Azelaic acid

In December of 2002 the FDA approved azelaic acid as a topical prescription treatment for mild to moderate rosacea. Azelaic acid, in concentrations of either 15% or 20%, is an interesting, versatile ingredient that is prescribed not only for rosacea but also for acne and brown skin discolorations. It can have some irritating side effects similar to an AHA, but they are typically mild and transient. Overall, azelaic acid is considered a very effective and safe therapy for rosacea. On average, twice-daily application of azelaic acid has shown results in reducing the rosacea symptoms of redness, flaking, and papules that are similar to once-daily application when using metronidazole. One study demonstrated that azelaic acid was as effective as metronidazole but was tolerated better by patients. (Sources: Jour­nal of the European Academy of Dermatology and Venereology, January 2009, pages 22-28; International Journal of Dermatology, May 2007, pages 533-538; and Cutis, April 2006, pages S3—S11.)