Azelaic Acid 20% Cream: A Complete Guide to Uses, Benefits, and Safety
When to Call Your Doctor IMMEDIATELY
- Severe allergic reaction: swelling of face, lips, throat, or difficulty breathing.
- Severe skin reaction: blistering, peeling, or open sores.
- Signs of infection: increased pain, redness, warmth, or pus at the application site.
- No improvement after 12 weeks of consistent use.
- Unusual skin lightening (hypopigmentation) in areas not treated.
- Severe burning or stinging that does not subside.
If experiencing severe symptoms, call emergency services immediately.
What is exazel 20% cream used for?
Azelaic acid 20% cream is a topical treatment for acne and rosacea that works by killing acne bacteria, unclogging pores, and reducing dark spots. It is applied twice daily to the affected area.
- Generic Name: Azelaic Acid (20% w/w)
- Manufacturer: East West Pharma
- Form: Allopathy
- Pregnancy Category: Consult doctor
- Prescription Required: Yes
🇮🇳 exazel 20% cream के बारे में (Hindi Summary)
उपयोग: यह दवा एक टॉपिकल क्रीम है जिसमें एज़ेलाइक एसिड 20% w/w होता है। इसका उपयोग मुख्य रूप से मुँहासे (एक्ने), गुलाबी रंगत (रोसैसिया), और त्वचा पर पड़े काले धब्बों (हाइपरपिग्मेंटेशन) के इलाज के लिए किया जाता है। यह मुँहासे पैदा करने वाले बैक्टीरिया को मारती है, बंद रोमछिद्रों को खोलती है, और सूजन को कम करती है। यह त्वचा में मेलेनिन के उत्पादन को भी कम करती है, जिससे काले धब्बे हल्के हो जाते हैं। इसका उपयोग बाहरी त्वचा पर ही किया जाता है।
साइड इफेक्ट्स: आम दुष्प्रभावों में लगाने की जगह पर हल्की जलन, खुजली, लालिमा, या सूखापन शामिल हैं। ये आमतौर पर अस्थायी होते हैं और कुछ समय में कम हो जाते हैं। कभी-कभी त्वचा का छिलना या एलर्जी हो सकती है। गंभीर एलर्जी दुर्लभ है लेकिन अगर सांस लेने में तकलीफ, चेहरे पर सूजन, या गंभीर दाने हों तो तुरंत डॉक्टर से मिलें।
सुरक्षा सलाह: इस क्रीम को केवल त्वचा पर ही लगाएं। आंखों, होंठों और श्लेष्मा झिल्ली से बचें। अगर गलती से लग जाए तो पानी से धो लें। टूटी त्वचा पर न लगाएं। धूप में जाने से पहले सनस्क्रीन लगाएं। अन्य त्वचा उत्पादों जैसे रेटिनॉइड या बेंज़ॉयल पेरोक्साइड के साथ एक ही समय पर न लगाएं। गर्भवती या स्तनपान कराने वाली महिलाएं डॉक्टर से सलाह लें। बच्चों की पहुंच से दूर रखें।
💊 exazel 20% cream Uses & Benefits
[{"condition":"Acne vulgaris","description":"Reduces both inflammatory and non-inflammatory acne lesions by inhibiting bacterial growth and unclogging pores.","evidence":"Well-established"},{"condition":"Rosacea","description":"Helps reduce redness, papules, and pustules associated with rosacea.","evidence":"Well-established"},{"condition":"Post-inflammatory hyperpigmentation","description":"Lightens dark spots caused by acne or other skin injuries by inhibiting melanin synthesis.","evidence":"Moderate"},{"condition":"Melasma","description":"May help lighten dark patches on the face, often used as an alternative to hydroquinone.","evidence":"Moderate"}]
Off-label uses: [{"condition":"Keratosis pilaris","description":"Sometimes used to smooth rough bumps on the skin.","evidence":"Limited"},{"condition":"Folliculitis","description":"May be used off-label for inflammation of hair follicles.","evidence":"Limited"}]
Primary treatment for: Acne vulgaris
Also treats: Rosacea, Post-inflammatory hyperpigmentation, Melasma
📋 Drug Information
| Generic Name(s) | Azelaic Acid (20% w/w) |
| Brand Name | exazel 20% cream |
| Manufacturer | East West Pharma |
| Packaging / Form | Varies by brand (Allopathy) |
| Therapeutic Class | DERMA |
| Action Class | Antimicrobials- Acne |
| Route of Administration | Topical |
| Storage | Store at room temperature (15-30°C). Protect from light and moisture. Keep the tube tightly closed when not in use. |
| Shelf Life | 24 months from the date of manufacture. |
| WHO Guideline | Not established from the available information. |
| ICMR Guideline | Not established from the available information. |
👨⚕️ Doctor's Practical Tips
Evidence-based practical advice from experienced clinicians
🔍 Is This Medicine Right for Your Symptom?
