Azelaic acid is a well-known inhibitor for 5%-reductase, and is, therefore, able to inhibit the conversion of testosterone into dihydrotestosterone. Reduction of the dihydrotestosterone concentration brings the hair follicle in the anagen stage, and consequently, the hair follicle gains it original functionality back. In a clinical study, the effect of azelaic acid was compared with the effectiveness of anthralin, a cream used for the treatment of alopecia areata. It was concluded that the performance of azelaic acid is comparable with the results obtained with anthralin for hair (re)growth.
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