Aziderm Cream
Aziderm Cream is a topical azelaic acid 20% cream from Micro Labs. First-line for papulopustular rosacea, mild-to-moderate acne, and melasma. Pregnancy Category B (safe in pregnancy). Apply twice daily; visible response at 4–12 weeks. Pairs well with ivermectin 1% and brimonidine for mixed-subtype rosacea.
✓ Medisch beoordeeld door Morgan Ellis — Apotheekonderzoeker · 8 jaar ervaring · Laatst beoordeeld: mei 2026
⚡ Quick Answer — What is Aziderm Cream?
Aziderm Cream is a topical cream containing azelaic acid 20% from Micro Labs — one of the most versatile dermatology actives in use today. It is first-line treatment for papulopustular rosacea, an evidence-based therapy for mild-to-moderate acne vulgaris, and a pregnancy-safe option for melasma and post-inflammatory hyperpigmentation. Apply a thin layer to clean, dry skin twice daily (morning and night). Onset: visible redness reduction in rosacea at 4–6 weeks; acne lesion clearance at 8–12 weeks; pigmentation fade at 12–16 weeks. The three main side effects are a brief stinging/warmth on first application (usually settles within a week), mild transient dryness, and — rarely — a tingling sensation. Azelaic acid is FDA Pregnancy Category B (compatible with pregnancy and breastfeeding), does not increase sun sensitivity, and can be combined with most other actives including retinoids, niacinamide and vitamin C.
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What Is Aziderm Cream?
Aziderm Cream is a topical cream containing azelaic acid 20%, manufactured by Micro Labs and supplied in a 15 g tube. Azelaic acid is a saturated nine-carbon dicarboxylic acid that occurs naturally in grains like wheat, rye, and barley. In dermatology it is one of the rare active ingredients that addresses three separate pathologies — inflammatory rosacea, acne vulgaris, and hyperpigmentation — through a combination of anti-inflammatory, antimicrobial, and tyrosinase-inhibiting effects.
Because it is Pregnancy Category B and carries none of the photosensitivity / thinning / peeling of retinoids, azelaic acid is often the first choice for patients who cannot tolerate or should not use retinoids, hydroquinone, or topical steroids.
How Azelaic Acid Works
Azelaic acid acts on four separate pathways that explain its unusually broad utility:
- Ontstekingsremmend — inhibits neutrophil reactive-oxygen-species (ROS) production and suppresses cathelicidin/kallikrein-5 signalling, the cascade that drives the persistent redness, papules and pustules of rosacea.
- Antibacterial — selectively reduces Cutibacterium acnes (voorheen Propionibacterium acnes) on follicular skin without disrupting the wider skin microbiome or selecting for antibiotic resistance (a key advantage over topical clindamycin/erythromycin).
- Comedolytisch — normalises follicular keratinisation, unclogging microcomedones that would otherwise progress to inflammatory acne lesions.
- Tyrosinase inhibition — selectively inhibits hyperactive melanocytes (does niet affect normally-pigmented skin), making it effective for melasma and post-inflammatory hyperpigmentation without the ochronosis risk of hydroquinone.
Approved and Evidence-Based Uses
- Papulopustular rosacea — US FDA-approved indication; azelaic acid 15–20% is a first-line topical (alongside topical ivermectin and topical metronidazole) in the American Acne & Rosacea Society (AARS) 2020 guidelines and in NICE UK guidance.
- Mild-to-moderate acne vulgaris — effective for both inflammatory papules/pustules and comedonal acne; safe for long-term use because it does not select for bacterial resistance.
- Melasma — 20% azelaic acid matches the efficacy of 4% hydroquinone over 24 weeks in head-to-head trials, without the ochronosis, post-inflammatory rebound, or pregnancy risk.
- Post-inflammatory hyperpigmentation (PIH) after acne or eczema — particularly useful in skin of colour.
