Azelaic acid: A versatile and potent pharmaceutical-grade topical agent

When it comes to treating skin conditions like acne vulgaris and rosacea, Azelaic acid has become a popular option for dermatologists. Thanks to its multi-faceted properties, this topical therapeutic agent has proven to be effective in reducing inflammation, keratinization, and melanogenesis, making it a highly versatile choice for treating a variety of skin-related concerns.

But what exactly is azelaic acid, and how does it work? #

Azelaic acid is a powerful antimicrobial agent that targets both aerobic and anaerobic bacteria. Extensive in vitro and in vivo studies have shown its ability to eliminate Cutibacterium acnes, the primary culprit behind acne.

This effect is achieved by azelaic acid altering the pH of the bacterial cell membrane. By inhibiting the cell’s ability to maintain pH balance, it disrupts the bacteria’s respiratory metabolism, ultimately leading to its demise.

Azelaic acid possesses anti-inflammatory properties by inhibiting pro-inflammatory molecules and reactive oxygenated species. It disrupts the pro-inflammatory MAPK pathway, resulting in the downregulation of NF-kB. This decrease leads to a reduction in pro-inflammatory cytokines like IL-6, TNF-a, and IL-1B. In rosacea specifically, azelaic acid has been shown to inhibit kallikrein 5, a serine protease, leading to a decrease in the expression of cathelicidin proteins.

Another interesting fact about azelaic acid is its ability to reduce hyperpigmentation – a condition where the skin produces excess melanin resulting in dark spots. Through its anti-melanogenesis properties, azelaic acid can help to reduce the appearance of hyperpigmentation and even out skin tone.

Azelaic acid is known for its ability to reduce keratinization, although the exact mechanisms are not fully understood. It is believed that this reduction is due to a decrease in the thickness of the outermost layer of the skin, known as the stratum corneum, as well as the disruption of protein synthesis and inhibition of DNA.

Azelaic acid is safe to use during pregnancy #

Importantly, azelaic acid has been shown to be safe for use during pregnancy, making it a viable option for women who are pregnant or breastfeeding and might not be able to use other topical agents like tretinoin.

In summary, pharmaceutical-grade azelaic acid is a versatile and powerful topical agent that is effective in treating a range of skin-related conditions. Its anti-inflammatory, antimicrobial, and anti-melanogenesis properties, combined with its tolerability and lack of skin irritation, make it an excellent choice for those looking to improve their skin health. While more research is needed to fully explore its benefits, Azelaic acid is certainly one to watch in the world of dermatology.

Updated on 30 juni 2023

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