Azelaic acid for acne treatment

Hi,

I have a question about the use of azelaic acid for treatment of acne.  I am curious to know why it is not more widely used compared to other acne treatments such as retinoids, benzoyl peroxide, and antibiotics.  I have read a number of research studies that have found azelaic to be as effective as retin-A, benzoyl peroxide, clindamycin, and oral tetracycline in reducing both inflamed and non-inflamed acne lesions.  These studies also report less irritation and fewer side effects from azelaic compared to some of the other acne medications.  Given that azeliac is antibacterial, anti-inflammatory, reduces comedone formation, and also helps with pigmentation issues, it seems that it would be an ideal topical for treating acne.  I also see very little research in the US published dermatology journals on azelaic (most of the research I have seen was done in other countries).  In your experience, is azelaic as effective as other, more widely prescribed acne treatments?  If so, why is it not prescribed more frequently?  

Thank you very much for your time,

Kim    

[Alan Rockoff, MD]

I don't know.  There is a popular cream used for rosacea containing azelaic acid.  I recommend it for acne patients as well, especially when they have issues of excess skin pigmentation, for which azelaic acid has some modest effectiveness.  There was an acne cream containing azelaic acid marketed a few years ago, but insurers wouldn't cover it.  This seemed odd, but maybe the lack of studies in US journals you point out had something to do with it, and when insurers balk, patients complain and don't want to use it, which in turn inhibits doctors from prescribing it.

Best.

Dr. Rockoff

[almond30]

which is better for drying pustoles and taking the redness, azelaic acid or tretinoin topic?

[neonate]

hello!

i've had a really bad break out of acne in the past one month. i've never had acne problems before. for about 2 months before the pimples went red and began to burst, my cheeks got filled with little skincoloured bumps...

the only cause i can think of is these couple of "ayurvedic" oil massages i'd gotten done in May, and then i had one course of ECPs last months (NORLEVO), which i think was a catalyst in this really unfortunate condition.

its really bothering me... finally, my dermatologist has prescribed AZIWOK 500 ( 1x 6 days)
cynomycin 50 (2 x 10 days)

and cyndamycin gel twice a day...

can someone tell me if this is the best treatment available? and whether i should ask some questions to my dermatologist? he didn't exactly tell me WHAT my condition was. he said to give it 15 days time, its been 7 already with not much improvement...

any advice, or just sharing your past experiences with a similar condition would be very appreciated.

whata bout the above mentioned azeliac gel, is it available in stores worldwide?