Skinoren

Skinoren is a prescription-only medication containing the active ingredient azelaic acid. It is approved for the treatment of acne vulgaris and rosacea and is available as a gel (15%) or cream (20%).

Azelaic acid is a naturally occurring dicarboxylic acid that is produced on the skin by a yeast (Malassezia). It has antibacterial, anti-inflammatory, and skin-lightening properties.

There are no adequate controlled studies on use during pregnancy. Skinoren is prescribed to pregnant women only with caution.

Azelaic acid works through several mechanisms:

Antibacterial effect:

• Inhibits the growth of Propionibacterium acnes
• No known development of resistance
• Reduces bacterial colonization of the follicles

Normalization of keratinization:

• Acts on the disturbed keratinization in the hair follicles
• Prevents the formation of blackheads
• Has a mild peeling effect

Anti-inflammatory effect:

• Reduces the formation of free radicals
• Inhibits inflammatory mediators
• Effective against redness in rosacea

Tyrosinase inhibition:

• Blocks melanin production
• Helps with hyperpigmentation (acne marks)
• Lightening effect on dark spots

Skinoren is suitable for:

• Adolescents and adults with mild to moderate acne
• Patients with rosacea (papulopustular form)
• People with pigmented spots after acne

Particularly suitable for:

• Acne with hyperpigmentation (dark acne marks)
• Sensitive skin that does not tolerate other acne medications
• A combination of acne and rosacea

Less suitable for:

• Severe cystic acne
• When quick results are desired (azelaic acid works more slowly)

Skinoren Gel:

• Azelaic acid: 150 mg/g (15%)
• Pack sizes: 5 g, 30 g, 50 g

Skinoren Cream:

• Azelaic acid: 200 mg/g (20%)
• Pack sizes: 30 g, 50 g

Recommendation:

• Gel (15%): Better for oily skin, for rosacea
• Cream (20%): For drier skin, higher concentration for acne

Application: 1. Cleanse the skin thoroughly and dry it 2. Apply a thin layer in the morning and/or evening 3. Apply to the affected areas, not just to individual pimples 4. Massage in gently 5. Allow to absorb, then apply other products if needed

Frequency:

• Standard: 2x daily (morning and evening)
• For sensitive skin, start with 1x daily
• Once the skin has adjusted, can also serve as the sole morning treatment

Duration of treatment: First improvements after 4 weeks, optimal effect after 2-4 months. Can be used long-term.

Notes:

• Mild burning or tingling at the beginning is normal
• No photosensitization – can be used in the morning
• Combines well with other products

Skinoren must not be used in cases of:

• Hypersensitivity to azelaic acid or the excipients

Caution in cases of:

• Very sensitive skin (start with a low concentration/frequency)
• Asthma (worsening of asthma has been reported rarely with azelaic acid)

Pregnancy and breastfeeding: There are no adequate controlled studies on the use of azelaic acid during pregnancy. Skinoren is prescribed to pregnant women only with caution. During breastfeeding, Skinoren should be used with care. Infants must not come into contact with the treated skin or breast. Less than 4% of the applied amount is absorbed through the skin.

Very common (10% or more):

• Burning (especially at the beginning)
• Itching
• Skin redness (with the cream)

Common (1-10%):

• Stinging or tingling (especially at the beginning)
• Dry skin
• Scaling

Uncommon:

• Skin redness (with the gel)
• Contact dermatitis
• Skin lightening (desired effect in hyperpigmentation)
• Acne inflammation at the beginning

Rare:

• Allergic reactions
• Worsening of asthma (in predisposed patients)

Typical initial reactions: The burning and tingling during the first applications is normal and subsides after a few days to weeks. If skin irritation is more pronounced, the amount per application should be reduced or use should be limited to once daily until the irritation has subsided.

No known interactions with:

• Other topical acne medications
• Benzoyl peroxide
• Retinoids (can be combined after consulting a doctor)
• Antibiotics (topical or systemic)

Combines well with:

• Moisturizers
• Sunscreens
• Other acne active ingredients (applied at different times)

Recommendation for combination therapy: Apply azelaic acid in the morning and the retinoid in the evening.