Azelaic acid is a prescription-only medication used to treat acne as well as rosacea. As with all medications, a person must decide along with a doctor whether the benefits outweigh the risks. This is especially true for pregnant or nursing women.
Azelaic acid is used to treat acne. It's in a class of medications called dicarboxylic acids, and is a naturally occurring acid. It is derived from cereal grains like barley, wheat and rye, according to Nucelle Inc. of Blaine, Wash. In the United States, it's marketed under the brand names Azelex, Finevin, Finacea and Finacea Plus, according to the Mayo Clinic.
Azelaic acid comes in a gel or cream. It helps the skin to renew itself more quickly, which in turn reduces formation of pimples and blackheads. It also kills the bacteria that infect pores and decreases keratin production. Keratin is a natural substance that can contribute to acne development, according to the National Institutes of Health. Azelaic acid may also be used to treat rosacea, a skin disease that causes flushing, redness and facial pimples, according to the Archives of Dermatology.
Topical azelaic acid is in FDA pregnancy category B. This category is for drugs that are not expected to be harmful to an unborn baby. For drugs placed in this category, either animal studies show no harm to fetuses but studies have not been done on pregnant women, or animal studies do show an adverse effect but adequate studies among pregnant women have shown no risk to fetuses, according to the Mayo Clinic. Drugs.com recommends discussing the use of azelaic acid with a doctor if you are pregnant or could become pregnant during use. Also, it is unknown whether topically applied azelaic acid passes into breast milk. The Mayo Clinic notes that azelaic acid is sometimes used for pregnant women or women taking birth control pills to treat tan discoloration in the face.
To use azelaic acid, the person must first wash the affected skin with mild soap and water and dry it. Then apply a thin layer of gel or cream to the area, gently massaging it into the skin, before washing it off. Do not cover the affected area with bandages, wrappings or dressings. You may apply non-irritating makeup over the azelaic acid after it dries, advises the National Institutes of Health.
Side effects of azelaic acid can include burning, itching, stinging or tingling and sometimes a rash, according to the NIH. It should not be used on windburned, sunburned, dry, chapped or irritated skin, as it can make such conditions worse. It also must not be used on areas with wounds or eczema. People who use azelaic acid need to avoid using abrasive, drying or harsh soaps as well as alcoholic cleansers, astringents, tinctures, abrasives and peeling agents, recommends Drugs.com.