Anyone with rosacea or stubborn acne knows how frustrating it can be to exhaust his list of potential treatments just to see a raging red spot in the mirror. Outside of blogs and Reddit one component of the acne-fighting effect is often overlooked: azelaic acid.
Here's what you need to know when using it – in recipe and over-the-counter formulas. Azelaic acid is often recommended for people with acne, rosacea and pigmentation problems.
Azelaic acid is a dicarboxylic acid that is naturally synthesized by yeast and is now made from products such as barley and wheat. "Temitayo Ogunleye, MD, Assistant Professor of Clinical Dermatology, University of Pennsylvania Perelman School of Medicine, says to SELF (in itself it's just an acid, so it's still gluten free .)
"No one knows exactly how it works, but it's an acid and most acids help Skin Peeling "John G. Zampella, MD, Assistant Professor in the Dermatology Department of Ronald O. Perelman at NYU Langone Health, tells SELF that this makes azelaic acid useful for the treatment of acne," but azelaic acid It's also useful for other things that are beneficial to the skin, "he says.
In particular, it can help lighten the skin in hyperpigmentation problems n (such as melasma and dark spots after acne) by indirectly destroying melanocytes the skin cells that produce melanin.
It also appears to have some antibacterial properties, both of which contribute to acne-fighting abilities and their effectiveness in sedating and preventing inflammation, which is particularly beneficial for people with rosacea Ogunleye. (The bacteria that cause acne trigger the production of inflammatory cytokines explains them that are part of your immune system's response to pathogens.)
Unlike some acne medications (including retinoids and Benzoyl peroxide ), azelaic acid is generally considered safe for use during pregnancy. According to the American Academy of Dermatology (AAD), there is no human research, but data from animal studies suggest that it does not cause birth defects when applied topically. However, Prescribing Information for prescriptions of azelaic acid recommend caution to patients who are pregnant or planning to become pregnant, which requires that the drug be used only when needed during pregnancy.
Azelaic acid comes in two prescription forms.
Azelaic acid can be prescribed in two concentrations: 15 percent (Finacea) and 20 percent (Azelex).
And we have a pretty good idea that both are effective : A systematic review of the clinical trials of both concentrations published in JAMA Dermatology in 2006 contained data for five studies (873 participants) and the researchers concluded that both formulations were effective in the treatment of rosacea especially the papules and pustules that are associated with the disease. (The other common symptoms – persistent irrigation and visible blood vessels – are notoriously hard to deal with without laser treatment says Dr. Zampella.)
But these prescription options are not always accessible. "The problem with these is that it is getting harder and harder to get them through the versic hedge, "says Dr. Zampella. And without insurance, "they can be very expensive," Dr. Ogunleye, usually a few hundred dollars. If your insurance company does not cover it, your dermatologist may be taking you to an over-the-counter product containing azelaic acid.
There are no prescription options, but they are not necessarily explored.
For example, The Ordinary manufactures a 10% azelaic acid suspension (available for $ 8) that was not in clinical trials but is much cheaper than a prescription. If a patient's prescription is not covered by insurance, Dr. Ogunleye, that she often suggests to her patients what they can get on Amazon. You can also find Paula's Choice BOOST 10 percent Azelaic Acid Booster $ 36, which also contains Salicylic Acid.
There is not much research on these concentrations, but there is a study] published in the Journal of Medical Sciences that was promising for a concentration below regulation. For this study, researchers studied 40 participants with mild to moderate acne, all receiving a 10 percent azelaic acid gel (half received in an alcohol-free base, the other half in an alcoholic base). After eight weeks, the severity of acne in both groups declined significantly, but there was no difference between the groups, suggesting that a 10% concentration of azelaic acid might help with acne.
However, this study also has some obvious drawbacks. Including the fact that there was a relatively small sample size, there was no control group and there was no comparison with a concentration of 15% or 20%.
These options may not be as effective as the prescription versions. But they may still be "worth a try," Dr. Ogunleye. "My general approach, if we can not reach the prescription strength, is that I'll let them test the 10%," Dr. Zampella. These products are usually quite inexpensive and "Azelaic acid is one of the safest medications you can try," he says – so the potential benefits usually outweigh the risks.
In particular, acids that are used to treat acne tend to be dry and hard, but most people – even those with sensitive skin or rosacea – can use azelaic acid with minimal problems says Dr. Zampella. "But like any acid, it can be irritating," he says, though that lasts over time.
Dr. Zampella suggests hugging a small amount to do a patch test. If this is okay and can not irritate the skin, you can apply a thin layer on your face up to twice a day or according to prescriptions. If you know that you have sensitive skin, you should use it once every other day to see how you handle it, says dr. Ogunleye.
If you feel itching, burning, or stinging, it will not go away, it's a sign to retire and check in with your skin. Other symptoms, such as swelling, rash or difficulty swallowing or breathing, are an emergency and can trigger an allergy according to MedlinePlus .
In general, if you use azelaic acid to treat acne or skin cancer. Zampella suggests staying with her for three months before deciding whether it works for you or not. However, some people see an advantage within four to six weeks or earlier. If you use it to dispel pigmentation concerns, "some people see benefit within a week," he says.
It's a good idea to stay away from hard or potentially irritating products while your skin adapts to azelaic acid. It is always good to limit the number of peeling products you use at the same time. But overall, it's a pretty straightforward ingredient, Dr. Zampella. And there really is nothing you can never use Ogunleye, although it is always wise to ask your derm about possible combinations. Really "the biggest hurdle is insurance coverage," says Dr. Zampella.
If you have questions about the use of Azelaic Acid or if you want to know if you qualify for a prescription, talk to your dermatologist.