Doctor’s Note: Your Easy Guide to Azelaic Acid
As dermatologists, we love azelaic acid! Known for its ability to fight acne, reduce pigmentation, and soothe inflammation, azelaic acid is a must-have in skincare regimens. It's versatile enough to be used in both morning and evening routines, making it a favored ingredient for promoting clear and even-toned skin.
Check out our video to the right, or read the highlights below!
Azelaic Acid at a Glance
Azelaic acid is a naturally occurring antioxidant found in barley, wheat, and rye, often hailed as the "Swiss Army Knife" of skincare. Its versatility makes it a go-to ingredient for various skin concerns, particularly safe for sensitive skin types. It effectively addresses redness associated with conditions like rosacea, acne, and sensitive skin, while also targeting issues such as acne-related pores and uneven texture. Azelaic acid is also beneficial for treating brown spots such as melasma and post-inflammatory hyperpigmentation. It can be seamlessly integrated into skincare routines alongside retinol, acids, hyaluronic acid, vitamin C, niacinamide, and benzoyl peroxide, though caution is advised when combining multiple active ingredients, especially for sensitive skin. Generally safe for use during pregnancy, azelaic acid requires consistent application over several months to achieve noticeable results.
Summary: Azelaic Acid is great for rosacea. It cleans out your pores and is safe for sensitive skin. We sometimes use it for acne, though it doesn’t work as well as other products (like retinol). It’s also a fairly strong pigment inhibitor, so we use it for dark spots as well. Rosacea + melasma (dark spots) are its main uses in dermatology.
What is Azelaic Acid?
Powerful antioxidant
Safe for sensitive skin
Most common uses: rosacea + melasma
Over-the-Counter: <15%
Prescription: >15%
What does Azelaic Acid Treat?
Redness: Rosacea, Acne, Sensitive skin
Pores: Acne, Large pores, Texture issues
Brown Spots: Melasma, Post-inflammatory hyperpigmentation
How to Apply
Use in AM or PM routines
Apply after water-based products
Start slowly, gradually increase to daily use
Generally safe during pregnancy
May take months for noticeable results
Consistent use is key
What Does Azelaic Acid Do?
Azelaic acid is a versatile skincare ingredient with four key benefits. It effectively fights acne by killing bacteria and reducing inflammation, and also helps in fading dark spots and evening out skin tone. Additionally, azelaic acid boosts skin renewal, aiding in the reduction of fine lines and improving texture. It also fortifies the skin's barrier, increasing resilience against environmental stressors and enhancing moisture retention.
Check out how Azelaic Acid compares to Vitamin C, Retinol, and Niacinamide!
So… wtf is the above image? Take our VERY basic intro to skin anatomy here!
Why Are There So Few Azelaic Acid Products?
If you’ve been on the hunt for an azelaic acid product, you may have noticed that there’s not a *ton* of options to choose from. Why is this? Azelaic acid is a powder that is not very soluble in water, so as you can imagine, making a water-based formula can be hard! For comparison, let’s look at Sephora’s website. Retinol has 116 options, Vitamin C has 609 results, Niainamide has 261 options, while azelaic acid only has 20. So it’s a little harder to find! These are the result numbers from Sephora:
Azelaic Acid Burning?!
You might feel a burning, stinging, tingling, or itching sensation, especially when you first start using the treatment. These feelings usually get better as your skin gets used to it. Here are some tips to help with the burning discomfort:
Make sure your skin is completely dry before putting on the treatment.
Use azelaic acid every other day or night at first, so your skin can adjust.
Try the "sandwich method": put on a gentle moisturizer before and after using azelaic acid.
Consider using a lower concentration of azelaic acid.
Ask your friendly neighborhood dermatologist for personalized advice!
4 Best Azelaic Acid Products
When looking for good azelaic acid products, here are some top picks with great benefits. Paula's Choice BOOST 10% Azelaic Acid Booster is a lightweight formula that helps improve skin texture and even out skin tone. Naturium offers two great options: the Azelaic Topical Acid 10%, which combines azelaic acid with niacinamide and vitamin C for better brightening effects, and the Azelaic Acid Emulsion 10%, a soothing and hydrating formula perfect for sensitive skin. Lastly, The Ordinary 10% Azelaic Acid Suspension is a budget-friendly choice, though some users find it feels a bit "gritty." Each of these products has unique benefits, making them great choices for adding azelaic acid to your skincare routine!
Naturium Azelaic Acid Topical 10%
10% “Azelaic Acid”. Actually potassium azeloyl diglycinate (PAD), which is gentler than azelaic acid.
Niacinamide + Vitamin C
Note: Water-based, gel-like texture. PAD is not as well-studied as azelaic acid. AA is already gentle. Why do you need another product that doesn’t work as well and is less studied? Naturium needs to get its act together, get rid of this, and stick with the Emulsion only.
