Azelaic acid ( AzA), or nonanedioic acid, is an organic compound with the formula HOOC(CH2)7carboxylic acid.
Production
Azelaic acid is industrially produced by the
ozonolysis of
oleic acid. The side product is
nonanoic acid. It is produced naturally by
Malassezia furfur (also known as
Pityrosporum ovale), a
yeast that lives on normal
skin. The bacterial degradation of
Pelargonic acid gives azelaic acid.
Biological function
Plants biology
In plants, azelaic acid (AzA) functions as an endogenous signaling molecule that plays a central role in systemic defense responses after infection. It acts as a "distress flare," produced primarily in response to
biotic stress such as pathogen attack, and is transported from infected tissues to distant parts of the plant.
There, it primes systemic acquired resistance (SAR) against a broad spectrum of
by inducing the accumulation of
salicylic acid, a key component of the plant's immune response.
Mechanistically, AzA works in concert with other mobile signals, including glycerol-3-phosphate and specific lipid transfer proteins, to orchestrate a systemic defense network that enhances disease resistance and enables rapid defensive responses to subsequent infections.
Human biology
Azelaic acid treats acne through a multifaceted mechanism that includes
antibacterial, anti-
, and anti-inflammatory activities, as well as direct effects on
skin microflora. It exerts bacteriostatic action against Propionibacterium acnes and
Staphylococcus epidermidis by disrupting microbial cellular metabolism and membrane pH balance, resulting in reduced bacterial proliferation without promoting resistance. In
, azelaic acid inhibits DNA, RNA, and protein synthesis, thus normalizing follicular keratinization, which helps prevent the formation of
—clogged hair follicles that can develop into acne lesions and are considered a hallmark of the disease. Additionally, its anti-inflammatory properties decrease the production of
reactive oxygen species and pro-inflammatory cytokines, collectively reducing both visible inflammation and the severity of acne lesions.
Applications
Polymers and related materials
Esters of this dicarboxylic acid find applications in lubrication and plasticizers. In lubricant industries, it is used as a thickening agent in lithium complex grease. With hexamethylenediamine, azelaic acid forms
Nylon-6,9, which finds specialized uses as a plastic.
Medical
In 2023, it was the 309th most commonly prescribed medication in the United States, with more than 200,000 prescriptions.
Azelaic acid is used to treat mild to moderate acne, both comedonal acne and inflammatory acne.
In topical pharmaceutical preparations and scientific research AzA is typically used in concentrations between 15% and 20% but some research demonstrates that in certain vehicle formulations, the pharmaceutical effects of 10% Azelaic acid have the potential to be fully comparable to that of some 20% creams.
Acne treatment
Azelaic acid is effective for mild to moderate acne when applied topically at a 15%-20% concentration.
In patients with moderate
acne, twice daily application over 3 months of 20% AzA significantly reduced the number of comedones, papules, and pustules;
at this strength, it's considered to be as effective as benzoyl peroxide 5%, tretinoin 0.05%, erythromycin 2%, and oral tetracycline at 500 mg-1000 mg.
In a comparative review of effects of topical AzA,
Salicylic acid,
Nicotinamide, Sulfur, Zinc, and alpha-hydroxy acid, AzA had more high-quality evidence of effectiveness than the rest.
Results can be expected after 4 weeks of twice-daily treatment. The effectiveness of long-term use is unclear, but it's been recommended that AzA be used for at least 6 months continuously for maintenance.
Whitening agent
Azelaic acid is used for the treatment of skin pigmentation, including
melasma and postinflammatory hyperpigmentation, particularly in those with darker skin types. It has been recommended as an alternative to
hydroquinone.
As a
tyrosinase inhibitor,
azelaic acid reduces synthesis of
melanin.
According to one report in 1988, azelaic acid in combination with
zinc sulfate in vitro was found to be a potent (90% inhibition) 5α-reductase inhibitor, similar to the hair loss drugs
finasteride and
dutasteride.
In vitro research during mid-1980s evaluating azelaic acid's depigmenting (whitening) capability concluded it is effective (cytotoxic to
) at only high concentrations.
A 1996 review claimed 20% AzA is as potent as 4% hydroquinone after a period of application of three months without the latter's adverse effects and even more effective if applied along with tretinoin for the same period of time.
Brand names
/ref> Crema Pella Perfetta (micronized azelaic acid, kojic dipalmitate, and liquorice extract), Azepur99, Azetec99, Azaclear (azelaic acid and niacinamide), AzClear Action, Azelex, White Action cream, Finacea, Finevin, Melazepam, Skinoren, Ezanic, Azelac, Azelan, Azaderm, (Acnegen, Eziderm, Acnicam, Azelexin in Pakistan)
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