Essential Guide azelaic acid

Applications / Anti-rosacea

FUNCTIONALITY

PRODUCTS FOR TREATMENT OF ROSACEA

COSMETIC USE

MEDICAL DEVICE USE

PHARMACEUTICAL USE

Azelaic acid

++

++

+

BRIMONIDINE

-

-

+

METRONIDAZOLE

-

-

+

ALPHA-HYDROXY ACIDS

+

+

+/-

ORAL ANTIBIOTICS

-

-

+/-

ISOTRETINOIN

-

-

++

ALTERNATIVE THERAPIES

+

+/-

-

TABLE 6: Legend: (++ Strongly recommended / Very suitable) (+ Limited recommended / Suitable) (+/- Limited allowed / Limited suitable) (- Forbidden)

ADVERSE EFFECTS

PRODUCTS FOR TREATMENT OF ROSACEA

CMR PROPERTIES

SKIN IRRITATION

SIDE EFFECTS

PHOTO ACTIVITY

CYTOTOXI CITY

EXFOLIATION

Azelaic acid

-

+

-

+

-

-

BRIMONIDINE

+

+

+

-

-

+

METRONIDAZOLE

+

+

+

-

-

+

ALPHA-HYDROXY ACIDS

-

+

-

++

+

-

ORAL ANTIBIOTICS

++

++

++

-

+

++

ISOTRETINOIN

++

++

++

-

++

++

ALTERNATIVE THERAPIES

+/-

+/-

+/-

+/-

-

+/-

TABLE 7: Legend: (++ Very strong effects) (+ Noticable effects) (+/- Hardly noticable) (- Not noticable)

General anti-rosacea ingredient characteristics Azelaic acid

Azelaic acid has been considered effective for the treatment of rosacea. It is available as a 20% cream or a 15% hydrogel. Azelaic acid reduces inflammatory lesions and erythema in rosacea patients and also inhibits neutrophilic Reactive Oxygen Species (ROS). In the neutrophil system, Azelaic acid inhibits ROS formation in a dose-dependent manner, significantly decreasing the number of free radicals. In the xanthine–xanthine oxidase system, none of the generated ROS was decreased by any dose of Azelaic acid. This indicates that Azelaic acid does not scavenge ROS after they are formed but instead inhibits cell metabolism—possibly by reducing enzymatic activity within the cell membrane. Azelaic acid is likely the only non-pharmaceutical ingredient that has demonstrated substantial efficacy in treating rosacea, with minimal or no side effects.

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