Azelaic Acid and Breastfeeding

Summary of use during lactation

Topical azelaic acid has not been studied during breastfeeding. Because only 4% of a dose is absorbed after topical application and it is a chemical that appears in foods, bloodstream and breastmilk normally, azelaic acid is considered a low risk to the nursing infant.[1-3] If azelaic acid is required by the mother, it is not a reason to discontinue breastfeeding. Do not apply azelaic acid to the breast or nipple and ensure that the infant's skin does not come into direct contact with the areas of skin that have been treated. Only water-miscible cream or gel products should be applied to the breast because ointments may expose the infant to high levels of mineral paraffins via licking.[4]

Drug levels in milk and infant serum

Maternal Levels. Relevant published information was not found as of the revision date. Infant Levels. Relevant published information was not found as of the revision date.

Effects in breastfed infants

Relevant published information was not found as of the revision date.

Effects on lactation and breastmilk

Relevant published information was not found as of the revision date.

Alternative drugs to consider

(Acne) Benzoyl Peroxide, Clindamycin, Erythromycin, Tretinoin; (Rosacea) Metronidazole

References

1. Akhavan A, Bershad S. Topical acne drugs: Review of clinical properties, systemic exposure, and safety. Am J Clin Dermatol 2003;4:473-92.12814337 PubMed
2. Leachman SA, Reed BR. The use of dermatologic drugs in pregnancy and lactation. Dermatol Clin 2006;24:167-97.16677965 PubMed
3. Yaghi M, McMullan P, Truong TM, et al. Safety of dermatologic medications in pregnancy and lactation: An Update - Part II: Lactation. J Am Acad Dermatol 2024;91:651-68.38280680 PubMed
4. Noti A, Grob K, Biedermann M, et al. Exposure of babies to C(15)-C(45) mineral paraffins from human milk and breast salves. Regul Toxicol Pharmacol 2003;38:317-25.14623482 PubMed