Can People with Keloid Skin Use Azelaic Acid Safely? - Dermatology

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Can individuals with keloid-prone skin use azelaic acid?


Hello Doctor: I have a tendency to develop keloids and have been using azelaic acid (Simei ointment) to treat my rosacea on the face.
I came across information online stating that individuals with a keloid tendency should not use azelaic acid, which has left me confused, especially since some doctors have suggested using retinoids (A acid) to treat keloids.
I have the following questions: 1.
Can I continue using azelaic acid to treat my rosacea on the face? 2.
If some doctors recommend using retinoids for keloids, does that imply that azelaic acid is also safe to use? Thank you for your assistance! I appreciate your help!

A Bin, 30~39 year old female. Ask Date: 2020/08/02

Dr. Wu Yuxin reply Dermatology


1.
Yes.
2.
Rhododendron acid is ineffective in treating keloids.

Reply Date: 2020/08/02

More Info


When it comes to the use of azelaic acid (also known as azelaic acid cream or gel) for individuals with keloid-prone skin, it is essential to consider both the properties of the acid and the nature of keloids. Keloids are raised scars that can develop after skin injury, and they are characterized by an overproduction of collagen. Individuals with a predisposition to keloids should be cautious when using any topical treatments that may irritate the skin or cause inflammation, as these factors can potentially trigger keloid formation.

1. Can you continue using azelaic acid for rosacea while having a keloid tendency?
Azelaic acid is generally considered safe for treating conditions like rosacea and acne due to its anti-inflammatory and antibacterial properties. However, if you have a history of keloids, it is crucial to monitor your skin's response to the treatment. If you experience any irritation, redness, or unusual reactions, it would be wise to discontinue use and consult a dermatologist. Some individuals with keloid-prone skin may tolerate azelaic acid well, while others may find that it exacerbates their condition.

2. Is it safe to use topical retinoids (like A acid) for keloid-prone skin?
Topical retinoids, such as tretinoin (A acid), are often recommended for various skin conditions, including acne and signs of aging. Some studies suggest that retinoids can help in the management of keloids by promoting skin cell turnover and reducing the thickness of the scar tissue. However, similar to azelaic acid, retinoids can also cause irritation, especially in sensitive skin. Therefore, if you are considering using A acid, it is essential to start with a low concentration and apply it sparingly, observing how your skin reacts.

3. Can azelaic acid and A acid be used together?
While both azelaic acid and A acid have beneficial properties for skin health, using them simultaneously may increase the risk of irritation, especially for individuals with sensitive or keloid-prone skin. It is generally advisable to introduce one product at a time and allow your skin to adjust before adding another. If you decide to use both, consider alternating their application days or using one in the morning and the other at night, ensuring adequate time for your skin to recover.

4. What precautions should you take?
- Patch Test: Before applying any new product, perform a patch test on a small area of skin to check for adverse reactions.

- Consult a Dermatologist: Given your keloid-prone skin, it is highly recommended to consult a dermatologist who can provide personalized advice based on your skin type and medical history.

- Moisturize: Keeping your skin well-hydrated can help reduce irritation from topical treatments. Look for non-comedogenic moisturizers that won't clog pores.

- Sun Protection: Both azelaic acid and A acid can increase your skin's sensitivity to the sun. Always apply a broad-spectrum sunscreen during the day to protect your skin from UV damage.

In conclusion, while azelaic acid can be beneficial for treating rosacea, individuals with keloid-prone skin should proceed with caution. Monitoring your skin's response and consulting with a dermatologist will help ensure that you choose the safest and most effective treatment options for your specific needs.

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