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Frequently Asked Questions about Azelaic Acid Azelaic Acid is a naturally occurring dicarboxylic acid found in whole grain cereals and animal products. It is FDA approved as a topical preparation to treat acne vulgaris. It is also used by dermatologist to lighten hyperpigmented skin. 2. How does Azelaic Acid help reverse androgenetic alopecia? There is scientific evidence that Azelaic Acid is a competitive inhibitor of Alpha-5 Reductase. Inhibiting Alpha-5 Reductase decreases the levels of DHT (dihydrotestosterone) in the scalp. As you know, at a genetically predetermined time, it is DHT that causes the progressive miniaturization of the hair follicles, which ultimately leads to male patterned baldness. 3. Why do you combine it with Minoxidil? Minoxidil and Azelaic Acid work on different mechanisms of action in preventing baldness. Theoretically, the combination of the two would work more effectively than either alone. 4. What are the side effects of Azelaic Acid? Side effects of Azelaic Acid are generally mild and transient in nature. The most common side effects are itchiness, tingling, or stinging sensation occurring in 1-5% of patients. Other side effects are redness, dryness and peeling of the skin seen in less than 1% of patients. Some patients have noted a lightening of the skin. 5. Who should not us Azelaic Acid? Any patient that is hypersensitive to any component of the Azelaic Acid solution. 6. What is the most effective topical solution for the treatment of male patterned baldness? In my experience there is no topical medication better than the combination of Minoxidil, Retinoic Acid, and Azelaic Acid. However, I still feel there is no better product for the prevention and reversal of male patterned baldness than the oral pill, Propecia. I do believe using the combination of Propecia and a topical solution is better than Propecia alone.
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