33. The Blemish Buster - Azelaic Acid

Doctor Jacob here, and we're talking today about the Blemish Buster - Azelaic Acid. Azelaic acid is a prescription, but there are over-the-counter versions of slightly chemically modified derivatives of azelaic acid which are just as good for blemish busting.

Before we go any further, let's talk about what is an acne blemish. An acne blemish is a flat spot which is typically pink, but can be red or eve brown, especially in darker-skinned individuals. These pink or reddish-colored flat spots that are left behind after an acne pimple are called blemishes. If you close your eyes and you run your finger over the blemish you won't be able to feel it because it's flat, whereas a scar has a textural change - either raised up scar, called a hypertrophic scar, or an indented acne scar, which can be subdivided into other subtypes of acne scars, but that's not what this is about. This is about a blemish.

Many blemishes fade with time, time alone. There are certain lasers that can do it, but they get expensive for something that will fade with time, but a lot of patients want something that helps the blemish fade a little more quickly. There are two things that can do that. The first is the topical retinoid which we have a whole episode on, and the second is slightly better than a topical retinoid, it's azelaic acid, which is what this episode is about. Again, there's a prescription form as well as an over-the-counter form.

Azelaic acid is a prescription for acne, it comes as a cream 20%, called Azelex cream. It's actually safe for pregnancy and breastfeeding, believe it or not. It actually works to treat acne as well as prevent blemishes, but it tends to be a bit expensive as a prescription and its effect on actual acne isn't all that powerful, so I don't prescribe a lot of it for the actual treatment of acne. But for blemishes, there you go.

A lot of times I'm actually recommending the over-the-counter form of this. There's a slightly chemically modified form of the azelaic acid called Potassium Azeloyl di-Glycinate. That's a mouthful, but it's basically very slightly chemically modified to enhance the penetration of the azelaic acid into the skin, and it's over-the-counter - no prescription required.

There are several redness-relief therapies which are marketed as redness-relief treatment gels that work on this post-inflammatory erythema as we call it, or for simple terms a blemish, and it really does help it go a little bit faster. It can be used once or even twice a day and it's a spot treatment; you don't treat the entire zone for a blemish treatment, you just treat the actual little red pink or discolored spot. Again, these products do not help scars, so if you have acne scarring please see one of the later episodes. This is good for discolorations or blemishes. I'm going to put a link to one of these great products on our website under Blemish Treatment, and if you're interested, go check it out.

I'm Doctor Jacob, we'll see you next time.