Last update Nov. 4, 2023

Azelaic Acid

Very Low Risk

Safe. Compatible. Minimal risk for breastfeeding and infant.

Azelaic acid is a saturated dicarboxylic acid that inhibits the growth of Propionibacterium spp. and reduces keratinization. it is used to treat mild to moderate acne vulgaris and rosacea. Topical application twice daily.

At the time of the last update, we found no published data on its excretion in breast milk.

It is a natural product found in various foods including breast milk. 

Less than 4% is absorbed through the skin (Täuber 1992) and eliminated rapidly, so it is unlikely to reach a significant concentration in breast milk and may be considered safe during lactation. (Ly 2023, Kong 2013, Fluhr 2010, Leachman 2006, Worret 2006, Akhavan 2003)

Do not apply on the breast or clean well before breastfeeding.

It is advisable to avoid applying creams, gels and other topical products containing kerosene (mineral oil) to the nipple so that the infant does not absorb it. (Concin 2008, Noti 2003)

Alternatives

  • Benzoyl Peroxide ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Clindamycin ( Safe. Compatible. Minimal risk for breastfeeding and infant.)
  • Erythromycin (Possibly safe. Probably compatible. Mild risk possible. Follow up recommended. Read the Comment.)
  • Tretinoin (topical use) ( Safe. Compatible. Minimal risk for breastfeeding and infant.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Azelaic Acid in other languages or writings:

Group

Azelaic Acid belongs to this group or family:

Tradenames

Main tradenames from several countries containing Azelaic Acid in its composition:

Pharmacokinetics

Variable Value Unit
Molecular weight 188 daltons
oral: 0.75. Dermal: 12 hours

References

  1. Ly S, Kamal K, Manjaly P, Barbieri JS, Mostaghimi A. Treatment of Acne Vulgaris During Pregnancy and Lactation: A Narrative Review. Dermatol Ther (Heidelb). 2023 Jan;13(1):115-130. Abstract Full text (link to original source)
  2. Kong YL, Tey HL. Treatment of acne vulgaris during pregnancy and lactation. Drugs. 2013 Jun;73(8):779-87. Abstract
  3. Fluhr JW, Degitz K. [Antibiotics, azelaic acid and benzoyl peroxide in topical acne therapy]. J Dtsch Dermatol Ges. 2010 Abstract
  4. Concin N, Hofstetter G, Plattner B, Tomovski C, Fiselier K, Gerritzen K, Fessler S, Windbichler G, Zeimet A, Ulmer H, Siegl H, Rieger K, Concin H, Grob K. Mineral oil paraffins in human body fat and milk. Food Chem Toxicol. 2008 Abstract
  5. Worret WI, Fluhr JW. [Acne therapy with topical benzoyl peroxide, antibiotics and azelaic acid]. J Dtsch Dermatol Ges. 2006 Abstract
  6. Leachman SA, Reed BR. The use of dermatologic drugs in pregnancy and lactation. Dermatol Clin. 2006 Abstract
  7. Akhavan A, Bershad S. Topical acne drugs: review of clinical properties, systemic exposure, and safety. Am J Clin Dermatol. 2003 Abstract
  8. Noti A, Grob K, Biedermann M, Deiss U, Brüschweiler BJ. Exposure of babies to C15-C45 mineral paraffins from human milk and breast salves. Regul Toxicol Pharmacol. 2003 Abstract
  9. Täuber U, Weiss C, Matthes H. Percutaneous absorption of azelaic acid in humans. Exp Dermatol. 1992 Abstract

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