Azelaic acid and rosacea
Rosacea is a common chronic inflammatory skin disease. It mostly occurs in the middle of the face, with erythema, papules, pustules and telangiectasia as the main manifestations, which seriously affect the appearance and quality of life of patients. In recent years, the treatment methods and drugs for rosacea have become more and more diverse, among which azelaic acid has attracted much attention.

Azelaic acid, which naturally exists in a variety of plant and animal tissues, is chemically named heptanedioic acid, which has multiple pharmacological effects such as antibacterial, anti-inflammatory and regulation of keratinocyte differentiation. Azelaic acid has shown unique advantages in the field of rosacea treatment.

From an antibacterial perspective, azelaic acid has a significant inhibitory effect on the key pathogens causing rosacea - Demodex follicularis and Propionibacterium acne. It can reduce the number of such microorganisms, thereby reducing the triggers of inflammation. Clinical studies have shown that after topical azelaic acid preparations, the density of Demodex follicularis and Propionibacterium acne on the skin surface of patients decreased significantly, and symptoms such as erythema and papules improved.

In terms of anti-inflammatory, azelaic acid can inhibit the release of inflammatory cytokines, such as interleukin-1α and tumor necrosis factor-α. These cytokines play an important role in the inflammatory cascade of rosacea. Azelaic acid can effectively reduce the inflammatory response of the skin by down-regulating its expression, relieve redness, swelling, pain and other uncomfortable symptoms.

Regulating the differentiation of keratinocytes is also an important effect of azelaic acid. Rosacea patients are often accompanied by abnormal stratum corneum metabolism. Azelaic acid can promote normal differentiation of keratinocytes, correct abnormal keratinization process, and improve skin barrier function. An intact skin barrier can block the invasion of external irritants and reduce the occurrence of inflammation.

In clinical practice, topical azelaic acid preparations are usually well tolerated. After use, most patients experience only mild skin irritation symptoms, such as short-term itching and burning sensation, which gradually reduce or disappear with the extension of medication time. After several weeks of continuous use in some patients, the symptoms of rosacea were significantly relieved and the appearance of the skin was significantly improved.

In summary, azelaic acid, as an effective drug for the treatment of rosacea, has brought new hope to rosacea patients with its antibacterial, anti-inflammatory and regulatory mechanisms such as keratinocyte differentiation. However, the specific use still needs to be carried out according to the individual situation of the patient and under the guidance of a professional doctor to achieve the best treatment effect.