From this article you will learn
- Skinoren instructions for use,
- gel or cream – which form is better,
- reviews of Skinoren from dermatologists.
The article was written by a specialist with higher medical education.
The drug Skinoren is a drug based on azelaic acid, which is used to treat acne, mild forms of acne, and also for the treatment of rosacea. The drug is produced well-known (Germany) and has 2 release forms - gel or cream for external use. These drugs are dispensed in pharmacies without a doctor's prescription, and according to the instructions for use, they can be used from 12 years of age.
Reviews from dermatologists about Skinoren are quite positive, however, according to international protocols for the treatment of acne, drugs with azelaic acid are only 2nd choice drugs (inferior in effectiveness to drugs from the group of topical retinoids). The latter include drugs such as Clenzit, Differin or Adaklin. However, drugs with azelaic acid also have their undeniable advantages, which we will discuss below.
What Skinoren gel looks like: photo
Indications for use –
- acne*,
- papulopustular form of acne (pimples)*,
- treatment of rosacea (gel only),
- treatment of chloasma (cream only).
* Please note that the use of drugs with azelaic acid is justified only for mild forms of acne and pimples. In addition, these drugs can be used to prevent new outbreaks of acne and pimples (after the full course of treatment with topical retinoids has been completed), i.e. used as maintenance therapy.
How much does Skinoren cost in pharmacies:
For Skinoren, the price in pharmacies depends on the size of the tube. Skinoren gel is available in tubes of 15 g, 30 g and 50 g, and their cost will be 600, 1200 and 1450 rubles, respectively. Skinoren cream is available only in 30 g tubes - at a price of 1200 to 1300 rubles. The cost is for 2021. By the way, sometimes a 30 g tube of Skinoren cream or gel can be bought at a discount for about 950-1000 rubles.
In fact, it is expensive, considering that preparations with azelaic acid are somewhat inferior in effectiveness to topical retinoids, and also require significantly greater consumption of the drug. For example, Klenzit gel costs only about 800 rubles (for a 30 g tube), and Differin gel or cream costs 900 rubles (for a 30 g tube). Although from a logical point of view everything should be quite the opposite.
Types of the drug Skinoren
Skinoren is produced only for the purpose of application to problem skin. The pharmacy sells gel and cream of the same name.
The main component in both drugs is azelaic acid. One gram of gel contains 150 mg of acid, one gram of cream contains a little more - 200 mg.
The 15% gel also contains: triglycerides, sodium hydroxide, lecithin, propylene glycol, disodium ededate, polyacrylic and benzoic acids, polysorbate and purified water.
The gel is a mass of grayish or slightly yellowish color with a weak medicinal odor, opaque. You can buy it in tubes of 15, 30 or 50 g, placed in a box complete with instructions.
Cream 20% additionally contains: benzoic acid, glycerol, macrogol glyceryl stearate, propylene glycol, a mixture of cetostearyl alcohol and coconut oil fatty acid glycerides, cetostearyl ethyl capronate and purified water.
Skinoren cream has a uniform structure and white color. Sold in 30 g aluminum tubes, placed in a cardboard package along with instructions.
Skinoren and its analogues -
Skinoren gel and cream: price in pharmacies from...
- gel (tube 15 g) – from 680 rub.
- gel (tube 30 g) – from 1200 rub.
- gel (tube 50 g) – from 1450 rub.
- cream (tube 30 g) – about 1200 rubles.
Analogues of Skinoren gel and cream –
Skinoren gel: analogues
- Azelik gel (Russia) – from 650 rubles (tube 30 g),
- Skinoclear gel (Russia) – from 500 rubles (tube 30 g).
Skinoren cream: analogues
- Skinoclear cream (Russia) – from 500 rubles (tube 30 g).
- Azix-Derm cream (India) – from 650 rubles (tube 30 g).
Skinoren during pregnancy -
The absorption of the active ingredients is so low that the drug is not contraindicated during pregnancy and breastfeeding, but you should inform your doctor about the use of the drug. We hope that our article on the topic: Reviews of Skinoren for acne and acne was useful to you!