- Maintenance therapy after an oral isotretinoin course or a Kligman-triple melasma cycle — gentle enough for continuous long-term use.
Aziderm Cream for Rosacea — What to Expect
Azelaic acid is one of three first-line topical treatments for papulopustular rosacea, alongside topical ivermectin 1% (Ivrea Cream / Soolantra) and topical metronidazole. The evidence base for azelaic acid in rosacea comes from two 12-week randomised controlled trials (Thiboutot 2003, Elewski 2003) showing significantly greater reduction in inflammatory lesions (papules and pustules) and erythema vs vehicle.
Expected timeline on Aziderm Cream for rosacea:
- Week 0–2: first application may cause brief transient stinging or warmth. This almost always settles within 7–10 days.
- Week 4–6: visible reduction in papules and pustules; erythema starts to soften.
- Week 12: peak effect on inflammatory lesions (typically 50–70% reduction vs baseline).
- Maintenance: azelaic acid is safe for continuous long-term use — unlike topical steroids, it has no cumulative atrophy / telangiectasia risk.
Azelaic acid does niet reduce the facial flushing or background redness of erythematotelangiectatic rosacea — for that, brimonidine 0.33% gel (Erythego) is the option. Many patients with mixed-subtype rosacea use azelaic acid for the inflammatory component and brimonidine for flushing, on alternating mornings.
Aziderm Cream Dosage and How to Apply
- Wash the face with a gentle non-foaming cleanser; pat dry gently (do not scrub).
- Wait until skin is fully dry — azelaic acid stings slightly more on damp skin.
- Squeeze a pea-sized amount and dot over the affected zone (cheeks, chin, nose, forehead — wherever rosacea or acne is present).
- Rub in a thin, even layer until fully absorbed. Do not apply a thick pack — more product is not more effective.
- Apply twice daily — morning and night. Consistency over 12 weeks is what produces clinical response.
- Wait 5–10 minutes, then layer a non-comedogenic moisturiser on top.
- Daytime: always finish with SPF 30+ broad-spectrum sunscreen (UV triggers all three conditions azelaic acid treats).
- Avoid the eye area, lip corners, and inside of the nostrils.
Tolerance tip: if the first week’s stinging is marked, start once-daily at night only for 7 days, then add the morning application from week 2. 90% of patients achieve twice-daily use without issue within 2 weeks.
Side Effects & Tolerability
Common (up to 10–30% of users, mostly weeks 1–2, usually transient):
- Mild burning, stinging or warmth on application
- Tingling or prickling
- Mild dryness or scaling
- Mild erythema (transient redness)
Minder vaak voorkomend: contact dermatitis to azelaic acid itself (rare), hypopigmentation in very dark skin (rare; usually reversible on discontinuation).
Not seen with azelaic acid: no photosensitivity, no cumulative atrophy, no telangiectasia, no pregnancy risk, no bacterial-resistance selection, no “purging” or retinoid-style peeling.
Aziderm Cream vs Other Rosacea / Acne Topicals
| Topical | Beste voor | Zwangerschap | Typical onset |
|---|---|---|---|
| Azelaic acid 20% (Aziderm Cream) | Rosacea, acne, melasma | Cat B (safe) | 4–12 weeks |
| Ivermectin 1% (Ivrea) | Papulopustular rosacea (first-line) | Cat C (caution) | 4–8 weken |
| Brimonidine 0.33% (Erythego) | Facial flushing / background redness | Cat B | 30 min (onset), 12 h (effect) |
| Topical metronidazole 0.75%–1% | Mild rosacea (first-line) | Cat B | 8–12 weken |
| Tretinoin 0.025–0.1% | Acne, photoaging | Cat C — avoid | 12–16 weken |
Contraindications & Precautions
- Hypersensitivity to azelaic acid or any cream excipient.
- Broken or eczematous skin — wait until broken skin has healed; azelaic acid will sting markedly on broken epidermis.
