Azelaic acid is a naturally occurring substance produced by Pityrosporum ovale, a type of yeast that lives normally on the skin. Azelaic acid is toxic to the bacteria that causes acne and thus inhibits their growth. When you reduce the population of the bacteria that lives on the pores, you also reduce the inflammation and redness commonly associated with acne. The good thing about Azelaic acid is that it does not cause bacterial resistance and you can use it for very long periods of time. Azelaic acid is also a keratolytic/comedolytic agent. This action helps unclog blocked pores by encouraging mild shedding of skin cells and it also normalizes the disordered growth of keratin which is a contributing factor in pore blockage. The end result is a reduction in the formation of comedos such whiteheads and blackheads. Azelaic acid also lightens the brown marks or brown spots ( hyperpigmentation ) left by acne. This may be useful for people with darker skin complexion.
Precautions and Side Effects:
Do not use azelaic acid without consulting your doctor if you are pregnant or could become pregnant during acne treatment. This acne medication is not intended to be used on children.
The only side effect presented by Azelaic Acid is the burning and stinging sensation that is felt almost immediately after its topical application. This feeling usually subsides after a few minutes. Some people with very sensitive skin may experience redness and dryness of the skin which can be reduced by using topical niacinamide, topical B5, or hyaluronic acid.
Azelaic acid (15%) gel was as effective as 5% benzoyl peroxide gel and clindamycin
Azelaic acid in 20% cream and 15% gel formulations appears to be effective in the treatment of papulopustular rosacea, particularly about decreases in mean inflammatory lesion count and erythema severity. Compared with metronidazole, azelaic acid appears to be an equally effective, if not better, treatment option.
Commercial Azelaic acid is usually available in 20% cream or gel formulation that is topically applied on the skin at least twice daily