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Azelaic Acid

Rob (PHH)

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Azelaic acid is naturally occurring and found in cereal grains such as wheat, rye, and barley, as well as in animal products. It is also produced by Malassezia furfur, a yeast that lives on the skin. For more than 30 years azelaic acid has been used due to its antimicrobial and anti-inflammatory properties.

Key insights:

  • The in vitro/ex vivo evidence shows that treatment of isolated mouse hair follicles with azelaic acid alone induced the activity of an enzyme called catalase which is known to help clear reactive oxygen species (ROS) from our cells (which may confer protection from UV) as well as upregulates key genes involved in hair follicle growth and cycling. Combination treatment with minoxidil also upregulated key genes involved in hair follicle growth, indicating that azelaic acid alone and in combination with minoxidil could potentially enhance hair follicle growth.
  • The in vivo (in mice) evidence suggests that combination treatment with azelaic acid and vitamin B6 can enhance hair follicle elongation and thickness compared to azelaic acid or B6 treatment alone as well as increase the levels of growth factors such as IGF-1.
  • The clinical data suggest that azelaic acid may be an effective topical therapy for patchy alopecia areata, and demonstrates a similar hair regrowth level as treatment with anthralin – which is thought to be a reasonable therapeutic option for severe alopecia areata – however there does not appear to have been any further studies to confirm this. Furthermore, the researchers themselves state that the sample size was too small (n=31) for definite conclusions to be drawn.
  • Our experience tracking members: azelaic acid by itself is not enough to improve hair loss outcomes.
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