Educational reference. Always consult a doctor for diagnosis.
🔬 How This Medicine Works (Pharmacology)
Pharmacokinetics
How It Works
Azelaic acid exerts its effects through multiple mechanisms: it inhibits the synthesis of proteins in Cutibacterium acnes, reducing bacterial colonization; it normalizes keratinization by decreasing the production of keratin filaments, preventing pore blockage; and it inhibits tyrosinase, an enzyme involved in melanin production, which helps reduce hyperpigmentation. Additionally, it has anti-inflammatory properties by scavenging free radicals and inhibiting the release of pro-inflammatory cytokines.
Mechanism Steps
💡 How to Take exazel 20% cream
Strength: Cream, 20% w/w
Dosage Information
| Adult Dosage | Apply a thin layer of this medicine to the affected area twice daily (morning and evening) after cleansing the skin. For acne, start with once daily to assess tolerance, then increase to twice daily if tolerated. For rosacea, apply twice daily. The dose and frequency must be individualized by a qualified clinician based on the condition, severity, and response to treatment. |
| Pediatric Dosage | Pediatric dosing is not established from available information. Consult a pediatrician. |
| Elderly Dosage | No specific dosage adjustments are required for elderly patients. Use as directed by a doctor. |
| Renal Impairment | No dosage adjustment is necessary for renal impairment due to minimal systemic absorption. |
| Hepatic Impairment | No dosage adjustment is necessary for hepatic impairment due to minimal systemic absorption. |
| Maximum Daily Dose | Not established from the available information. Use as prescribed by your doctor. |
Dosage Timeline
🍽️ Food Timing Guide
⏰ What to Do If You Miss a Dose
⚠️ Side Effects of exazel 20% cream
✅ Common Side Effects
🚨 Serious Side Effects
⚠️ Rare Side Effects
Consult your doctor if you experience any unusual symptoms.
🔬 Drug Interactions
| Drug | Severity | Effect |
|---|---|---|
| Tretinoin | Moderate | |
| Benzoyl peroxide | Moderate | |
| Salicylic acid | Minor | |
| Glycolic acid | Minor | |
| Hydroquinone | Minor |
⚡ Moderate Interactions
- Topical retinoids (e.g., tretinoin, adapalene)
- Benzoyl peroxide
- Alcohol-containing skincare products
🍷 Alcohol Interaction
No known interaction between topical azelaic acid and alcohol. However, alcohol consumption may worsen acne and rosacea, so moderation is advised.
🔎 Check Your Other Medicines
Educational tool. Always confirm with your doctor or pharmacist.
🛡️ Safety & Warnings
🚫 Contraindications
["Known hypersensitivity to azelaic acid or any ingredient in the cream","Application on broken or eczematous skin","Avoid contact with eyes and mucous membranes"]
⚠️ Warnings & Precautions
["For external use only.","Avoid contact with eyes, lips, and mucous membranes. If contact occurs, rinse thoroughly with water.","Do not apply to open wounds or irritated skin.","Use sunscreen daily as azelaic acid may increase sun sensitivity.","Avoid concurrent use of other topical irritants unless directed by a doctor.","Consult a doctor if you are pregnant, planning pregnancy, or breastfeeding.","Keep out of reach of children.","Do not use if the tube is damaged or past the expiry date."]
🤱 Lactation Safety
It is not known whether azelaic acid passes into breast milk. Since systemic absorption is minimal, risk to the infant is likely low. Avoid applying to the breast area to prevent infant exposure. Consult your doctor.
💊 Overdose Management
Topical overdose is unlikely. If excessive amounts are applied, rinse the area with water. If ingested, seek medical attention immediately. Symptoms of ingestion may include nausea, vomiting, and abdominal pain.
⏰ Missed Dose
If you miss a dose, apply it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not apply a double dose to make up for a missed one.
Additional Safety Advice
For external use only. Avoid contact with eyes, lips, and mucous membranes. If accidental contact occurs, rinse thoroughly with water. Do not apply to open wounds or eczematous skin. Use sunscreen daily, as azelaic acid may increase sun sensitivity. Avoid using other topical irritants (e.g., retinoids, benzoyl peroxide, alcohol-based products) on the same area unless directed by a doctor. Wash hands before and after application. Keep out of reach of children. Do not use if you are allergic to any ingredient. Consult a doctor if you are pregnant, planning pregnancy, or breastfeeding. Do not cover the treated area with airtight dressings unless instructed.
