106 ANTI-ACNE


Benefits of solubilized azelaic acid on C. acnes


James V Gruber, Nicole Terpak, Sebastien Massard, Elva Chen, Yurah Kim - Vantage


Acne is a skin condition that affects individuals throughout their lives. The causes of acne are complex and are principally based on a person’s genetics while a person’s age, eating habits, hygiene, and hormonal changes among other etiologies can also play a significant role in the progress of the disease.1 However, emerging now is a more nuanced


understanding of the causes of acne that appear to be linked to the skin’s innate immunity and the communication between the skin’s living cells, including epithelial and immune cells, and Cutibacterium acnes (C. acnes), a known skin commensal that is associated with acne.2,3 More profoundly, it now appears that acne


may have a relationship to various acneic strains of C. acnes, so called bad C. acnes, against strains that are known to be less pathogenic.4


A recent publication noted that


one of the key drivers of acne inflammation is the Tumor Necrosis Factor (TNF-a) pathways of inflammation.5 Regardless of the complexity of the source of the disease, it has been found that if the


PERSONAL CARE April 2024


increase in C. acnes is controlled either by antibiotics, retinoids, topical antimicrobials like benzoyl peroxide or salicylic acid, or combinations of treatments that control the growth of the C. acnes, the condition can be made to improve.6 As noted in the work by Monteiro et al,


the overabundant use of antibiotics is being frowned upon as this is leading to bacteria that possess antimicrobial resistance. Presently, there are five topical active ingredients that are approved by the FDA in the US for the treatment of acne including salicylic acid, benzoyl peroxide, sulfur, resorcinol, and resorcinol monoacetate.7 When one logs onto the web, it is easy to


find references that suggest other ingredients such as tea tree oil, niacinamide, retinol and adapalene also provide benefits.8


Among the


treatments that have been reported to address various aspects of troubled skin and acne development and progression, azelaic acid has been shown to be effective as a topical treatment for the condition.9,10 There are products on the market where the


FDA has provided approval for the complete formulation containing azelaic acid to make acne claims. There is, however, no FDA monographed use of azelaic acid itself for acne. In Europe, acne is considered a cosmetic claim and so the opportunity to explore a broader palette of ingredients to treat the condition exists. In addition to being effective at treating


acne, azelaic acid has several known cosmetic benefits including skin brightening, inflammation reduction, reductions in skin redness (erythema) and even potential improvements in hair volume, texture and retention.11-13


Current commercial gels that


are sold for acne contain the ingredient at high levels (15-20%) and typically have the ingredient suspended as a particle in the base formulation. The reason for this is straightforward,


azelaic acid is difficult to solubilize in the most commonly suitable cosmetic solvents, particularly water. Reconstructed human epidermis (RHE) models colonized with skin microorganisms


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