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Reviewed by Dr Yasmin Aghajan, MD
Information last reviewed 07/31/19
Azelaic Acid is a topical gel used in the treatment of rosacea, acne and other skin conditions. Azelaic Acid should reduce the inflammation related to rosacea when used continuously over 15 weeks.
A naturally occurring acid, Azelaic Acid aids in skin renewal. Though the exact mechanism(s) by which it interferes with the pathogenic events in rosacea are unknown,
it is believed to work as an anti-bacterial, reducing reactive oxygen species on the skin and producing an anti-inflammatory effect. In turn, this reduced inflammation results in the formation of fewer pimples and lesions. Although Azelaic Acid may also provide some reduction in redness, its clinical effectiveness in treating erythema has not been established.
The active ingredient in Azelaic Acid is azelaic acid at a concentration of 0.15g in 1g. The mechanism(s) by which Azelaic Acid helps to resolve rosacea are unknown.
Azelaic Acid contains the following inactive ingredients:
Those with known hypersensitivity to Azelaic Acid gel or any of its components should avoid its use.
*Note: inactive ingredients may vary between different brands of generic drugs
Azelaic acid does cause a burning or stinging sensation which should disappear after the first few uses, however it rarely causes a severe allergic reaction. Signs of a severe allergic reaction are skin rashes/hives, facial swelling, itchy throat, difficulty breathing and dizziness. If you experience any of these shortly after use, please get immediate medical help.
Azelaic Acid Gel contains 15% Azelaic Acid. Squeezing the gel onto the fingertip of your index finger (from the crease to the end of your finger) will give you one dose of Azelaic Acid that is enough to cover the whole face.
Dosage: Twice daily (morning and evening)
Avoid thermally hot beverages and foods, spicy foods, and alcoholic beverages
Not for oral, ophthalmic or intravaginal use.
The most common side effects are stinging, burning, itching, dry skin, increased reddening of the skin and irritation. Most side effects are mild and disappear with continued use.
Warnings and Precautions:
In patients using Azelaic Acid formulations, the following adverse events have been reported: worsening of asthma, vitiligo, depigmentation, small depigmented spots, hypertrichosis (excessive hair growth), reddening (signs of keratosis pilaris) and exacerbation of recurrent herpes labialis (oral herpes also known as cold sores or fever blisters). If any of these events occur, discontinue use and consult your physician.
The following adverse reactions have been identified post approval of Azelaic Acid gel. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate the frequency or establish a causal relationship to drug exposure.
If you experience any of these adverse reactions, discontinue use and consult your physician immediately.
Do not use Azelaic Acid if you are allergic to any of its ingredients. You should inform your doctor if this is the case and they can recommend an alternative treatment.
There are no known interactions between Azelaic Acid and other drugs.
Yes. Azelaic Acid naturally occurs in cereals, such as barley, wheat and rye. Throughout history, such ingredients have been used to reduce hyperpigmentation. They are also thought to contain antibacterial properties.
Yes. In fact, Azelaic Acid 15% Gel is considered the “first line” topical treatment for mild-to-moderate acne-like rosacea. Not only do patients see significant improvement with continuous use, but any side effects are usually mild, subside within a few weeks, and rarely necessitate discontinuing use of the product.
For some patients, Azelaic Acid can provide some level of redness reduction in rosacea sufferers. However, the mechanism by which this occurs is not known, and no clinical studies have evaluated Azelaic Acid’s effectiveness for reducing redness alone. For these reasons, it is usually only prescribed for subtype 2 rosacea which presents with acne-like pustules.
Disclaimer: This is not medical advice. You and your physician will determine if and how you should take any medication prescribed to you following a medical consultation.
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