Saturday, 23 April 2016

Azelaic acid for Acne, Rosacea and Hyperpigmentation

There's one acid I completely missed in my chemical exfoliation post, and it seems to be the most promising one. Most people haven't heard of this as you can only get it through prescription in the US and it's hard to find in Australia and elsewhere.
Azelaic acid is a naturally occurring dicarboxylic acid which is found in wheat, barley and rye.

Here's why it's great for many skin concerns:

Antibacterial
Propionibacterium acnes and Staphylococcus epidermidis are two of the dominant bacterium found in acne. Topical application of 20% azelaic acid cream has been found to inhibit the growth of these bacteria in many studies (Bladon et al., 1986), including a recent study which showed a reduction in 60 % of pimples in sixty patients (Iraji et al., 2007). Azelaic acid also acts against many other bacteria.

Anti-Inflammatory
Applying azelaic acid has been shown to reduce inflammation (Elewski, 2006)

Rosacea
Azelaic acid reduces inflammation and redness in rosacea patients (David A. Jonesand, 2009) and only requires a daily application (Worcester, 2008).

Anti-oxidant
Azelaic acid is also anti-inflammatory because it can scavenge free radicals which would otherwise be harmful for the skin, which means it has an anti-oxidant effect. Skin damage is also more prevalent in skin conditions like acne and rosacea.

Keratolytic
This describes the process of the outermost layers of skin softening and shedding, much like exfoliation. Like alpha- and beta-hydroxy acids, azelaic acid is able to chemically exfoliate and reveal 'new' skin.

Comedolytic
Azelaic acid is able to inhibit the formation of blemishes and comedones which usually form when oil and skin cells become trapped.

Acne
Having anti-inflammatory, comedolytic and exfoliating properties makes azelaic acid a great treatment for acne, blackheads and whiteheads. Studies have shown that azelaic acid gel in 20% form can be an effective treatment for mild to moderate acne (Iraji et al., 2007). Azelaic acid also targets the bacteria associated with acne and seems to be a great ingredient that is effective overall in targeting acne through many pathways. 

Hyperpigmentation
Discolouring after acne scars or other skin conditions like melasma is a problem many people face. If you have a darker skin tone, scars can be dark, and while some products may help, they can also lighten the skin surrounding the scars and make your overall skintone uneven. Azelaic acid interferes with melanin production where it is abnormal and blocks the extra production but does not affect the normal melanocytes.


Brands
Finacea Gel - you need a prescription in the US and it apparently costs between $240-$300, which is ridiculous, ordering it and shipping it online from Australia seems to be a better option. Details will be up this week.
Azclear Action Medicated Lotion - is what I'll be trialling and reviewing soon - probably purchase from Chemist Warehouse







Bibliography


Bladon PT, Burke BM, Cunliffe WJ, Forster RA, Holland KT, King K: Topical azelaic acid and the treatment of acne: a clinical and laboratory comparison with oral tetracycline. Br J Dermatol 1986;114:493–499.

Iraji, F., Sadeghinia, A., Shahmoradi, Z., Siadat, A. and Jooya, A. (2007). Efficacy of topical azelaic acid gel in the treatment of mild-moderate acne vulgaris. Indian J Dermatol Venereol Leprol, 73(2), p.94.


Jones DA. Rosacea, Reactive Oxygen Species, and Azelaic Acid. The Journal of Clinical and Aesthetic Dermatology. 2009;2(1):26-30.


Worcester, S. (2008). For Rosacea, Azelaic Acid Only Requires Once-Daily Application. Skin & Allergy News, 39(8), p.37.


Iraji, F., Sadeghinia, A., Shahmoradi, Z., Siadat, A. and Jooya, A. (2007). Efficacy of topical azelaic acid gel in the treatment of mild-moderate acne vulgaris. Indian J Dermatol Venereol Leprol, 73(2), p.94.


Sieber, M. and Hegel, J. (2014). Azelaic Acid: Properties and Mode of Action. Skin Pharmacol Physiol, 27(s1), pp.9-17.

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