Azelaic acid is another option for the topical treatment of mild to mo
derate inflammatory acne vulgaris. It offers effectiveness similar to
that of other agents without the systemic side effects of oral antibio
tics or the allergic sensitization of topical benzoyl peroxide and wit
h less irritation than tretinoin. Azelaic acid is less expensive than
certain other prescription acne preparations, but it is much more expe
nsive than nonprescription benzoyl peroxide preparations. Whether it i
s safe and effective when used in combination with other agents is not
known.