Drawbacks

The study done in people with undifferentiated hyperpigmentation disorders23 found that people using azelaic acid cream had a higher incidence of burning, particularly at weeks 4 and

12 (P= 0-046 and 0-021, respectively; detailed data not provided) and significantly higher stinging symptoms at week 4 (P = 0-002, detailed data not provided) than those using placebo.

In the comparison with hydroquinone, complaints of mild symptoms such as itching and burning were more frequent with azelaic acid (61/167 (37%)) than with hydroquinone (22/173 (12%); RR 3-0, CI 1-7-4-7; NNH 4, CI 3-6). Withdrawals related to intolerance (local irritation) occurred in both groups (4/167 (2%) with azelaic acid compared with 2/173 (1%) with hydroquinone). Marked irritation was more frequent with azelaic acid (15/167 (9%)) than with hydroquinione (2/173 (1%)); RR 7-8, CI 1-8-33-5; 12, CI 7-30).24

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