Anti-inflammatory and antibacterial azelaic acid

Azelaic acid is a nine-carbon dicarboxylic acid. It is mostly produced by the peroxidation of linoleic and linolenic acids. This acid has a broad spectrum of action – it has exfoliating, whitening, anti-inflammatory, antioxidant and antimicrobial properties.

 

Azelaic acid for skin with rosacea

The exfoliating action is due to the acidic nature of this substance. The whitening properties are related to its ability to inhibit a number of enzymes important in skin pigment formation. A mechanism related to the inhibition of DNA synthesis of stimulated melanocytes and cytotoxic properties towards hyper-reactive pigment cells is indicated (Mazurek and Pierzchała 2016). Azelaic acid reduces skin hyperpigmentation (mainly osteoids and post-inflammatory hyperpigmentation) and that resulting from rosacea lesions.

The popularity of brightening treatments with azelaic acid both alone and in combination therapy is related to these properties (Kakita and Lowe 1998). It does not cause phototoxic or photoallergic reactions, so it can also be used in spring and summer.

 

Anti-inflammatory and antibacterial activity

It has an anti-inflammatory effect – a significant reduction in inflammation (papules and pustules) as well as redness and erythema is achieved here. Other propertiesof azelaic acid include an anti-epidermal action and the ability to normalise the keratinisation process. It is therefore recommended in applications for irritated skin with erythema, also for oily skin.

The use of acids may be associated with the occurrence of possible localised symptoms. These include a subjective burning sensation of slight intensity and redness, which usually disappears within 30 minutes of application.

Azelaic acid also has an antimicrobial effect (even with long-term use) and is therefore effective in the treatment of acne. Its efficacy is demonstrated in numerous scientific publications and also in guidelines for the use of therapeutic substances in the treatment of acne published in scientific journals (Nast. et al. 2016). Azelaic acid is one of the few therapeutic substances that simultaneously counteracts both juvenile acne and rosacea (Del Rosso and Kircik 2014).

Another important use of azelaic acid is against hair loss. This property is due to the ability of azelaic acid to inhibit the activity of an enzyme important in testosterone metabolism, which is associated with hair loss.

 

Azeleic acid in cosmetic treatments

The experts at Chantarelle have used azelaic acid in the Red Stop Couperose & Rosacea Sensitive Skin treatment. This is a dermo-cure for vascular and rosacea-sensitive skin and in a treatment with Azelaic acid 40% pH 2.8. These treatments can be used all year round because azelaic acid does not exhibit phototoxic effects. However, high UVA/UVB protection is recommended after each exfoliation treatment.

 

dr Marcin Wasylewski

 expert at Chantarelle Laboratory Derm Aesthetics

 

 

 

 

Literature

• Del Rosso JQ, Kircik LH. Update on the management of rosacea: a status report on the current role and new horizons with topical azelaic acid. Journal of drugs in dermatology: JDD. 2014 Dec;13(12):s101-7.
• Kakita LS, Lowe NJ. Azelaic acid and glycolic acid combination therapy for facial hyperpigmentation in darker-skinned patients: a clinical comparison with hydroquinone. Clinical therapeutics. 1998 Sep 1;20(5):960-70.
• Mazurek K, Pierzchała E. Comparison of efficacy of products containing azelaic acid in melasma treatment. Journal of cosmetic dermatology. 2016 Sep 1;15(3):269-82.
• Nast A, Dreno B, Bettoli V, Bukvic Mokos Z, Degitz K, Dressler C, Finlay AY, Haedersdal M, Lambert J, Layton A, Lomholt HB. European evidence-based (S3) guideline for the treatment of acne-update 2016-short version. Journal of the European Academy of Dermatology and Venereology. 2016 Aug 1;30(8):1261-8.