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Azelaic Acid for Acne


Generic NameBrand Name
azelaic acidAzelex, Finacea

Azelaic acid is available as a cream or gel that is spread on your skin.

How It Works

Azelaic acid is a natural material that kills bacteria in the skin. It can help clear and prevent acne that is caused by bacteria.

Why It Is Used

Doctors prescribe azelaic acid in a cream form to help clear up acne and prevent new outbreaks. This medicine kills bacteria and reduces acne inflammation.

How Well It Works

Azelaic acid works well in mild to moderate outbreaks of acne by killing bacteria. But it doesn't work well for acne that isn't infected with bacteria. Studies show that azelaic acid works as well as other creams (such as benzoyl peroxide, tretinoin, and antibiotics).1 It takes 1 to 2 months after you start applying the cream for acne lesions to start disappearing.

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Callor other emergency services right away if you have:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.

Call your doctor if you have:

  • Hives.
  • Changes in your skin color (pigment).
  • Severe skin irritation or skin irritation that doesn't go away after a few weeks.

Common side effects of this medicine include:

  • Burning, stinging, or tingling.
  • Dry, scaly, or itchy skin.
  • Irritated or red skin.

Some skin irritation (burning, stinging, or itchiness) may happen for the first few weeks you are using this medicine. If the irritation is severe or doesn't go away, talk to your doctor.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Wash your face gently before applying this medicine. Try to keep it off skin areas that don't have acne. Also, keep azelaic acid away from the eyes, mouth, and inside the nose.

After putting this medicine on your skin, do not cover your skin with bandages, gauze, or anything else.

Be sure to wash your hands after you apply this medicine. You can apply makeup after letting this medicine dry for about 15 minutes.

While using this medicine, avoid any foods or beverages that make your face more red, such as spicy food, alcoholic drinks, or hot tea or coffee.

Azelaic acid may work to treat acne in some people. But if your acne doesn't start to clear up after a couple of months, your doctor will most likely have you try another medicine.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

If you are pregnant, breast-feeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breast-feeding, or planning to get pregnant.


Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF)Click here to view a form.(What is a PDF document?) to help you understand this medication.



  1. Thiboutot D (2008). Versatility of azelaic acid 15% gel in treatment of inflammatory acne vulgaris. Journal of Drugs in Dermatology, 7(1): 13–16.


ByHealthwise Staff
Primary Medical ReviewerKathleen Romito, MD - Family Medicine
Specialist Medical ReviewerE. Gregory Thompson, MD - Internal Medicine
Last RevisedJanuary 23, 2013

eMedicineHealth Medical Reference from Healthwise

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