Combination azelaic acid therapy for acne vulgaris

J Am Acad Dermatol. 2000 Aug;43(2 Pt 3):S47-50. doi: 10.1067/mjd.2000.108318.


There is no topical antiacne medication that acts against all four of the major pathophysiologic features of acne: hyperkeratinization, sebum production, bacterial proliferation, and inflammation. Topical azelaic acid cream helps both to normalize keratinization and to reduce the proliferation of Propionibacterium acnes, and has proven to be effective against both noninflammatory and inflammatory lesions. The results of a recent study now demonstrate that its efficacy can be enhanced, and patient ratings of overall impression improved, when it is used in combination with other topical medications such as benzoyl peroxide 4% gel, clindamycin 1% gel, tretinoin 0.025% cream, and erythromycin 3%/benzoyl peroxide 5% gel. Furthermore, another study has shown that azelaic acid plus benzoyl peroxide achieves greater efficacy and higher patient ratings of convenience than monotherapy with erythromycin-benzoyl peroxide gel.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Acne Vulgaris / drug therapy*
  • Administration, Topical
  • Clinical Trials as Topic
  • Dermatologic Agents / administration & dosage*
  • Dermatologic Agents / adverse effects
  • Dicarboxylic Acids / administration & dosage*
  • Dicarboxylic Acids / adverse effects
  • Drug Therapy, Combination
  • Humans
  • Treatment Outcome


  • Dermatologic Agents
  • Dicarboxylic Acids
  • azelaic acid