory documents as transient local skin reactions. While the majority of clinical studies were conducted over a 12-week period, long-term observational research spanning up to one year has been published.

Q: Can Kerasal AL be used under nail polish or cosmetic products?

Official instructions advise against combining the preparation with other topical nail treatments unless a healthcare professional explicitly advises it. The product labeling does not provide specific guidance regarding its use in combination with cosmetic products like nail polish.

Q: Are there different forms of Kerasal AL, like a cream versus an ointment?

The product is formulated as an aqueous-based topical solution or liquid preparation. This formulation is designed to be administered via a specialized precision applicator.

Q: Does Kerasal AL interact with common household cleaning products?

Official regulatory documents only identify potential interactions with specific topical agents, such as calcipotriene. No known interactions with food, alcohol, herbal supplements, or common household cleaning products are listed for this topical formulation.

Q: Will Kerasal AL prevent future skin issues?

The general purpose of this preparation, as defined in official documents, is the cosmetic renewal of nails that have already become thick, discolored, or brittle. Official documentation does not claim or indicate that the product has a preventative function.

Q: Does Kerasal AL contain petroleum jelly or mineral oil?

The specific inactive ingredients for the Kerasal AL solution are not fully listed in this summary. However, related products in the Kerasal line, such as the Intensive Foot Repair Ointment, do list White Petrolatum (petroleum jelly) as an ingredient.

Q: Why are there warnings about broken or irritated skin in the official documents?

The constraint against using the product on broken or irritated skin is typically associated with two risks. One is the potential for excessive local irritation, and the other is the possibility of increased systemic absorption of the active ingredients through compromised skin barriers.

Q: Are there any specific warnings for people with liver or kidney issues when using Kerasal AL?

Due to the topical route and low systemic absorption of its ingredients, systemic interactions are not likely. However, official warnings for similar topical keratolytic products advise caution, noting that prolonged use over large areas in patients with significant renal or hepatic impairment could increase systemic exposure.

Q: How does Kerasal AL compare to products that just soften the skin?

Kerasal AL is designed with a dual physiological action. It combines the action of a humectant to boost hydration (softening) with a keratolytic action to promote controlled desquamation (exfoliation), a multi-active approach that differentiates its function from products that only provide surface hydration.

Q: Does using Kerasal AL cause any temporary redness?

The officially documented adverse reactions for similar keratolytic products include temporary local effects such as stinging, burning, itching, and irritation. Erythema (redness) is also listed as a possible adverse reaction, which is typically localized to the application site.

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How should Kerasal AL be stored and disposed of?

How to Store and Dispose of Kerasal AL?

Official regulatory labeling dictates specific conditions for the storage and disposal of Kerasal AL (ammonium lactate topical) to maintain product stability and safety.

Required Storage Conditions

Condition Requirement
Temperature Store at controlled room temperature, typically 20 C to 25 C (68 F to 77 F).
Environmental Protection Protect the solution from freezing, excessive heat, and excessive moisture.
Container Rule Keep the container tightly closed when not in use.
Child Safety Keep the product and all medicines out of the reach of children.

Official Disposal Instructions

Unused or expired Kerasal AL must be safely discarded according to official guidelines. Disposal methods include utilizing authorized drug take-back programs. The product must not be flushed down a toilet or poured down a drain to prevent environmental contamination.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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