The Multiple Uses of Azelaic Acid in Dermatology: Mechanism of Action, Preparations, and Potential Therapeutic Applications

Azelaic acid (AZA) is a versatile dicarboxylic acid used in dermatology for its anti-inflammatory, antioxidant, and antimicrobial properties, particularly against Propionibacterium acne, making it effective in treating acne vulgaris and rosacea. It inhibits tyrosinase, mitochondrial enzymes, DNA synthesis, and reactive oxygen species production, and has anti-proliferative effects on cancer cells. AZA is widely used for hyperpigmentation disorders like melasma due to its inhibitory effect on melanocytes. Available in 5%-20% formulations, AZA is well-tolerated with minimal side effects. Liposomal technology enhances its skin penetration and accumulation, potentially revolutionizing skin cancer treatment by overcoming absorption challenges. This review covers AZA's mechanisms, pharmacokinetics, dermatological uses, and market preparations.