Two trials run to an identical design, covering 664 people between them, compared azelaic acid 15% gel with the same gel minus the active ingredient. Inflammatory bumps fell 58% versus 40% in the first trial and 51% versus 39% in the second. Redness improved in more people on azelaic acid as well (about 45% versus 28%). Running the same trial twice and getting the same answer both times is what makes this convincing. No serious treatment-related side effects were reported.
Thiboutot D, Thieroff-Ekerdt R, Graupe K. Efficacy and safety of azelaic acid (15%) gel as a new treatment for papulopustular rosacea: results from two vehicle-controlled, randomized phase III studies. J Am Acad Dermatol. 2003;48(6):836-845.
Read the full study in the Journal of the American Academy of Dermatology ↗