Azelaic Acid is a topical medication primarily used to treat mild to moderate acne vulgaris and rosacea, alleviating redness and inflammation. It combines antibacterial, anti-inflammatory, and keratolytic effects, reducing Propionibacterium acnes on the skin surface and promoting keratinocyte turnover to improve pore blockage. This medication is also commonly used to improve dullness and pigmentation caused by skin inflammation, especially effective for photosensitive skin issues.
Azelaic acid has a chemical structure classified as a dicarboxylic acid. Its mechanisms include inhibiting bacterial growth, reducing hyperkeratinization, and regulating sebum production. Compared to other topical antibiotics, it has a lower risk of resistance, making it suitable for long-term use. It is usually available in cream or gel formulations and should be used under medical supervision for optimal results.
Different brands may vary in formulation or concentration, but the main active ingredient is azelaic acid. Pharmacists will recommend suitable formulations and usage frequency based on the patient's skin condition.
Azelaic acid is classified as a "keratolytic agent" and "topical antimicrobial agent," with anti-inflammatory properties. It acts on both bacterial growth inhibition and skin repair, making it a multifaceted dermatological therapeutic agent.
It is not classified as a vitamin A derivative or salicylic acid, but its keratolytic mechanism has similar effects to these drugs. Its unique dual-action mechanism offers advantages in treating chronic skin inflammation.
Main indications include:
In some cases, physicians may also prescribe it for other skin inflammatory issues such as seborrheic keratosis or mild seborrheic dermatitis. This medication is not suitable for severe nodulocystic acne or widespread skin infections.
Minor side effects include:
Serious but rare side effects include:
Patients who need special attention include:
During treatment, avoid concurrent use of other irritating cosmetics or medications (such as benzoyl peroxide), which may cause skin discomfort. Follow the physician's instructions strictly and do not increase the dosage on your own.
Potential interactions with the following drugs or substances:
Avoid contact with alcohol-containing or fragranced skincare products during use, as these ingredients may weaken the drug's effectiveness and increase irritation. When treating acne with oral antibiotics, physicians may recommend combined use to enhance efficacy.
General usage:
Apply after cleansing at night, combined with sunscreen during the day to reduce photosensitivity risk. Therapeutic effects usually become apparent within 4-8 weeks, and continuous use for at least 3 months is recommended for optimal results.
If a dose is missed:
If missed doses lead to worsening symptoms, contact your physician immediately to adjust the medication plan. Do not alter the frequency of application on your own.
Common consequences of topical overdose:
If systemic symptoms occur (such as difficulty breathing, facial swelling), seek medical attention immediately, as these may indicate rare allergic reactions. Mild local overdose can be managed by wiping excess medication with a clean cloth and applying a cold compress to relieve irritation.
What steps should be taken for daily skin cleansing when using azelaic acid ointment?
Use gentle, soap-free cleansing products and avoid vigorous scrubbing. After cleansing, wait 15-30 minutes for the skin to dry before applying the ointment. Over-cleansing or using irritating products may reduce efficacy or cause discomfort.
What should I do if redness or stinging occurs during use?
Mild irritation may occur initially. Reduce usage frequency (e.g., every other day) and apply cold compresses to soothe. If symptoms persist for more than a week or blisters develop, discontinue use and consult a doctor. Do not mix with other topical medications without medical advice to prevent increased irritation.
Is it safe to use with vitamin A derivatives (such as tretinoin)?
Both can cause photosensitivity and irritation. It is recommended to use them at different times (e.g., alternately in the morning and evening) or under medical supervision with dose adjustments. When combined, strict sun protection measures should be followed, and skin tolerance should be closely monitored.
Can I wear makeup or use skincare products during treatment?
Yes, but choose oil-free, non-comedogenic products. Apply makeup after the ointment is fully absorbed and thoroughly remove makeup at night to prevent residual effects on medication absorption. Avoid using products containing alcohol or alpha hydroxy acids.
How long does it take to see treatment results? Will stopping use affect the outcome?
Improvements typically appear after 4-8 weeks. Patients with acne or rosacea should complete the full course as prescribed. Discontinuing abruptly may lead to symptom rebound. Discuss with your doctor about gradually reducing the medication to avoid sudden withdrawal effects.
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