Azelaic Acid

Topical Antibacterial

The following side effects are expected to occur in the first few weeks of using azelaic acid cream, foam, or gel. These side effects usually decrease with continued use of azelaic acid.  Contact your doctor if these symptoms are severe and/or do not go away:

How Common (based on clinical studies)

Redness and/or warmth in the areaUp to 17.5% of all users
Skin peeling or scalingUp to 15.8% of all users
Itching Up to 15.4% of all users
Burning, stinging, or tingling sensationsUp to 10% of all users
Soreness / Tenderness in the areaUp to 6.2% of all users
Dryness of skinUp to 0.7% of all users

If you experience any of the following side effects, stop using azelaic acid immediately and contact your doctor or get emergency medical care right away:

  • A sudden appearance of swelling and rash (known as hives)
  • Swelling of the eyes, lips, tongue, or entire face
  • Severe itching
  • Trouble breathing or swallowing
  • Changes in voice (hoarseness)

Azelaic may also cause other side effects that are not mentioned here. Contact your doctor if you experience any other troublesome symptoms when using azelaic acid. 

References
  1. UpToDate. Azelaic Acid: drug information. Available from: https://www.uptodate.com/contents/azelaic-acid-drug-information?search=azelaic%20acid&source=panel_search_result&selectedTitle=1~14&usage_type=panel&kp_tab=drug_general&display_rank=1. Cited October 29, 2018.
  2. Katsambas A, Graupe K, Stratigos J. Clinical studies of 20% azelaic acid cream in the treatment of acne vulgaris. Acta Derm Venereol, Suppl 143, 35-39 (1989).
  3. Cunliffe WJ, Holland KT. Clinical and laboratory studies on treatment with 20% azelaic acid cream for acne. Acta Derm Venereol, Suppl 143, 31-34 (1989)
  4. Cavicchini S, Caputo R. Long-term treatment of acne with 20% azelaic acid cream. Acta Derm Venereol, Suppl 143, 40-44 (1989).
  5. Gollnick H, Graupe K. Azelaic acid for the treatment of acne: comparative trials. Journal of Dermatological Treatment, 1, 27-30 (1989).
  6. DailyMed. Azelaic Acid. Available from: https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=AZELAIC+ACID&pagesize