Overview

Malic acid is available over-the-counter in skin care products, oral sprays, and as a dietary supplement. These products are used for many reasons, but their benefits for most uses are not well defined. Applying malic acid to the skin may cause mild irritation. But there is not enough research to know what side effects may be caused by malic acid supplements or oral sprays. Before using these products, tell your health care provider about any health conditions you have or medicines you are taking.

Uses

What is malic acid used for?

Malic acid is used in many different forms for various reasons. It is sometimes applied topically to improve the health and appearance of the skin. It is also used as an oral spray to help with dry mouth (xerostomia). Malic acid supplements are taken by mouth for various reasons, including fibromyalgia and kidney stones. But the benefits of malic acid for any use are not well defined.

Note: Malic acid is generally recognized as safe (GRAS) by the FDA for use in foods, except for those that are intended for infants. Learn more about GRAS status here. The FDA has not reviewed malic acid in skin care products, oral sprays, or dietary supplements for safety and effectiveness, and these are not approved by the FDA. Learn more about cosmetics here. Learn more about dietary supplements here.

How does malic acid work (mechanism of action)?

Malic acid is a type of chemical known as an alpha hydroxy acid (AHA). It is naturally found in some fruits, including apples, and is commonly added to cosmetic and skin care products. It is also added to foods and drinks as a preservative and for flavor.

When applied to the skin, most AHAs are used as exfoliators, meaning that they cause the top layer of dead skin cells to detach from each other and fall off. However, malic acid does not seem to work as well as other AHAs for this purpose. Instead, it is often added to skin care products to help balance their pH levels. Some skin care products contain a certain form of malic acid, called sodium malate. This chemical can work as a humectant, helping to keep your skin hydrated. Using products that contain sodium malate, along with other ingredients, may help to improve the appearance of your skin.

Malic acid may also be found in oral sprays that are marketed for dry mouth. These sprays are thought to help increase the amount of saliva in your mouth. In fact, some research shows that these sprays may help to relieve the symptoms of dry mouth for a short time. Although these sprays seem to work better than a placebo spray (with no medicine), it is not clear how they compare to other treatments for dry mouth.

Supplements that contain malic acid are of interest for various uses, including fibromyalgia and certain types of kidney stones. But there is not enough research to know if or how malic acid may work for these uses.

How should I store malic acid?

You should store malic acid according to the product label. Most dietary supplements should be kept in a cool, dry location that is out of the reach of children and pets and not in direct sunlight.

Side Effects

What are the most common side effects of malic acid?

The most common side effect of topical malic acid is red or irritated skin. There is not enough research to know what the common side effects of malic acid supplements or oral sprays may be. Tell your health care provider if you have any side effects that bother you.

There may be other side effects of malic acid that are not listed here. Contact your health care provider if you think you are having a side effect of a supplement. In the U.S., you can report side effects to the FDA at www.safetyreporting.hhs.gov or by calling 888-SAFEFOOD (888-723-3366). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of malic acid?

While less common, the most serious side effects of malic acid are described below, along with what to do if they happen.

Severe Allergic Reactions. Malic acid may cause allergic reactions, which can be serious. Stop using malic acid and get help right away if you have any of the following symptoms of a serious allergic reaction.

• Breathing problems or wheezing
• Racing heart
• Fever or general ill feeling
• Swollen lymph nodes
• Swelling of the face, lips, mouth, tongue, or throat
• Trouble swallowing or throat tightness
• Itching or skin rash
• Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
• Nausea or vomiting
• Dizziness, feeling lightheaded, or fainting
• Stomach cramps
• Joint pain

Precautions

Who should not use malic acid?

Allergies to Ingredients. People who are allergic to any of the following should not use malic acid.

• L-malic acid
• Malic acid
• Sodium malate
• Any of the ingredients in the specific product

Your pharmacist can tell you all of the ingredients in the specific malic acid products they stock.

What should I know about malic acid before using it?

Malic acid is available as a dietary supplement, in skin care products, and as an oral spray. It is also added to some foods and drinks. It cannot be marketed to treat or cure a disease.

Read and follow the directions on the specific product you are using, or use it as recommended by your health care provider.

Keep malic acid out of the reach of children.

Malic acid comes in many forms. Dietary supplements that contain malic acid are taken by mouth. Oral sprays that contain malic acid are sprayed into the mouth to help with dry mouth. Malic acid is also added to skin care products such as creams, gels, and serums. Many of these products also contain other ingredients and may contain a different form of malic acid called sodium malate. Read the product label closely to check which ingredients it contains.

The FDA has not tested malic acid products to confirm that they contain the ingredients stated on their labels. Some dietary supplements have been tested by third-party organizations to confirm that they contain the ingredients listed on their labels and do not contain any harmful chemicals. Learn more about how to choose a safe dietary supplement product here.

What should I tell my health care provider before using malic acid?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if malic acid is right for you.

In particular, make sure that you discuss any of the following.

Pregnancy. It is not known if or how malic acid could affect pregnancy or harm a fetus. Tell your health care provider if you are pregnant or plan to become pregnant.

Breastfeeding. It is not known if malic acid passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed.

Interactions

Does malic acid interact with foods or drinks?

There are no known interactions between malic acid and foods or drinks.

It is unknown if drinking alcohol will affect malic acid.

Does malic acid interact with medicines (drug interactions)?

There are no known interactions between malic acid and medicines. Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

The interactions between malic acid and medicines are not fully understood. As with most dietary supplements, the research on drug interactions with malic acid is incomplete. Always check with your health care provider before using malic acid with any medicines.

Dosing

What should I do if I accidentally use too much malic acid?

If you or someone else has used too much malic acid, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

Read the product label closely and speak with a health care provider about how to use malic acid safely. Do not use double or extra doses, even if you miss a dose.