Azelaic Acid Cream: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Azelaic Acid Cream (azelaic acid) is a topical treatment made from a naturally occurring acid found in grains like barley, wheat, and rye. It has antibacterial, anti-inflammatory, and skin-lightening properties and is used to treat acne and other skin conditions. It is applied directly to the skin as a cream, gel, foam, or lotion.

What is Azelaic Acid Cream

Azelaic acid is a naturally occurring acid found in grains like barley, wheat, and rye. It has antibacterial, anti-inflammatory, and skin-lightening properties, and is applied to the skin as a cream, gel, or foam to treat acne and other skin conditions.

Azelaic Acid Cream uses

• Mild to moderate acne vulgaris (both comedonal and inflammatory types)
• Papulopustular rosacea
• Hyperpigmentation and dark spots left after acne (post-inflammatory pigmentation)
• Melasma
• Periocular dermatitis
• Periorificial dermatitis
• Rhinophyma
• Acne scarring
• Skin lightening in areas with uneven pigmentation

Benefits of Azelaic Acid Cream

• Has anti-inflammatory properties and helps with uneven skin tone
• Exfoliates the skin and helps unclog pores
• Milder side effects compared to more potent acne therapies
• Does not cause bacterial resistance to antibiotics
• Does not reduce sebum production
• Does not cause photosensitivity (easy sunburn)
• Does not stain skin or clothing
• Does not bleach normal skin or clothing
• Well tolerated by most skin types, including sensitive skin

How Azelaic Acid Cream works

The medicine fights the bacteria that cause acne, calms inflammation in the skin, and gently speeds up skin cell turnover, which helps reduce scarring. It also blocks an enzyme involved in making skin pigment, which helps even out skin tone.

Azelaic Acid Cream dosage

Wash the affected area thoroughly with warm water and pat dry, using a cleanser or mild soap to make sure the area is clean. Wash your hands before applying the medication. Apply a small amount to the affected area, rub it in, and let it dry completely. Once the medication has dried, you can apply cosmetics; there is no need to cover or bandage the skin. Avoid using astringents or deep-cleansing cleansers while using this medicine.

Apply to clean, dry skin before your moisturizer. For sensitive skin, introduce the product gradually, starting with an application every other day for the first two weeks, then increasing frequency as tolerated. Start with once-daily application, then build up to twice daily after cleansing the skin, if tolerated. It can be used in the morning and evening since it does not increase sun sensitivity.

Acne responds slowly; some improvement may be seen after about one month, with further improvement over several months of continued use.

Available forms and strengths

• Cream
• Gel
• Lotion
• Foam

Side effects of Azelaic Acid Cream

Common

• Burning or tingling on the skin
• Peeling skin at the site of application
• Skin dryness or redness
• Temporary redness or slight flaking, especially at higher concentrations

Serious

• Blistering or flaking skin
• Irritation and swelling
• Tightness or pain in your joints
• Hives and itching
• Fever
• Difficulty breathing
• Worsening of asthma

Warnings and precautions

• Do not use if you are allergic to azelaic acid or to any of the ingredients in the cream, such as propylene glycol.
• Do not apply to broken or irritated skin, and avoid contact with eyes and mucous membranes.
• People with very sensitive skin or eczema may find it irritating, which can cause mild irritant contact dermatitis.
• This medicine may cause skin lightening (hypopigmentation), which is more noticeable in darker skin tones.
• Azelaic acid is one of the few dermatological ingredients considered compatible with pregnancy, but you should still check with your doctor or dermatologist before using it. It is also considered one of the few dermatological ingredients compatible with breastfeeding, but check with your doctor or dermatologist before use.
• No routine liver-specific adjustment is established. 
• No important direct interaction is expected with alcohol when using topical azelaic acid. This medicine does not normally affect driving.

When to see a doctor

• Stop using the cream and get medical advice if you develop severe redness, scaling, itching, or burning.
• See a doctor if your asthma gets worse while using this medicine.
• Stop using the product and see a doctor if you experience side effects such as blistering, swelling, joint pain, hives, fever, or difficulty breathing.

Alternatives

• Adapalene
• Benzoyl peroxide
• Clindamycin topical
• Tretinoin