👴 Special Considerations for Elderly
💡 For Patients Above 65
No specific precautions for elderly patients. Use as directed by a doctor.
🤰 Pregnancy Planning (TTC)
If you are planning pregnancy, consult your doctor. Topical azelaic acid is generally considered safe, but your doctor may adjust your treatment.
🏥 Post-Surgery Considerations
Avoid applying to surgical wounds or irritated skin. Consult your doctor before resuming use after surgery.
🦷 Dental Procedures
No specific considerations for dental procedures. Continue use as normal.
💚 Lifestyle Tips for Better Results
🏋️ Exercise Considerations
No specific exercise restrictions. However, if you sweat heavily, gently cleanse your skin afterward to prevent pore clogging.
🥗 Diet Recommendations
💼 Impact on Daily Work & Life
This medicine does not affect your ability to drive or operate machinery. It can be used during work hours as part of your skincare routine.
🛑 When to Stop This Medicine
Do not stop using this medicine without consulting your doctor. If you experience severe side effects, stop and seek medical advice. If your condition does not improve after 12 weeks, consult your doctor for alternative treatments.
📅 Long-Term Use Effects
Long-term use of topical azelaic acid is generally safe. It does not cause thinning of the skin or systemic side effects. Regular monitoring by a dermatologist is recommended to assess effectiveness and adjust treatment. If no improvement after 12 weeks, consult your doctor.
🌿 Non-Medicine Approaches
These can complement medicine but do not replace prescribed treatment.
Another topical treatment for acne that kills bacteria and unclogs pores.
Evidence: Well-establishedDerivatives of vitamin A that help unclog pores and reduce acne.
Evidence: Well-establishedFor moderate to severe acne, oral antibiotics may be prescribed.
Evidence: Well-establishedProfessional peels can help with acne and hyperpigmentation.
Evidence: Moderate💉 Vaccination Considerations
💉 If You're Getting Vaccinated
No known interaction with vaccines. Continue routine vaccinations as scheduled.
📦 Storage Guide
✅ DO
Store at room temperature (15-30°C)
❌ DON'T
Do not refrigerate unless specified
✅ DO
Keep in original container
❌ DON'T
Do not transfer to unmarked containers
✅ DO
Keep away from direct sunlight
❌ DON'T
Do not store in bathroom cabinet
✈️ Traveling with This Medicine
Carry this medicine in its original packaging with a copy of your prescription. Store at room temperature and protect from extreme heat or cold. If traveling by air, keep it in your carry-on luggage. No time zone adjustments are needed for topical application. Check customs regulations for prescription medicines in your destination country.
💰 Cost Analysis & Savings
👥 Real Patient Stories
Educational, anonymized scenarios. Individual results may vary.
💬 Questions Patients Often Ask
A: You may start seeing improvement in 4 weeks, but full effects typically take 8-12 weeks of consistent use.
A: Yes, but avoid using other irritating products at the same time. Consult your doctor for a suitable regimen.
A: Topical azelaic acid is considered low risk, but consult your doctor before use.
A: Apply as soon as you remember, but if it's almost time for the next dose, skip it. Do not double dose.
A: Acne may return if you stop. Your doctor may recommend maintenance therapy.
🤔 Common Patient Concerns
🔄 Substitutes for exazel 20% cream
View AllAlternative brands with exact same active ingredient:
-
azac 20% creamMark India ₹140.63 33.5% CHEAPER
-
zebor 20% gelHetero Drugs Ltd ₹197.80 6.5% CHEAPER
-
azecare 20 creamCanbro Healthcare ₹198.00 6.4% CHEAPER
-
azerin 20 creamElixir Pharma ₹201.56 4.7% CHEAPER
-
acnerus az 20% gelCyrus Remedies ₹206.25 2.5% CHEAPER
Medical Note: Always consult your doctor before switching medications.
🛑 Myths vs. Facts
- Myth: Azelaic acid 20% cream works overnight.
Fact: It may take several weeks to see noticeable improvement. - Myth: You can stop using it once acne clears.
Fact: Acne may return if treatment is stopped; maintenance therapy is often needed. - Myth: It can be used on any skin condition.
Fact: It is specifically for acne, rosacea, and hyperpigmentation; consult a doctor for other conditions.
🔄 Alternative Options
Generic Alternatives
- Azelaic acid 20% cream (generic)
Brand Alternatives
- Aziderm 20% Cream
- Ezanic 20% Cream
- Azelaic Acid 20% Cream (various manufacturers)