Sources:
1. Higher medical education of the author of the article, 2. Textbook on dermatology “Fitzpatrick's Dermatology” (8th edition), 3. “Modern methods of treatment and rehabilitation of patients with acne vulgaris” (Barinova A.N.), 4. “Acne with positions of evidence-based medicine" (Anisimova M.Yu.),5. “Azelaic acid is the drug of choice for local acne therapy” (Zhuraeva).
How does Skinoren work?
The therapeutic effect of Skinoren is due to the healing properties of azelaic acid, which can reach the deep layers of the epidermis, but practically not enter the general circulatory system.
According to the instructions for use, Skinoren has an effect in four areas:
- cleanses the skin of acne by suppressing the growth of bacteria located on the skin and causing blockage of the sebaceous glands;
- relieves inflammation, thereby preventing the appearance of new acne;
- helps exfoliate dead skin particles from its surface;
- fights skin pigmentation due to the ability to block the production of melanin in excess.
With regular use of the gel or cream, acne, manifestations of rosacea or seborrheic dermatitis, and increased pigmentation of the skin disappear.
A noticeable effect can be seen after 14-28 days of proper use.
Thanks to its more liquid consistency and the absence of an oily base, the gel penetrates the dermis faster and gives faster results compared to cream. In addition, the gel is more suitable for people with oily skin, as it has a watery base.
Cautions when using the product
Cream and gel are contraindicated in case of hypersensitivity to azelaic acid or excipients from the composition of the drugs.
In children:
- Do not use both forms of the drug to combat acne until the age of 12;
- not prescribed for the treatment of rosacea and hyperpigmentation in adolescents under 18 years of age.
When diagnosed with bronchial asthma, drugs are prescribed with caution.
The manufacturer of the products warns about the possible occurrence of side effects:
- most often possible: an unpleasant burning sensation and itching, local redness of the skin, peeling of the top layer of skin, tightness and dryness;
- hypersensitivity reactions - swelling of the eyes and face, Quincke's edema, bronchospasm;
- deterioration of the condition - manifestations of seborrhea, discoloration of skin areas, increased appearance of acne.
If the condition worsens or discomfort occurs during the course of treatment, you must stop the drug and visit a doctor.
Skinoren cream d/nar.approx. 20% in tubes 30g in pack No. 1
Name
Skinoren cream 20% 30g
Description
White opaque cream.
Main active ingredient
Azelaic acid
Release form
Cream
special instructions
The drug is intended for external use only. Avoid contact of the drug with the eyes, mouth and mucous membranes. In case of accidental contact, rinse thoroughly with plenty of water. If eye irritation persists, consult a doctor. Hands should be washed after each application of the drug. Skinoren™ cream contains benzoic acid, which may cause irritation to the skin, eyes and mucous membranes, and propylene glycol, which may cause skin irritation. The simultaneous use of Skinoren™ cream with cosmetics, alcoholic or aggressive detergents, tinctures, astringents or abrasives or exfoliating agents should be limited. In rare cases, exacerbation of asthma symptoms is possible when using azelaic acid.
Pharmacological properties
Pharmacodynamics
Azelaic acid, the active ingredient of the drug Skinoren™, is a natural straight-chain dicarboxylic acid, devoid of toxicity, teratogenicity and mutagenicity. It is believed that the therapeutic effectiveness of Skinoren™ cream is determined by its antimicrobial effect and direct effect on follicular hyperkeratosis. Clinically, there is a significant decrease in the colonization density of Propionibacterium acnes and a significant decrease in the free fatty acid fraction of skin surface lipids. Azelaic acid in vitro and in vivo inhibits the proliferation of keratinocytes and normalizes the disruption of the processes of terminal differentiation of the epidermis during the formation of acne. At a concentration of 0.31% -2.5%, the biocidal effect against gram-positive and gram-negative aerobic bacteria, anaerobic bacteria and fungi appears after prolonged contact for 30-120 minutes. In vitro studies have not demonstrated the presence of azelaic acid-resistant mutants in either Staphylococcus epidermidis or Propionibacterium acnes.
