How does azelaic acid topical gel or cream treat facial blemishes?

As a dicarboxylic acid, azelaic acid topical works by killing surface bacteria on the face that can cause facial blemishes, by decreasing keratin production, and by keeping skin pores from becoming blocked. Azelaic acid's blocking of keratin production may be key to its success, as bacteria need proteins such as keratin to survive. It is not known how azelaic acid treats rosacea and skin discolorations, but it may help reduce inflammation.

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