DHT causes an increase in p53 and p21 expression, which leads to DKK1 apoptosis of the hair follicle. Azelaic acid represses p53 and p21.
http://www.ncbi.nlm.nih.gov/pubmed/22859066
http://www.ncbi.nlm.nih.gov/pubmed/23278893
Also, apparently Azelaic acid competes with the NADPH sites of 5 alpha reductase. No clear proof, but sure explains why some articles and people on the forums with acedotal evidence claim that Azelaic acid works as a 5 alpha reductase inhibitor.
http://www.ncbi.nlm.nih.gov/pubmed/22859066
http://www.ncbi.nlm.nih.gov/pubmed/23278893
Also, apparently Azelaic acid competes with the NADPH sites of 5 alpha reductase. No clear proof, but sure explains why some articles and people on the forums with acedotal evidence claim that Azelaic acid works as a 5 alpha reductase inhibitor.