Pharmacokinetics
After topical application of the cream, azelaic acid penetrates into all layers of the skin. Penetration occurs faster in damaged skin than in healthy skin. After a single topical application of 1 g of azelaic acid (5 g of cream), approximately 3.6% of the applied dose is absorbed. Part of the absorbed acid is excreted unchanged by the kidneys. The remaining part in the form of dicarboxylic acids with a shortened chain length (C7, C5), formed as a result of beta-oxidation, is also excreted by the kidneys.
Indications for use
Acne: acne vulgaris, characterized by the presence of comedones, papules, pustules and small nodules.
Directions for use and doses
Externally. Adults and children over 12 years of age: apply the cream to the affected areas of the skin and rub lightly 2 times a day (morning and evening). Approximately 2.5 cm of cream is enough for the entire face. Before using Skinoren™ cream, the skin should be cleansed with water or a mild cleansing cosmetic and then dried. It is important that Skinoren™ cream is used regularly throughout the entire treatment period. The duration of treatment may vary depending on the individual picture of the disease and is determined by the degree of its severity. For acne, improvement is usually observed after 4 weeks. To achieve the best results, Skinoren cream should be used continuously for several months. There is experience in continuous use of the drug for up to 1 year. In case of excessive skin irritation, you should reduce either the amount of Skinoren™ cream applied or the frequency of use of the drug to 1 time per day until the irritation disappears. If necessary, you can temporarily interrupt treatment for several days. If there is no improvement within a short period of treatment, you should consult a doctor.
Use during pregnancy and lactation
Caution should be exercised when using Skinoren™ cream during pregnancy and breastfeeding. There have been no controlled studies of topical use of azelaic acid in women during pregnancy. Animal studies have identified possible risks in relation to pregnancy, embryo/fetal development, birth and postnatal development. However, in animal studies, no adverse effects were observed at 3 to 32 times the maximum recommended dose based on body surface area. Some in vitro studies have demonstrated the possibility of the drug passing into breast milk. Children should avoid contact with skin/breasts that have been treated with the cream.
Interaction with other drugs
No studies have been conducted to study interactions with other drugs.
Contraindications
Hypersensitivity to azelaic acid and other components of the drug.
Compound
1 g of cream contains: active ingredient - azelaic acid 200 mg excipients: benzoic acid (E210), stearoyl macrogol glycerides, Cutin CBS, ceteary loctanoate, propylene glycol (E1520), glycerol 85% (E422), purified water.
Overdose
Given the very low local and systemic toxicity of azelaic acid, intoxication is unlikely.
Side effect
The most common local adverse reactions are: burning, itching, erythema, as well as peeling of the skin, pain, dryness, discoloration of the skin and irritation at the site of application. Less commonly, seborrhea, acne, skin discoloration, paresthesia, dermatitis, discomfort and swelling, cheilitis (inflammation of the lips), urticaria, eczema, a feeling of warmth, skin ulcers and hypersensitivity reactions at the site of application of the drug may be observed. There are known cases of skin rash and worsening of bronchial asthma in patients treated with azelaic acid. As a rule, local skin irritation decreases during the course of treatment.
Storage conditions
At a temperature not exceeding 30°C, out of the reach of children.
How to use Skinoren
The cream or gel should be applied only to clean, dry skin. After using the drug, you must wash your hands with soap, and the application area should not be covered with a bandage.
The gel or cream is applied twice a day - in the morning and in the evening. For application to the face, a strip 2.5 cm long is enough; the composition can be lightly rubbed into the skin. This regimen is also suitable for the treatment of acne in adolescents aged 12-18 years.
The minimum duration of treatment for acne is one month, longer use is allowed.
The use of the drug in the treatment of melasma should last for at least three months, rosacea - for at least two months.
If irritation occurs during treatment, it is necessary to reduce the amount of the drug applied or reduce the number of applications to once a day.
If Skinoren is prescribed for the treatment of increased pigmentation, then to prevent exacerbation or relapse it is necessary to use sunscreen.
Reviews of Skinoren for acne and acne –
Next, about the most important thing you should know if you decide to cure your acne and pimples on your own.
