Abstract
Azelaic acid is a natural product of Pityrosporum ovale; used topically it has been shown to be of benefit in acne by a marked antimicrobial effect against Propionibacterium acnes. No study to date, however, has included a placebo group. We have investigated 40 patients with clinical acne in a double‐blind study; half received 20% azelaic acid cream and half the base cream. Assessments were made of total acne grade, lesions counts and side‐effects. Azelaic acid was significantly better than placebo at 1, 2 and 3 months in improving overall acne grade (P < 0·01) and inflamed lesions (P < 0·001). Side‐effects were minimal—the main drawback of the preparation was greasiness of its base. We also collaborated in a multicentre study involving 859 patients in which azelaic acid was compared with other treatments. It was found to be as effective as benzoyl peroxide, retinoic acid and oral tetracycline over an 8‐month study. It gave a significantly lower incidence of dermatitis (P < 0·01) than either retinoic acid or benzoyl peroxide and, in contrast to the latter, it did not bleach clothes. We conclude that azelaic acid is a safe and beneficial topical treatment for acne vulgaris.
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