Azelex

"Skin purging" is a term used to describe the worsening of acne that people might experience when starting certain acne medications. In clinical studies, people who used Azelex didn't report a worsening of acne. But they did note skin irritation, such as burning or tingling, at the application site. Typically, these side effects are mild and should go away with time.

The length of time it takes for you to see results from Azelex depends on how severe your skin condition is and your body's response to the medication. People typically see an improvement in their acne after about 4 weeks of treatment. Let your provider know if your skin doesn't get better by this time, you might need to consider other options for your skin condition.

Typically, your dermatologist will ask you to apply Azelex to your face twice daily, in the morning and evening. Ask your care team if you're not sure how often to use this medication.

Ask your dermatologist if you can use Azelex with adapalene (Differin), a retinoid. Both are topical medications used to treat acne, but they work in different ways. Your dermatologist might recommend that you use them together to help with acne. But because they both cause similar side effects (e.g., burning, stinging, dry skin), using Azelex with adapalene (Differin) can cause more skin irritation.

Your dermatologist can talk with you about the risks and benefits of using Azelex with Retin-A (tretinoin). Azelex is a a topical dicarboxylic acid and Retin-A (tretinoin) is a topical retinoid. The American Academy of Dermatology recommends that when using topical acne medications, it's best to use multiple therapies that work in different ways, like Azelex and Retin-A (tretinoin), to manage your condition. But because these medications can cause similar side effects, you might notice more drying, burning, or other skin irritations if you use them together.

You can only get Azelex (azelaic acid 20%) cream at the pharmacy with a prescription from a dermatologist. But some topical azelaic acid can be found over-the-counter (OTC), such as azelaic acid 10% cream. In general, these products have a lower concentration of azelaic acid compared to what's in the prescription-strength version. Talk with your healthcare team if you have more questions about the difference between prescription and OTC azelaic acid.

You can continue to use Azelex if you experience mild burning, tingling, and pain at the application site. Most of the time, these side effects are temporary and should go away after a few weeks. But let your dermatology team know right away if your symptoms are severe or if the skin irritation doesn't get better after a few weeks. They might ask you to consider other options.