Azelaic Acid

Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Unlabeled Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Genes that may be involved
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names


Austria: Skinoren; Belgium: Skinoren; Bulgaria: Finacea, Skinoren; Cyprus: Azelderm, Skinoren; Czech Republic: Skinoren; Denmark: Finacea, Skinoren; Estonia: Finacea, Skinoren; Finland: Skinoren; France: Finacea, Skinoren; Germany: Skinoren; Greece: Arbonid; Azedose, Azelaic acid; Azelderm, Cevigen, Exazen, Noreskin, Skinoren, Sonalent, Zelicrema, Zumilin; Hungary: Finacea, Skinoren; Ireland: Skinoren; Italy: Finacea, Skinoren; Latvia: Finacea, Skinoren; Lithuania: Finacea, Skinoren; Malta: Skinoren; Netherlands: Finacea; Poland: Acne-derm, Finacea, Hascoderm, Skinoren; Portugal: Finacea, Skinoren; Romania: Skinoren; Slovakia: Finacea, Skinoren; Slovenia: Skinoren; Spain: Finacea, Skinoren, Zelaika, Zeliderm; Sweden: Finacea, Skinoren; UK: Finacea, Skinoren.

North America

Canada: Finacea; USA: Azelex, Finacea.

Latin America

Argentina: Cutacelan; Brazil: Azelan, Dermazelaic, Dermizan; Mexico: Finacea.

Drug combinations


Azelaic Acid: C~9~H~16~O~4~. Mw: 188.22. (1) 1,7-Heptanedicarboxylic acid; (2) Nonanedioic acid. CAS-123-99-9.

Pharmacologic Category

Skin and Mucous Membrane Agents, Miscellaneous; Anti-acne preparations for topical use. (ATC-Code: D10AX03).

Mechanism of action

The mechanism(s) by which azelaic acid interferes with the pathogenic events in rosacea are unknown. In vitro, azelaic acid possesses antimicrobial activity against Propionibacterium acnes and Staphylococcus epidermidis. May decrease microcomedo formation.

Therapeutic use

Topical treatment of inflammatory papules and pustules of mild-to-moderate rosacea; mild-to-moderate inflammatory acne vulgaris (Finacea is not FDA-approved for the treatment of acne).

Pregnancy and lactiation implications

Should be used during pregnancy only if clearly needed. Although the uptake of azelaic acid into maternal milk is not expected to cause a significant change from baseline azelaic acid levels in the milk, caution should be exercised in nursing mothers.

Unlabeled use

Treatment of erythema in rosacea in the absence of papules and pustules has not yet been evaluated.


Individuals with history of hypersensitivity to propylene glycol or any other component of the formulation.

Warnings and precautions

For dermatologic use only; not for ophthalmic, oral or intravaginal use. Hypopigmentation has been reported after use of azelaic acid. Contact with the eyes, mouth, and other mucous membranes should be avoided. If sensitivity or severe irritation develops, treatment should be discontinued. In a transgenic mouse study, chronic use of azelaic acid gel led to an increased number of animals with papillomas at the treatment site (clinical relevance in humans is not clear). Avoid the use of occlusive dressings or wrappings.



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