- Asthma: caution — very rare reports of worsening asthma control.
Zwangerschap en borstvoeding: Category B. The safest topical anti-rosacea and anti-pigmentation option available during pregnancy. Systemic absorption is <4%. Widely used in obstetric dermatology.
Kinderen: safe for use in adolescents 12+ for acne. Data in children <12 is limited.
Opslag
Store below 30°C in the original tube with the cap screwed tight. Do not refrigerate. Protect from direct sunlight. Use within 6 months of opening or before the expiry date.
Veelgestelde vragen
How long does it take for Aziderm Cream to work on rosacea?
Visible improvement in papules and pustules is typical at 4–6 weken. Maximale effect na 12 weken. Erythema reduction is slower than lesion reduction and plateaus around week 12–16. Continue as maintenance indefinitely — rosacea is chronic and flares on discontinuation.
Can I use Aziderm Cream if I’m pregnant?
Yes. Azelaic acid is FDA Pregnancy Category B — one of the very few dermatology actives considered compatible with pregnancy and breastfeeding. It is the first choice for both rosacea and melasma during pregnancy, since topical retinoids, hydroquinone, and oral isotretinoin are all contraindicated.
Does Aziderm Cream cause purging?
Azelaic acid does not cause the retinoid-style purge of new acne breakouts. The brief 1–2 weeks of stinging and mild redness at startup is tolerance, not purging — the existing lesions improve steadily from week 2 onwards without a flare phase.
Can I layer Aziderm Cream with retinoids, niacinamide, or vitamin C?
Yes to all three. Azelaic acid plays well with niacinamide (anti-inflammatory synergy), vitamin C (brightening synergy), and retinoids (combined acne / PIH protocol — apply azelaic in the morning and retinoid at night). Avoid layering with benzoyl peroxide in the same application (not dangerous, but BPO deactivates some of the azelaic acid on skin contact).
Will Aziderm Cream make me sun-sensitive?
No. Azelaic acid does not increase UV sensitivity. That said, UV is a primary trigger for all three conditions (rosacea, acne, melasma), so daily SPF 30+ broad-spectrum sunscreen is a non-negotiable part of the treatment plan regardless.
Can I use Aziderm Cream for melasma instead of hydroquinone?
Yes. 20% azelaic acid matches the efficacy of 4% hydroquinone over 24 weeks in head-to-head trials, without ochronosis risk or the need for cyclical breaks. It is the first choice for pregnancy-related melasma and for maintenance between hydroquinone cycles.
Is Aziderm Cream the same as Finacea / Skinoren?
Pharmacologically yes — all three are azelaic acid 15–20% topicals. Finacea (US / Bayer) is azelaic acid 15% gel; Skinoren (Europe) is 20% cream; Aziderm Cream (Micro Labs) is 20% cream. Clinical response is equivalent at equivalent strengths.
How is Aziderm Cream different from topical metronidazole for rosacea?
Both are first-line topicals for papulopustular rosacea with similar efficacy in head-to-head trials. Azelaic acid is slightly more effective on papulopustular lesions; metronidazole is slightly better tolerated on first application; azelaic acid also addresses acne and melasma in patients with mixed pathology. Choice is usually based on tolerability and individual response.
Where can I buy Aziderm Cream online?
You can buy Aziderm Cream (20% azelaic acid, 15 g tube) from MedsBase with discreet packaging and worldwide shipping.
Related Treatments on MedsBase
- Erythego Gel — Brimonidine 0.33%
- Ivrea Cream — Ivermectin 1% Topical
- Ivrea Shampoo — Ivermectin 1%
- Verpin — Ivermectin 6 mg Tablets
- Browse all Rosacea Treatments
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| Sterkte | 15 g 10% w/w, 15 g 20% w/w |
|---|---|
| Hoeveelheid | 1 Tube/s, 2 Tube/s, 3 Tube/s, 6 Tube/s |
Aziderm Cream
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