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Azelaic acid is a naturally occurring saturated dicarboxylic acid found in wheat, rye, barley, and produced by the skin yeast *Malassezia furfur*. It is used topically as a cream (typically 20%) or gel/foam (typically 15%) for the treatment of mild to moderate acne vulgaris and rosacea. Azelaic acid works through multiple mechanisms including antibacterial activity against *Propionibacterium acnes* by inhibiting bacterial protein and DNA synthesis (notably via inhibition of thioredoxin reductase), anti-inflammatory effects by reducing reactive oxygen species from neutrophils and interfering with inflammatory cytokine expression, normalization of keratinization to prevent comedone formation, and inhibition of tyrosinase which reduces melanin production—making it useful for hyperpigmentation disorders such as melasma. It also has antioxidant properties[1][3][5][6].
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