What is the clinical efficacy of topical 20% azelaic acid cream and 15% azelaic acid gel compared with their respective vehicles and metronidazole gel in treating papulopustular rosacea?
Arch Dermatol · 2006 · PMID 16924055 · DOI 10.1001/archderm.142.8.1047
Topical azelaic acid effectively reduces inflammatory lesions and erythema in papulopustular rosacea and is comparable to metronidazole.
The question
What is the clinical efficacy of topical 20% azelaic acid cream and 15% azelaic acid gel compared with their respective vehicles and metronidazole gel in treating papulopustular rosacea?
What they tested
The study aims to evaluate the efficacy of azelaic acid formulations for papulopustular rosacea.
How they did it
Electronic searches of MEDLINE, EMBASE, BIOSIS, SciSearch, and the Cochrane Central Register of Controlled Trials were conducted through July or August 2004. Hand searches of reference lists, conference proceedings, and clinical trial databases were also performed, and experts were contacted. Randomized controlled trials comparing topical azelaic acid (cream or gel) with placebo or other topical treatments for rosacea were included. Two authors independently identified studies, extracted data, and assessed methodological quality. Five studies involving 873 patients were included.
What they found
A meta-analysis could not be conducted due to a lack of standard deviation data for four of the five studies. Four of the five studies showed significant decreases in mean inflammatory lesion count and erythema severity after azelaic acid treatment compared with vehicle. No studies demonstrated a significant decrease in telangiectasia severity.
What it means
Topical 20% azelaic acid cream and 15% azelaic acid gel are effective for treating papulopustular rosacea, particularly in reducing inflammatory lesion count and erythema severity. Azelaic acid appears to be as effective as, or potentially better than, metronidazole.
Limitations
A meta-analysis could not be performed because standard deviation data were unavailable for four out of five included studies.
The paper at a glance
| Magellan’s evidence label | anti-inflammatory, antioxidant (our label for this citation — see PubMed for the paper’s own title and authors) |
|---|---|
| Journal | Arch Dermatol |
| Year | 2006 |
| PMID | 16924055 ↗ |
| DOI | 10.1001/archderm.142.8.1047 ↗ |
| Topic | Skin, hair & photoaging |
Read the source: PubMed record (authors, abstract, full citation) ↗ · Publisher via doi.org ↗
Where Magellan uses this paper
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Azelaic Acid Gel
Multiple randomized controlled trials, Cochrane reviews, and meta-analyses find that topical azelaic acid significantly reduces inflammatory lesions and erythema in papulopustular rosacea - a systematic review of five trials (873 patients) found four of five superior to vehicle - and a 2019 GRADE-assessed review…
Azelaic acid is a naturally occurring saturated dicarboxylic acid found in grains such as wheat, rye…
Research describes the compound or intervention studied. It is not a claim about any specific product.
Cite this page
These citations point at this summary. To cite the original paper with its full author list, use the PubMed record or doi.org.
Magellan Longevity. (2026). What is the clinical efficacy of topical 20% azelaic acid cream and 15% azelaic acid gel compared with their respective vehicles and metronidazole gel in treating papulopustular rosacea? [Plain-English summary of Arch Dermatol 2006, PMID 16924055, DOI 10.1001/archderm.142.8.1047]. Magellan Longevity. https://magellanlongevity.com/study/s182.html@misc{magellan_s182,
title = {What is the clinical efficacy of topical 20% azelaic acid cream and 15% azelaic acid gel compared with their respective vehicles and metronidazole gel in treating papulopustular rosacea?},
author = {{Magellan Longevity}},
year = {2026},
howpublished = {\url{https://magellanlongevity.com/study/s182.html}},
note = {Plain-English summary of PubMed PMID 16924055; DOI 10.1001/archderm.142.8.1047; Arch Dermatol 2006. Reviewed by Gabriel Radu, DO},
urldate = {2026-08-11}
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