Bryan Shelton - Once again Azelaic Acid.

[VoRteX]

Bryan,

I was thinking of taking finasteride out of my regimen in the near future for various reasons and going strictly topical.

I know we've discussed Azelaic before but I had one quick question to run by you. I know Dr. Lee bases his sole Azelaic theory on a single in vitro experiment and further in vivo experiments have shown azelaic to probably not be a "dht inhibitor" or 5ar blocker.

However, Azelex cream is effective for acne. What is the mechanism of action that makes azelex effective on acne? Is it known? I ask this because I know acne is most times hormonally mediated so If Azelaic acid has a genuine effect on skin hormones for acne, then it would seem to give more credence to using it for male pattern baldness.

weigh in dood.

 

[Bryan]

Bryan,

I was thinking of taking finasteride out of my regimen in the near future for various reasons and going strictly topical.

Ahhh...you wanna be a "topical kinda guy" just like me, huh?

I know we've discussed Azelaic before but I had one quick question to run by you. I know Dr. Lee bases his sole Azelaic theory on a single in vitro experiment and further in vivo experiments have shown azelaic to probably not be a "dht inhibitor" or 5ar blocker.

However, Azelex cream is effective for acne. What is the mechanism of action that makes azelex effective on acne? Is it known?

Sure! Azelaic acid has a number of properties which make it useful for fighting acne. Chief among those is its antibacterial properties, but it also normalizes keratinization and fights comedones. To find out a lot more about it, search Pubmed for the words "azelaic acid acne", and you'll get about 70 hits. One of them is a nice review article whose abstract I've copied below...notice that it's from 1989, which is the same year as the (in)famous Stamatiadis study which found the in vitro inhibition of 5a-reductase; the authors of this study make a clear reference to it, although I give them a lot of credit for being very cautious by saying that "...it MAY interfere with the process of sobegenesis". Further studies have indicated that it does NOT do that, which is the basis for my belief that it doesn't really inhibit 5a-reductase in vivo.

Bryan


G Ital Dermatol Venereol. 1989 Apr;124(4):175-84.

"Azelaic acid in the treatment of acne"

Nazzaro-Porro M, Passi S, Picardo M, Breathnach AS, Zina G.

This review is an update of the literature accumulated over the past 6 years following the original observation that topically applied azelaic acid, a non-toxic C9 dicarboxylic acid, has a beneficial therapeutic effect on acne vulgaris. These studies have shown that azelaic acid has a modulating influence on the process of keratinization, and that it acts as a keratolytic and anti-comedogenic agent. There is evidence that it inhibits mitochondrial and microsomal oxido-reductases, including 5-alpha-reductase, and that it may interfere with the process of sebogenesis. It has a spectrum of antimicrobial activity, both in vitro and in vivo, against aerobic microorganisms and is effective against the anaerobic Propionibacterium acnes. Extensive multi-centre clinical trials have established that topical azelaic acid (a 20% cream) is an effective treatment for all types of acne. It compares well with other agents, such as topical tretinoin or benzoyl-peroxide, or oral tetracycline. It is non-irritant, and does not give rise to allergic or photo-toxic reactions. Its use is not associated with teratogenicity, possible endocrine unbalance, or the disadvantages of antibiotic treatment. It can be applied for long periods, in recurrences, and as maintenance "spot" therapy against individual lesions.

 

[VoRteX]

thanks.

Basically I was wondering if its worth it to keep paying for Xandrox. Guess there is no way to know for sure

How do you feel about Retin-A? I'm using retin-a free Xandrox now.

What topicals are you currently using and how has your hair progressed since the OLD pictures on this site?