[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Other dermatological medicines](https://durgical.com/en/pharmacology/classes/other-dermatological-medicines/) › Azelaic acid

# 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.

Updated Nov 1, 2026

## Quick facts

**Group**
[Other dermatological medicines](https://durgical.com/en/pharmacology/classes/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.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## 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 →](https://durgical.com/en/conditions/rosacea/)
- Acne vulgaris (cream) [Acne vulgaris →](https://durgical.com/en/conditions/acne-vulgaris/)

## Adverse effects

### Common

- Itching, burning, stinging or tingling where applied
- Dry or tender skin
- Changes in skin colour, especially in darker skin

### Serious (rare, important)

- Allergic reactions: swelling of the face, lips or throat, trouble breathing, hives

## 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

## Memory aid

AZELAIC acid: A-to-Z for Acne and rosacea, Lightens a little.

## 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).

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[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## Connections

## Related drugs 3

- [Benzoyl peroxide](https://durgical.com/en/pharmacology/benzoyl-peroxide/)
- [Adapalene](https://durgical.com/en/pharmacology/adapalene/)
- [Hydroquinone](https://durgical.com/en/pharmacology/hydroquinone/)

## Related conditions 2

- [Rosacea](https://durgical.com/en/conditions/rosacea/)
- [Acne vulgaris](https://durgical.com/en/conditions/acne-vulgaris/)

[← Back to the class: Other dermatological medicines](https://durgical.com/en/pharmacology/classes/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](https://medlineplus.gov/druginfo/meds/a603020.html) (MedlinePlus (U.S. National Library of Medicine), 2016); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=D10AX03) (WHO Collaborating Centre for Drug Statistics Methodology, 2026).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/pharmacology/azelaic-acid/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/azelaic-acid/