azelaiinihappo

Azelaic acid, known as azelainihappo in Finnish, is a saturated nine-carbon dicarboxylic acid (nonanedioic acid, C9H16O4) used primarily in dermatology. Naturally, it occurs in trace amounts in grains such as wheat, rye, and barley, and it can also be produced industrially by the oxidation of oleic acid.

Topically applied azelaic acid is indicated for mild-to-moderate acne vulgaris and inflammatory rosacea, and it is effective for certain hyperpigmentation conditions, including post-inflammatory hyperpigmentation and melasma.

Mechanism: it has antibacterial activity against Propionibacterium acnes (Cutibacterium acnes) and reduces inflammation by modulating cytokine production. It also normalizes keratinocyte turnover and inhibits tyrosinase, thereby decreasing melanin synthesis.

Formulations and use: available in creams and gels, commonly in 15% or 20% concentrations, applied once or twice daily with gradual titration to tolerance.

Safety and tolerability: adverse effects are usually mild and local, such as burning, stinging, itching, or redness; less commonly dryness or dermatitis. Systemic absorption is minimal, and azelaic acid is considered safe in pregnancy and lactation under medical guidance. Avoid contact with eyes and mucous membranes; may be used with moisturizers; consider spacing with other topical agents to minimize irritation.