Study: Azelaic Acid Shows Positive Outcomes in Pregnant Acne Patients

Key Takeaways

• Azelaic acid led to greater clinical improvement and satisfaction than clindamycin or erythromycin in treating acne during pregnancy.

• Side effect profiles were similar across all three topical treatments

New retrospective data on topical therapies for acne vulgaris during pregnancy suggested azelaic acid demonstrated greater efficacy compared to erythromycin or clindamycin.

 The study, conducted between 2018 and 2022, analyzed the treatment outcomes of 197 pregnant patients treated in an outpatient dermatology clinic. Participants were grouped by topical therapy received: erythromycin (n = 75), clindamycin (n = 96), or azelaic acid (n = 26). Investigators assessed Investigator’s Global Assessment (IGA) scores, lesion counts, side effect profiles, and patient satisfaction both before and after treatment.

According to the results, azelaic acid was associated with greater clinical improvement than the study comparators. Patients treated with azelaic acid showed greater reductions in IGA scores and total lesion count vs those treated with erythromycin or clindamycin (P < 0.001 for both comparisons). Patient-reported satisfaction was also highest in the azelaic acid group. Side effects did not differ significantly between groups (P = 0.093), and the treatment was well-tolerated by the patient population.

"As a result of the study, we see that azelaic acid is more successful in terms of both effectiveness and patient satisfaction," the authors wrote. "Therefore, azelaic acid is a good option in the treatment of mild to moderate acne during pregnancy."

Source: Hasanbeyzade S. Journal of Cosmetic Dermatology. 2025 Sep;24(9):e70410. doi: 10.1111/jocd.70410.