Products
Azelaic acid is commercially available as gel and cream (Skinoren). It has been approved in many countries since 1990.
Structure and properties
Azelaic acid (C9H16O4, Mr = 188.2 g/mol) is a saturated dicarboxylic acid. It exists as a white, odorless, crystalline solid that is poorly soluble in water at 20°C but dissolves well in hot water or in alcohol. Azelaic acid is found in various grasses such as wheat, rye and barley. It is thought to be involved in the defense mechanism against certain pathogens in Arabidopsis (cruciferous).
Effects
Azelaic acid (ATC D10AX03) is antibacterial, affects follicular hyperkeratosis, inhibits keratinocyte proliferation, and has a weak anti-inflammatory effect. It normalizes the differentiation processes of the epidermis, which are disturbed in acne, and reduces and the proportion of free fatty acids in the lipids of the skin surface. The anti-inflammatory effect is probably due to the inhibition of the formation of hydroxyl and superoxide radicals from neutrophils.
Indication
Azelaic acid is approved for the topical treatment of mild to moderate acne (acne vulgaris). Azelaic acid is also approved as a 15% gel in Germany (Skinoren) and the United States (Finacea) for the treatment of rosacea, but has not yet been approved by regulatory authorities in this indication in many countries.
Dosage
After cleansing and drying the skin, the gel or cream is applied to the affected area and massaged in thoroughly. Application is usually twice daily in the morning and evening. In the case of prolonged, pronounced irritant reactions of the skin, the amount to be applied can be reduced or the application intervals can be extended. The duration of therapy is individual and varies depending on the severity of acne. Generally, improvement occurs within 4 weeks.
Contraindications
- Hypersensitivity
- Pregnancy and lactation
The preparations should only be applied externally and should not get into the eyes. The full precautions can be found in the drug information leaflet.
Adverse effects
A burning or stinging sensation at the site of administration may occur within the first four weeks of treatment. Occasionally, this sensation does not subside throughout therapy. Local irritation of the skin such as itching, redness, dryness, and scaling is frequently observed. These symptoms occur predominantly at the beginning of treatment.
