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ORIGINAL ARTICLE
Long-term effect of azelaic acid peel on sebum production
in acne
Anna Szyma
nska
1
| Elzbieta Budzisz
1
| Anna Erkiert-Polguj
2
1
Department of Cosmetic Raw Materials
Chemistry, Faculty of Pharmacy, Medical
University of Lodz, Lodz, Poland
2
Department of Cosmetology and Aesthetic
Dermatology, Faculty of Pharmacy, Medical
University of Lodz, Lodz, Poland
Correspondence
Anna Erkiert-Polguj, Department of
Cosmetology and Aesthetic Dermatology,
Faculty of Pharmacy, Medical University of
Lodz, 90-151 Lodz, Muszynskiego Street
1, Poland.
Email: anna.erkiert-polguj@umed.lodz.pl
Abstract
Seborrhea and the associated oily skin are undoubtedly the problem of women and
men around the world. The pathogenesis of acne vulgaris involves excessive activity
of sebaceous glands, as well as disturbances in the composition of sebum. The aim of
the study was to assess the severity of seborrhea in a group of acne vulgaris patients
and to determine the effect of a 20% azelaic acid solution on the activity of seba-
ceous glands. Twenty seven women, aged 19–25 years, underwent a series of six
treatments with the application of a 20% solution of azelaic acid to the face. The
mean values of sebum level showed a decreasing tendency. On the forehead, the
results were as follows—195.5 before the treatment and 162.7 2 weeks after the last
treatment. Measurements of the right cheek decreased from 175.3 to 141.3 The
measurements taken 3 months after the study were 151.3 on the forehead and
138.9 on the cheek. Similarly, the values determining the total number of acne
lesions and the severity of the disease according to the IGA scale also changed signif-
icantly. Chemical peel with 20% azelaic acid shows long-term sebostatic action,
which inhibits the formation of new acne lesions.
KEYWORDS
acne, azelaic acid, peel, sebum
1|INTRODUCTION
Seborrhea and the associated oily skin are undoubtedly the problem
of thousands of women and men around the world, thus representing
a major challenge for modern medicine and cosmetology.
The sebaceous glands, also known as sebocytes, are an integral
part of the structure and function of the skin. The production of
sebum is crucial in maintaining skin homeostasis, the proper level of
its hydration and physiological defense against environmental and
infectious factors.
1,2
The number and size of sebocytes are not constant and vary
depending on the location. The highest density of sebaceous glands,
in relation to other areas of the body, can be observed on the face
(400–900 sebocytes/cm
2
), on the scalp, as well as in the back and
chest area where they form the so-called seborrheic gutters.
2,3
The composition of sebum is also variable and differs, depending,
for example, on the species. The specific secretion of sebaceous glands
in humans consists mainly of triglycerides and free fatty acids, which
accounts for up to 57.5% of the sebum content. Additionally, other
components are, among others, wax esters, squalene, and cholesterol.
4
The function of sebaceous glands is directly controlled by the
endocrine system, particularly androgen hormones. They regulate the
activity of sebocytes by binding to nuclear androgen receptors (AR),
which in turn stimulates cell proliferation and lipogenesis.
1
The activ-
ity of the glands is also influenced by age, sex, and other factors, both
intrinsic (e.g., genetic predisposition) and extrinsic (e.g., environmental
factors, lifestyle, diet and care habits).
Abnormalities related to the function of sebaceous glands,
resulting in their excessive activity, as well as disturbances in the com-
position of sebum, can lead to the development of seborrhea or acne
vulgaris.
2
Received: 26 August 2021 Revised: 13 October 2021 Accepted: 1 November 2021
DOI: 10.1111/dth.15186
Dermatologic Therapy. 2022;35:e15186. wileyonlinelibrary.com/journal/dth © 2021 Wiley Periodicals LLC. 1of6
https://doi.org/10.1111/dth.15186