The Ordinary Azelaic Acid
10% Azelaic Acid
Note: Texture is a bit gritty, due to this product being a suspension. It is the most affordable option, though!
Naturium Azelaic Acid Emulsion 10%
10% Azelaic Acid
Niacinamide + Bio-retinol
Note: Silky, creamy texture. Choose this over the Topical version.
Paula's Choice Azelaic Acid
10% Azelaic Acid
Licorice Root: Calms redness and brightens.
Salicylic Acid: Unclogs pores.
Azelaic Acid Body Lotion?!
Azelaic acid body lotion?! What a great idea! Unfortunately, there are not many options for this. However, you can create your own! Mix azelaic acid into your favorite body lotion. Prepare a fresh mixture daily to prevent the azelaic acid from oxidizing and losing its effectiveness. Remember, always use sunscreen to protect your skin from UV damage!
Prescription Azelaic Acid
Azelaic acid also comes in prescription form. The brand name is Finacea (15%), which is typically prescribed for rosacea (Finacea = Rosacea). Finacea typically comes as a foam that you apply twice daily. Finacea is great for individuals whose over-the-counter azelaic acid products do not provide sufficient relief. We almost always prescribe it for rosacea, but sometimes we use it for stubborn cases of acne and melasma, too!
If over-the-counter azelaic acid isn’t quite doing enough, prescription-strength azelaic acid is an option, particularly for sensitive, rosacea-prone skin.
Finacea = 15% Azelaic Acid Foam
Azelaic Acid 15% Before and After
Image: Dall'Oglio F, Tedeschi A, Lacarrubba F, Fabbrocini G, Skroza N, Chiodini P, Micali G. A novel azelaic acid formulation for the topical treatment of inflammatory rosacea: A multicentre, prospective clinical trial. J Cosmet Dermatol. 2021 Apr;20 Suppl 1(Suppl 1):28-31. doi: 10.1111/jocd.14098. PMID: 33934475; PMCID: PMC8252084.
Azelaic Acid FAQs
Can I Use Azelaic Acid After Microneedling?
Avoid using azelaic acid right after microneedling, as it may lead to skin irritation or excessive dryness. It's best to avoid any acid-based products and retinoids for up to two weeks surrounding the microneedling procedure. Instead, focus on using only hydrating products to soothe and support your skin's recovery.
Can You Use Azelaic Acid and Salicylic Acid Together?
Yes, you can use azelaic acid and salicylic acid together, but you need to be careful. Both are good for treating acne and improving skin texture, but they can be strong and might irritate your skin if used at the same time. To use them safely, apply azelaic acid in the morning and salicylic acid at night, or use them on different days. Always use a moisturizer to keep your skin hydrated. If you notice any irritation, reduce how often you use them or use only one.
Can You Use Azelaic Acid and Tretinoin Together?
Yes, you can use azelaic acid and tretinoin together as they complement each other in treating acne and hyperpigmentation. Start slowly to minimize irritation, and consider alternating their use on different nights to allow your skin to adjust.
Can You Use Azelaic Acid and Niacinamide Together?
Azelaic acid and niacinamide share several benefits: they reduce redness, improve skin texture, treat acne, and reduce dark spots. Here are the differences:
Azelaic Acid:
Antibacterial: Specifically targets acne-causing bacteria.
Exfoliating: Helps to gently exfoliate the skin, removing dead skin cells.
Known for treating rosacea.
Niacinamide:
Skin Barrier Support: Increases ceramides in the skin barrier.
Anti-Aging: Builds collagen.
Known for treating acne.
Both azelaic acid and niacinamide can be used together in a skincare routine to complement each other’s benefits. Apply niacinamide first, then follow with azelaic acid, and always remember to moisturize and use sunscreen during the day.
Can I use Azelaic Acid and Hyaluronic Acid Together?
Yes, you can use azelaic acid and hyaluronic acid together in your skincare routine. Azelaic acid helps treat acne, reduce redness, and improve skin texture, while hyaluronic acid hydrates the skin by attracting and retaining moisture, making it look plump and smooth. To use them effectively, apply hyaluronic acid first on clean skin to hydrate, then follow with azelaic acid. Finish with a moisturizer to seal in hydration, and always use sunscreen during the day to protect your skin.
Is Azelaic Acid for Melasma?
Yes, azelaic acid inhibits the production of melanin, making it a great treatment for melasma or hyperpigmentation in general!
Azelaic Acid vs Hydroquinone?
Azelaic acid helps everything! Acne, rosacea, sensitive skin, texture, and lightening dark spots. Hydroquinone has one job: lightening dark spots. It is much stronger than azelaic acid at lightening, but it can’t do everything else that azelaic acid does!