TLDR Azelaic acid and finasteride can help preserve skin flaps after surgery by increasing BCL-2 protein and decreasing bax protein.
In a study conducted in 2012, researchers evaluated the effect of azelaic acid 20% and finasteride on the expression of BCL-2 and bax proteins after skin flap surgery in 21 rats. The results showed that both azelaic acid and finasteride increased the expression of BCL-2 protein and decreased the expression of bax protein. This suggests that both substances have an antiapoptotic role, potentially helping to preserve the skin flap after the ischemia reperfusion insult, which is a common issue in reconstructive surgeries.
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January 2019 in “Advances in Medical Sciences” The combination of azelaic acid, minoxidil, and caffeine significantly increased the survival of skin flaps by affecting certain body channels and nitric oxide levels.
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