Azelaic acid is widely used in dermatology. Its anti-inflammatory and antioxidant properties explain its efficacy in papulopustular rosacea and acne vulgaris, amongst other cutaneous conditions. The present study conducted a literature review on using azelaic acid in dermatology. It evaluated the level of evidence and listed the studies using the Oxford Center of Evidence-Based Medicine 2011 guidance.

This review found:

• Strong evidence supports the use of azelaic acid in rosacea, followed by its use off-label in melasma, followed by acne vulgaris.
• Weak evidence supports using azelaic acid in several other conditions, such as hidradenitis suppurativa, keratosis pilaris and male androgenic alopecia.

Thus azelaic acid, either as a monotherapy or in combination, could serve as an effective first-line or alternative treatment, which is well-tolerated and safe for a range of dermatological conditions.

Source: Searle T, Ali FR, Al-Niaimi F. The versatility of azelaic acid in dermatology. J Dermatolog Treat. 2022;33(2):722-32.