Azelaic acid
Other dermatological medicines
Other dermatological medicines
A dicarboxylic acid gel, foam or cream for papulopustular rosacea and acne; it is antibacterial, unplugs pores and mildly lightens dark spots.
Quick facts
- Group
- Other dermatological medicines
- Target
- Several targets: skin bacteria, keratinisation and tyrosinase (no single receptor)
- Used for
- Papulopustular rosacea · Acne vulgaris
- Key effects
- Itching · Dry or tender skin · Changes in skin colour
- Monitor
- Skin response and irritation
- ATC
- D10AX03
No doses: the clinician sets them by the current guideline.
Mechanism of action
Azelaic acid is a dicarboxylic acid first found in cultures of Malassezia. On the skin it kills acne bacteria in the follicle, reduces keratin build-up that plugs pores, and calms inflammation, which helps acne and the bumps and redness of rosacea. It also weakly inhibits tyrosinase, the first enzyme of melanin synthesis.
- Applied to rosacea or acne skin
- Kills follicle bacteria and reduces keratin plugging
- Inflammation settles; tyrosinase is mildly inhibited
- Fewer bumps and pimples; dark marks fade
Indications
- Papulopustular rosacea (gel and foam) Rosacea →
- Acne vulgaris (cream) Acne vulgaris →
Adverse effects
Common
- Itching, burning, stinging or tingling where applied
- Dry or tender skin
- Changes in skin colour, especially in darker skin
Contraindications
- Hypersensitivity to azelaic acid or the vehicle
Key interactions
- Rosacea triggers: alcohol, spicy food and hot drinks
- Bring on flushing and redness; avoided during rosacea treatment.
What is monitored
- Skin response and irritation
- Skin colour changes in people with dark skin
Administration and safety
- A thin layer is applied to clean, dry skin; treated skin is not covered with dressings.
- Kept out of the eyes and mouth.
- The foam is flammable: no flames or smoking during and just after application.
Pregnancy and breastfeeding
Little reaches the blood; pregnancy and breastfeeding are mentioned to the clinician.
Nursing care
- Ask about asthma and recurrent cold sores before starting.
- Explain that mild stinging is common; severe or lasting irritation is reported.
- Teach to report swelling of the face or lips, hives or breathing difficulty at once.
Pharmacokinetics
- Absorption
- Applied to the skin
Test yourself
Think of the answer, then tap the question to see it.
Which two skin conditions is azelaic acid used for?
Papulopustular rosacea and acne vulgaris.
Which melanin enzyme does azelaic acid weakly inhibit?
Tyrosinase.
What skin side effect is noted especially in people with dark skin?
Changes in skin colour (lightening).
Connections
← Back to the class: Other dermatological medicines
Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.
Sources: Azelaic Acid Topical : MedlinePlus Drug Information (MedlinePlus (U.S. National Library of Medicine), 2016); ATCDDD - ATC/DDD Index (WHO Collaborating Centre for Drug Statistics Methodology, 2026).
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Representative model, for educational purposes only.