Topical azelaic acid in the treatment of rosacea

Azelaic acid is now an established therapeutic agent for acne vulgaris, where its antibacterial and comedolytic activity is responsible in the main for its beneficial effects. In this report we describe the results of a single-centre double-blind controlled contralateral split-face study of the effects of 20% azelaic acid cream in patients with rosacea. The study was designed as a randomized half-face comparison between a 20% azelaic acid cream preparation and its identical-appearing vehicle as placebo. Patients were treated over a 9-week period and reviewed 4 weeks after the end of the treatment period. Both ‘sides’ showed a reduction in papules, pustules and erythema, although the degree of improvement was superior on the azelaic acid-treated sides. This was also the case for the subjective overall evaluation used. No effect on telangiectasia was recorded. Minor degrees of skin irritation were recorded on both treatment sides in nearly equal numbers, although in the first 3 weeks this was more pronounced on the azelaic acid-treated sides. No serious adverse effects were experienced and no patient had to stop treatment prematurely on this account.