Azelaic acid acne treatment

Azelaic acid is a naturally occurring dicarboxyl-ic acid (1,7-heptanedicarboxylic acid) that has demonstrated beneficial therapeutic effects in the treatment of acne and several disorders of hyperpigmentation [48]. There are minimal effects on normally pigmented human skin, freckles, senile lentigines, and nevi. The cytotoxic and antiproliferative effects of azelaic acid may be mediated via inhibition of mitochondrial ox-idoreductase activity and DNA synthesis. Disturbance of tyrosinase synthesis by azelaic acid may also influence its therapeutic effects. Azelaic acid can be used as a hypopigmenting agent in patients sensitive to hydroquinone. 

With antibacterial and anti-inflammatory properties, and the ability to stabilize keratinization, azelaic acid is an effective alternative in the treatment of mild to moderate acne in patients who cannot tolerate benzoyl peroxide or topical retinoids.3,21 It also has a hypopigmentation effect that may prove effective in patients who are prone to post-inflammatory hyperpigmentation resulting from acne.22... 

Topical preparations for the treatment of acne include the use of azelaic acid, salicylic acid, benzoyl peroxide and triclosan. Clindamycin is an antibacterial preparation available for use in the treatment of acne both topically and systemically. 

Azelaic acid is also used in the treatment of acne. 

Azelaic acid is a straight-chain saturated dicarboxylic acid that is effective in the treatment of acnevulgaris (in the form of Azelex) and acne rosacea (Finacea). Its mechanism of action has not been fully determined, but preliminary studies demonstrate antimicrobial activity against P acnes as well as in vitro inhibitory effects on the conversion of testosterone to dihydrotestosterone. Initial therapy is begun with once-daily applications of the 20% cream or 15% gel to the affected areas for 1 week and twice-daily applications thereafter. Most patients experience mild irritation with redness and dryness of the skin during the first week of treatment. Clinical improvement is noted in 6-8 weeks of continuous therapy. 

Patient education with emphasis on goals, realistic expectations, and dangers of overtreatment is important to optimize therapeutic outcomes. Treatment regimens are targeted to types of lesions and acne severity. Mild acne usually is managed with topical retinoids alone or with topical antimicrobials, salicylic acid, or azelaic acid. Moderate acne may be managed with topical retinoids in combination with oral antibiotics, and if indicated, benzoyl peroxide. Severe acne is often managed with oral isotretinoin. 

Azelaic acid is an antibiotic agent that inhibits microbial cellular protein synthesis. It is indicated in the topical treatment of mild to moderate inflammatory acne vulgaris (cream) topical treatment of papules and pustules of mild to moderate rosacea. 

Azelaic acid (AA), 1,9-nonanedioic acid or heptane-1,7-dicarboxylic acid, is used in manifold application areas. AA is offered in the pharmaceutical field for the treatment of acne and rosacea due to its antibacterial effect [1,2]. However, AA is much more widely applied as a monomer for the production of polymers such as alkyd resins, polyamides, and impact-proof polyesters or for the synthesis of plasticizers, lubricants, lithium complex greases, corrosion inhibitors, dielectric fluids, heat-transfer fluids, metal to glass fluxes, emulsion breakers, waxes, tobacco sheet plasticizers, hot-melt coatings and adhesives, water-soluble coating resins, hydraulic fluids, fungicides, insecticides, and so on [3-7]. 

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