Noreskin (Azelaic Acid)

Azelaic acid is employed in dermatology to address disorders characterized by abnormal keratinocyte proliferation and bacterial colonization.

• Acne vulgaris: reduces inflammatory lesions and comedones, improving skin clarity.
• Rosacea: diminishes erythema and papulopustular lesions, helping control flare‑ups.
• Post‑inflammatory hyperpigmentation: lightens residual dark spots, promoting a more even skin tone.

• Azelaic acid exerts its therapeutic effect by inhibiting keratinocyte hyperproliferation, blocking 5‑α‑reductase, and interfering with the synthesis of free fatty acids that support Propionibacterium acnes growth. It also possesses direct antimicrobial activity against P. acnes and Staphylococcus epidermidis and reduces inflammatory mediators such as reactive oxygen species and cytokines, thereby normalizing skin cell turnover.

Topical azelaic acid may cause local skin reactions, most of which are mild and transient, while rare systemic events have been reported.

Common Side Effects

• Burning sensation: mild stinging at the site.
• Redness: mild erythema.
• Dryness or peeling: skin may become dry and flake.
• Itching: occasional pruritus.

Serious or Rare Side Effects

• Contact dermatitis: allergic rash with swelling.
• Hyperpigmentation or hypopigmentation: changes in skin colour.
• Severe irritation: intense burning requiring discontinuation.

When using topical azelaic acid, certain precautions help minimize adverse reactions and ensure safe use.

• Assess skin sensitivity: perform a patch test before full application.
• Avoid concurrent irritants: do not use other strong exfoliants or retinoids on the same area without medical guidance.
• Limit sun exposure: use sunscreen as azelaic acid may increase photosensitivity.
• Monitor for allergic reactions: discontinue if signs of contact dermatitis develop.
• Pregnancy and lactation: consult a healthcare professional before use, as safety data are limited.
• Store at ambient temperature: keep below 25°C in the original container, protect from moisture and direct sunlight.

Azelaic acid can interact with certain topical and systemic agents, influencing efficacy or tolerability.

Major Interactions (Avoid)

• Concurrent use of high‑strength topical retinoids: may increase irritation.
• Benzoyl peroxide combined with azelaic acid: can cause excessive dryness and burning.

Moderate Interactions (Monitor Closely)

• Other keratolytic agents (e.g., salicylic acid): may enhance irritation; monitor skin response.
• Systemic antibiotics for acne (e.g., doxycycline): no direct pharmacokinetic interaction but combined skin irritation possible.
• Physical exfoliation procedures (e.g., microdermabrasion): may increase sensitivity; schedule appropriately.