Expert opinion on the prescription practice of azelaic acid for the management of acne in various age groups in Indian settings

Abstract

Azelaic acid has been indicated to treat various common dermatoses including acne vulgaris, perioral dermatitis, inflammatory rosacea, melasma, and post-inflammatory hyperpigmentation due to its various modes of action and significant therapeutic efficacy.Considering the scientific advances contributing to the refinement of therapeutic options, it was important for clinicians to stay updated regarding the current treatment standards. This cross-sectional survey employed a multiple-response questionnaire to gather opinions of dermatologists who had experience in treating acne with a special focus on azelaic acid in Indian settings. There was a total of 28 queries and the majority of them were on the management of acne using azelaic acid monotherapy or in conjunction with oral antibiotics.The survey involved 467 participants, and 35% of them preferred the use of azelaic acid for the management of acne, melasma, and post-inflammatory hyperpigmentation disorders. About 6 to 8 weeks of optimal duration was recommended by 56% of the respondents for treating acne. Azelaic acid with glycolic acid was preferred by 66% of the respondents for acne treatment. Moreover, about 56% of the respondents preferred azelaic acid in combination with oral antibiotics for the treatment of mild-to-moderate papulopustular acne. Approximately 50% and 46% of respondents reported that they occasionally recommend topical azelaic acid as a treatment for keratosis pilaris and lentigo maligna, respectively. About 37% of the respondents preferred a daily dosage of 20% azelaic acid for the effective management of acne, melasma, and post-inflammatory hyperpigmentation. For the treatment of mild-to-moderate papulopustular acne, the use of azelaic acid in conjunction with other oral antibiotics was advocated. Experts preferred a daily dosage of azelaic acid to achieve better treatment outcomes in patients with acne, melasma, and post-inflammatory hyperpigmentation where they also endorsed for acne management in pregnant women, emphasizing its safety and efficacy.