Editing Acne (section)

====Azelaic acid====
{{Self-contradictory|section|about=efficacy|date=December 2023}}
[[Azelaic acid]] is effective for mild to moderate acne when applied topically at a 15–20% concentration.<ref name=Sieber2014/><ref name=Pugashetti2013/><ref>{{cite journal |last1=Gollnick |first1=Harald P. M. |last2=Graupe |first2=Klaus |last3=Zaumseil |first3=Rolf-Peter |title=15% Azelainsauregel in der Behandlung der Akne. Zwei doppelblinde klinische Vergleichsstudien. [[Azelaic acid]] 15% gel in the treatment of acne vulgaris. Combined results of two double-blind clinical comparative studies |journal=Journal der Deutschen Dermatologischen Gesellschaft |date=October 2004 |volume=2 |issue=10 |pages=841–847 |doi=10.1046/j.1439-0353.2004.04731.x |pmid=16281587 |s2cid=58809558 }}</ref><ref>{{cite journal |last1=Thiboutot |first1=D |title=Versatility of azelaic acid 15% gel in treatment of inflammatory acne vulgaris |journal=Journal of Drugs in Dermatology |date=January 2008 |volume=7 |issue=1 |pages=13–6 |pmid=18246693 }}</ref> Treatment twice daily for six months is necessary, and is as effective as topical benzoyl peroxide&nbsp;5%, isotretinoin&nbsp;0.05%, and erythromycin&nbsp;2%.<ref name=Herb2010>{{cite journal | vauthors = Morelli V, Calmet E, Jhingade V | title = Alternative therapies for common dermatologic disorders, part 2 | journal = Primary Care | volume = 37 | issue = 2 | pages = 285–96 | date = June 2010 | pmid = 20493337 | doi = 10.1016/j.pop.2010.02.005 | type = Review }}</ref> Azelaic acid is an effective acne treatment due to its ability to reduce skin cell accumulation in the follicle and its [[antibacterial]] and [[anti-inflammation|anti-inflammatory]] properties.<ref name=Sieber2014/> It has a slight skin-lightening effect due to its ability to inhibit melanin synthesis. Therefore, it is useful in treating individuals with acne who are also affected by post-inflammatory hyperpigmentation.<ref name=Vary2015/> Azelaic acid may cause skin irritation.<ref>{{MedlinePlusEncyclopedia|603020|Azelaic Acid Topical}}</ref> It is less effective and more expensive than retinoids.<ref name=Vary2015/> Azelaic acid also led to worse treatment response when compared to benzoyl peroxide. When compared to tretinoin, azelaic acid makes little or no treatment response.<ref>{{cite journal |last1=Liu |first1=Haibo |last2=Yu |first2=Haiyan |last3=Xia |first3=Jun |last4=Liu |first4=Ling |last5=Liu |first5=Guan J |last6=Sang |first6=Hong |last7=Peinemann |first7=Frank |date=2020-05-01 |editor-last=Cochrane Skin Group |title=Topical azelaic acid, salicylic acid, nicotinamide, sulphur, zinc and fruit acid (alpha-hydroxy acid) for acne |journal=Cochrane Database of Systematic Reviews |volume=5 |issue=5 |pages=CD011368 |doi=10.1002/14651858.CD011368.pub2 |pmc=7193765 |pmid=32356369}}</ref>