Azelaic Acid 15% Gel in the Treatment of Acne Vulgaris

Topical treatment is the mainstay in the management of mild-to-moderate acne vulgaris. Substances which influence more than one factor in the complex pathogenesis of acne are preferred. The efficacy and safety of a non-alcoholic hydrogel formulation containing 15% azelaic acid was evaluated in an observational study. The drug was applied twice daily for a treatment period of 9 - 210 (mean: 70.8) days. 1243 patients from 296 centers suffering from acne vulgaris were observed, with 1239 patients from 295 centers being available for evaluation. More than half of the patients had comedonal or papulopustular acne. The azelaic acid gel was given as monotherapy in 64.9% and in combination with other topical or systemic acne drugs in 35.1%. Acne symptoms showed moderate (43.0 %) or very good (36.1%) improvement in the vast majority of patients after 8 - 12 weeks of treatment. The therapeutic breakthrough was documented within the first 5 - 10 weeks in 53.6% of patients. The azelaic acid gel was well- or very well-tolerated by 95.7% of patients, with the occurrence of minor side-effects (mainly local irritation) in only 11 patients. Cosmetic acceptance was very good or good in 93.2% of patients. The vast majority of patients (86.5 %) continued topical application of azelaic acid after the end of observation period as a maintenance treatment. In conclusion, azelaic acid 15% gel is an effective and well- tolerated topical therapy for mild-to-moderate acne vulgaris, which can be used as monotherapy or combination therapy.