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Azelaic Acid
Azelaic acid is a topical medication used to treat acne and rosacea. It is a naturally occurring acid found in grains like barley, wheat, and rye. Azelaic acid works by reducing the growth of bacteria that cause acne and by decreasing the production of keratin, which can block pores and lead to acne formation. Additionally, it helps to reduce inflammation and redness associated with rosacea. Azelaic acid is well-tolerated and is available in various strengths and formulations, including creams, gels, and foams.
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Frequently Asked Questions
How long does it take for azelaic acid to work?
Azelaic acid typically shows improvement in acne and rosacea symptoms within 4 to 8 weeks, but maximum results may take up to 12 weeks of consistent use.
Can I use azelaic acid with other acne treatments?
Yes, azelaic acid can be used alongside other acne treatments like salicylic acid or retinoids, but it’s important to avoid irritating combinations. Always consult your healthcare provider for personalized advice.
Can azelaic acid help with hyperpigmentation?
Yes, azelaic acid may help reduce post-inflammatory hyperpigmentation (dark spots left after acne heals) by preventing excess melanin production.
Can I use azelaic acid during pregnancy?
Azelaic acid is considered safe for use during pregnancy, but you should always consult your healthcare provider before using any medication while pregnant or breastfeeding.
Is azelaic acid safe for long-term use?
Yes, azelaic acid is safe for long-term use, especially for chronic conditions like acne and rosacea. Regular use may help maintain clear skin.
Comprehensive Drug Guide
How Does Azelaic Acid Work?
- Antibacterial action: It inhibits the growth of Propionibacterium acnes, the bacteria responsible for acne.
- Keratolytic action: It helps to normalize the skin’s surface, preventing clogged pores by reducing the buildup of dead skin cells.
- Anti-inflammatory action: Azelaic acid reduces redness and swelling, making it effective for treating rosacea in addition to acne.
Common Dosages
- 15% gel/foam for rosacea
- 20% cream for acne
Typical Dosing
- For acne: Apply a thin layer of the 20% cream to the affected area twice daily, morning and evening.
- For rosacea: Apply a thin layer of the 15% gel or foam twice daily, morning and evening.
- Improvement can be seen within 4 weeks, but maximum results may take up to 12 weeks.
Typical Dosing
FDA Approved Indications
- Mild to moderate acne vulgaris in patients aged 12 years and older
- Rosacea to reduce redness and inflammatory papules and pustules
Who Shouldn't Take Azelaic Acid?
- Known hypersensitivity to azelaic acid or any of the ingredients in the formulation.
- Broken or irritated skin, as this may increase the risk of irritation.
Advice From The Pharmacist
- Apply azelaic acid to clean, dry skin and avoid contact with eyes, mouth, or other mucous membranes.
- Be consistent with applications to achieve the best results. It may take several weeks to see improvement in both acne and rosacea symptoms.
- If you experience significant irritation, scaling, or dryness, reduce the frequency of application or consult your healthcare provider.
- Azelaic acid may cause mild stinging or burning when applied, especially on sensitive skin. This should improve with continued use.
- Avoid using other harsh or abrasive skincare products, such as alcohol-based cleansers or exfoliants, while using azelaic acid.
Side Effects of Azelaic Acid
Common Side Effects
- Mild burning or stinging at the application site
- Itching or tingling
- Dryness or peeling of the skin
Uncommon/Severe Side Effects
- Severe allergic reactions (rash, swelling, difficulty breathing)
- Worsening of asthma symptoms in those with pre-existing asthma
Risks and Warnings of Azelaic Acid
- Irritation: Azelaic acid may cause mild skin irritation, particularly during the first few weeks of use. If severe irritation occurs, discontinue use and consult a healthcare provider.
- Hyperpigmentation: Although rare, azelaic acid can cause lightening of the skin in individuals with darker skin tones. This condition is usually temporary and resolves after discontinuation of the medication.
- Asthma exacerbation: In rare cases, azelaic acid may exacerbate asthma symptoms. Individuals with asthma should use this medication with caution.
Interactions with Azelaic Acid
Common Drug Interactions
- Azelaic acid is not known to have significant drug interactions when used topically. However, using harsh or irritating skin care products alongside azelaic acid can increase the risk of irritation.
Alternatives to Azelaic Acid
- Benzoyl peroxide: A topical antibacterial agent commonly used to treat acne by killing acne-causing bacteria and reducing inflammation.
- Retinoids (tretinoin, adapalene): Topical treatments that help clear acne by increasing cell turnover and reducing pore blockage.
- Metronidazole: A topical antibiotic used for treating rosacea.
- Clindamycin: A topical antibiotic often combined with benzoyl peroxide for acne treatment.
- Salicylic acid: A beta hydroxy acid that helps exfoliate the skin and treat acne.