As we said above, the full course of treatment with Skinoren is 6 months, and you will receive noticeable results only after 3-4 months from the start of treatment. At the same time, the full course of topical retinoids is only 3 months (preparations Klenzit, Differin and others), and comedolytic and other effects are expressed in topical retinoids much more strongly than in preparations with azelaic acid. According to the recommendations of the most famous English-language textbook on dermatology in the world, Fitzpatrick's Dermatology, which publishes international acne treatment protocols, drugs with azelaic acid are only 2nd choice drugs. You need to start treatment with topical retinoids. However, preparations with azelaic acid can also be used as maintenance therapy - after completing a full 3-month course of treatment with topical retinoids.
Important: it is worth considering that if you have oily skin, then it is optimal to prescribe topical retinoids, because the latter significantly reduce the production of fatty secretions by the sebaceous glands. Another important point is to compare the cost-effectiveness of applying products with azelaic acid and products with retinoids. Products with topical retinoids in the form of gels are very economical and easy to apply in a thin layer (in addition, they only need to be applied once a day).
Products with azelaic acid are very different in this regard. We have already said that gels with azelaic acid are more reminiscent of regular cream in texture - they are white in color, absorb very quickly and are very difficult to apply in a thin layer (this results in more consumption). And besides, you will also have to use them 2 times a day, morning and evening, which further increases the consumption of the drug.
1) Skinoren for acne
Everything here is quite simple, because... acne is represented only by non-inflammatory elements - black and whiteheads (open or closed comedones). Therefore, if you still choose Skinoren, then in this case it does not need to be combined with other drugs for the treatment of acne, for example, with antibiotics or benzoyl peroxide. Those. Skinoren in this case is a replacement for topical retinoids, albeit somewhat less effective. But in parallel, you can use cleansers with salicylic acid or alpha hydroxy acids.
Closed and open comedones (types of acne) –
→ Acne treatment protocols
2) Features of using Skinoren for acne
The term “acne” is a colloquial expression, and in dermatology this pathology is called papulopustular acne. This name has taken root because acne can be of 2 types: firstly, in the form of pustules (these are traditional pimples with pus inside), and secondly, in the form of papules, which are inflammatory formations without pus. In this case, papules can either transform into pustules or disappear without a trace.
Pimples in the form of papules and pustules -
According to Fitzpatrick's Dermatology, the drug Skinoren and its analogues can be used to treat papulopustular acne (pimples), but only in the case of a small amount of inflammatory elements. At the same time, drugs with azelaic acid in this case will only be drugs of the 2nd choice, and preference should still be given to topical retinoids. If you are still focused on using Skinoren, then you will still have to combine it with antimicrobial agents, because Skinoren's own bacteriostatic effect is not sufficiently expressed.
- If you have papules (without pus), in this case, in addition to Skinoren, you should use products containing a bactericidal component such as benzoyl peroxide. Such drugs include, for example, the drug Baziron AS. In this case, you will use Skinoren 2 times a day in the morning and evening, and Baziron is enough to use only 1 time a day (it is applied only pointwise to areas of inflammation).
- If you have pustules (with pus inside) - in this case, in addition to using drugs with azelaic acid, you will need even more active antimicrobial therapy.
Pustules are a strict indication for the prescription of external agents with antibiotics, but in order to prevent P.acnes bacteria from developing resistance to antibiotics, antibiotics are always combined with benzoyl peroxide. In this case, it may be the drug Indoxyl (contains benzoyl peroxide 5% + antibiotic clindamycin 1%). But of course, such a scheme, given the need to use products with azelaic acid twice, is very inconvenient. In this case, it is more convenient to use topical retinoids, for example, the drug Klenzit-S (contains the retinoid adapalene + clindamycin), and it can be used only once a day at night. And in addition to it, use Baziron with benzoyl peroxide once a day in the morning. Of course, this scheme is much more convenient.
Additional Information
When using a cream or gel, you should be careful not to get the composition on the mucous membranes of the mouth, eyes, or open wounds. If this happens, the accidental contact site must be rinsed with plenty of water.
Skinoren cream is effective only in the treatment of melasma located in the epidermis and dermis. The drug has no effect on those located only in the dermis.
When treating rosacea, you should avoid using cosmetics that contain alcohol, abrasives, or exfoliants.
