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Azelaic
acid is a dicarboxylic acid that can be found naturally on wheat, barley
and rye. It is also produced by Malassezia furfur also known as Pityrosporum
ovale which is a type of yeast that normally lives on human skin. Azelaic
acid is also used to stimulate hair growth. This product does not cause
bacterial resistance unlike antibiotics. It does not cause photosensitivity
which is typical with prolonged retinoid use. Azelaic acid does not
cause the bleaching of clothes and fabric unlike Benzoyl Peroxide.
II.
How does Azelaic Acid works on acne?
- Antibacterial
- it reduces the growth of acne causing bacteria that lives on skin
pores. (Proprionibacterium acnes and Staphylococcus epidermis)
- Keratolytic
and Comedolytic - Causes mild skin peeling that unblocks clogged pores.
Normalizes the disordered growth of skin cells. Reduces the production
of Keratin which can also block pores.
- Free
Radical Scavenger - reduces inflammation and redness
- Reduces
hyperpigmentation - very useful in people with dark skin where acne
spots tend to leave brown marks.
Although benzoyl
peroxide is the standard antibacterial agent used for acne, some users
will prefer the use of Azelaic Acid because it is a naturally
occurring
chemical. The long term side effect of Benzoyl Peroxide is still in
question. Some researchers believe that Benzoyl Peroxide is actually
causing free radical damage in skin cells. The stinging sensation after
the topical application of this product may be annoying for some users
although it subsides after a few minutes.
Advantages
- Helps reduce
hyperpigmentation
- Does not
cause bacterial resistance as compared to antibiotics
- Does
not bleach clothing compared unlike benzoyl peroxide
- It smoothens
the skin
- Since this
substance is naturally occurring, azelaic acid is safe to use even after
several years of continuous use.
Disadvantages
- Slow response
time, azelaic acid achieves its full benefit on acne after several months
of use
- The itching
sensation after the initial application of azelaic acid is very annoying
but it subsides after a few minutes.
Efficacy
-
Azelaic
acid (15%) gel was as effective as 5% benzoyl peroxide gel and clindamycin
(source: Iraji
F, Sadeghinia A, Shahmoradi Z, Siadat AH, Jooya A. Efficacy of topical
azelaic acid gel in the treatment of mild-moderate acne vulgaris.
Indian J Dermatol Venereol Leprol 2007;73:94-6)
-
Azelaic
acid in 20% cream and 15% gel formulations appears to be effective
in the treatment of papulopustular rosacea, particularly in regard
to 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.
( Source: Arch Dermatol. 2006 Aug;142(8):1047-52. Liu RH, Smith MK,
Basta SA, Farmer ER. Department of Dermatology, Eastern Virginia Medical
School, Norfolk, VA, USA.)
III.
Forms, Dosage and Administration
- In cream
form at 20% concentration. Spread on the areas to be treated forming
a thin film.
IV.
Precautions
- Do not use
over wounds or abraded skin
V.
Side Effects
- Itching,
burning, stinging, tingling sensation that subsides after a few minutes
from initial application of this product.
- Redness or
drying of skin
Brand
Names
Azelex®,
Skinoren®
References
- http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a603020.html
( Last update - 10/01/2003 American Society of Health-System Pharmacists,
Inc. )
- Br J Dermatol
1988 Nov;119(5):627-632 Inhibition of 5 alpha-reductase activity in
human skin by zinc and azelaic acid. Stamatiadis D, Bulteau-Portois
MC, Mowszowicz I , Laboratoire de Biochimie B, Hopital Necker-Enfants-Malades,
Paris, France. http://www.raztec.com/azelaic.html (last update 2001)
- http://www.rxlist.com/cgi/generic/azelex.htm
(updated 2007) Azelex
Page
last modified: January 07, 2008
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