Combined use of 20% azelaic acid cream and 0.05% tretinoin cream in the topical treatment of melasma

A comparison of adapalene gel 0.1% vs. tretinoin gel 0.025% in the treatment of acne vulgaris in China

“…12,13 Forty-five patients (23 Chinese and 22 Japanese) with photoagingassociated hyperpigmentation were randomized to 0.1% tretinoin cream or vehicle, once daily, for 40 weeks. 13 Good results were also reported when 0.05% tretinoin cream was combined with 20% azelaic acid, 14 and a multicentre study of 300 patients in Thailand and the Philippines found that 20% azelaic acid cream alone produced results substantially superior to 2% hydroquinone cream in the treatment of melasma. Colorimetry confirmed this difference, and histological analysis showed a 41% decrease in epidermal pigmentation in response to tretinoin, as compared with a 37% increase in pigmentation in the vehicle-treated patients.…”

“…The effect could be detected within 4 weeks of commencing treatment. 13 Good results were also reported when 0.05% tretinoin cream was combined with 20% azelaic acid, 14 and a multicentre study of 300 patients in Thailand and the Philippines found that 20% azelaic acid cream alone produced results substantially superior to 2% hydroquinone cream in the treatment of melasma. 15 While tretinoin may have some benefit in reducing hyperpigmented macules, it is important to remember that this agent may be irritating, especially in the first 2 weeks of treatment, depending on dose, gelenics and the individual tolerance of the patient.…”

Azelaic acid (15% gel) in the treatment of acne rosacea

“…Azelaic acid (1,7‐heptanedicarboxylic acid) is a naturally occurring saturated dicarboxylic acid, 2,3 often found as a dietary constituent, occurring in whole grains and some meat products, and can be formed endogeneously 3 . It has been used in various formulations to treat rosacea, 4–8 acne, 9–16 melasma, 17–22 lentigo maligna, 23,24 malignant melanoma 25 and even perioral dermatitis 26 . Interestingly, there is also evidence that it could have a biological effect on hair loss (androgenetic alopecia) through its ability to inhibit 5‐alpha‐reductase 27 and thus the conversion of testosterone to dihydrotestosterone (DHT).…”

Treatment Options for Rosacea With Concomitant Conditions

“…28 In a trial evaluating the efficacy of azelaic acid cream 20% in treating melasma, the majority of patients showed significant improvement. 30 This was likely mediated Typical presentation of PD in a 28-year-old woman. Photos used with permission from M. Siegel, MD, PC, Waterford, Mich.…”