What is Azelaic Acid?

Jacquelyn Gilchrist

Azelaic acid, which is a natural substance, is a prescription-strength acne medication. People apply it topically to the skin in the form of a cream or a gel to reduce incidences of pimples. Patients with rosacea may also use azelaic acid to treat their lesions, bumps, and flushing, which are symptoms of this skin disease. A doctor may also prescribe it to women who are either pregnant or taking birth control pills, as it can help treat melasma, a tan-colored discoloration on the face that can be caused by these pills or pregnancy.

Azelaic acid may be used to treat acne.
Azelaic acid may be used to treat acne.

This medication, which is a dicarboxylic acid, works in several ways. It inhibits the production of a natural substance called keratin in order to block acne formation. Azelaic acid also destroys the bacteria responsible for break outs, thereby keeping the pores in the skin unclogged. Patients may expect to use azelaic acid for about four weeks before seeing a noticeable improvement in their complexions. This is a long-term treatment plan, as acne may reappear once the patient discontinues this medication.

Azelaic acid may be prescribed to women taking birth control pills who have melasma.
Azelaic acid may be prescribed to women taking birth control pills who have melasma.

Before using azelaic acid, the patient should wash his face with a mild cleanser. Harsh astringents, alcoholic cleansers, and facial peel treatments should be avoided. The patient may then apply a very thin layer of the medicine to the affected area, washing his hands well afterward. Those who wish to apply makeup to the skin should allow the gel to dry completely before doing so. Typically, adults and adolescents will use this drug twice daily, however it may be used only once daily for the first few days to allow the skin to adjust.

Mild side effects such as redness, peeling, or itching of the skin may dissipate as the patient's skin adjusts to the medicine. Patients may also notice excessive dryness, as well as mild burning or tingling. Should these side effects persist or become bothersome, patients may reduce the application to once daily.

Severe side effects from the use of azelaic acid are rare, however if they do occur, the patient should get immediate medical help. These can include facial swelling, hives, and respiratory problems, which may be signs of a possible allergic reaction. Some patients, particularly those with darker complexions, may notice lightened or whitened areas of skin. Those who experience severe peeling, itching, or general skin irritation may be unable to continue using this medication.

Before using azelaic acid, patients should discuss their other medical conditions and medications with the prescribing physician. While this medicine is not known to cause harm to an unborn baby, as of 2011, it is unknown whether it passes into breast milk. Those who are allergic to this medicine or propylene glycol should not use it. It should also not be used on broken, sunburned, or irritated skin.

Azelex is sometimes used to manage rosacea.
Azelex is sometimes used to manage rosacea.

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