A Comprehensive Guide to Azelaic Acid

Posted by Azadeh Shirazi MD on

Azelaic acid is currently a Dermatologist favorite and one of the most underrated skincare ingredients. It is versatile and can be found in many different products including serums, moisturizers, and spot treatments. Azelaic can be beneficial for many different skin types but is specifically popular amongst those with Acne or Rosacea-prone skin. With April being Rosacea awareness month, I felt this was the perfect time to dive into this ingredient!

For more helpful tips on Rosacea, checkout my Youtube video!

What Are the Benefits of Using Azelaic Acid in Your Skin-Care Routine?

As a natural occurring acid found in grains, it has anti-microbial and anti-inflammatory properties making it a very effective treatment for Acne and Rosacea. It’s a gentle exfoliant, reduces hyperpigmentation, gets along well with other skincare ingredients, and it’s considered pregnancy safe.

How Does Azelaic Acid Work?

Azelaic acid is the jack of all trades and master of none. That’s because it does a little of everything yet it’s very gentle and not the most powerful ingredient. It brightens the skin by inhibiting tyrosinase, the enzyme involved in the production of pigment, therefore it reduces hyperpigmentation. Secondly, it kills acne causing bacteria and reduces mites associated with Rosacea. It has antimicrobial and anti-inflammatory properties making it effective in the treatment of skin conditions  such as Acne or Rosacea and helps prevent breakouts. It’s also an antioxidant that can counter the effects of, or neutralize, free radicals.

Is It Safe To Use With Other Ingredients?
Azelaic acid gets along well with other ingredients. It’s gentle enough to pair with salicylic acid if you are targeting acne or vitamin C if you are concerned with hyperpigmentation to help even out skin tone.
Is Azelaic Acid Good For All Skin Types?
Azelaic acid is well tolerated by almost all skin types particularly in formulations of less than 20%. As a gentle exfoliant, it’s beneficial for those with sensitive skin who can’t tolerate stronger actives like benzoyl peroxide or glycolic acid. It selectively targets abnormal pigment cells sparing normal pigment cells therefore safe to use on the whole face for hyperpigmentation, not just the darker areas. It’s also considered an effective ingredient for Keratosis Pilaris due to its keratolytic effects, particularly in those who can’t tolerate stronger acids. There’s always a risk for irritation with any active skincare ingredient, including Azelaic acid. It’s best to do a patch test to make sure your skin tolerates it.
How Often Should You Use Azelaic Acid?
It’s best used daily after cleansing along with a good moisturizer. Formulations of Azelaic Acid 10% are often tolerated twice daily as the main active treatment in a regimen. It’s best to avoid combining it with other acids like AHA/BHA when first starting Azelaic Acid, as it can increase the risk of dryness and irritation. The less variables the better when starting treatment products.  Be patient as it can take 4-6weeks to see results and can initially cause the skin to purge. 

Dr. Azi’s Product Recommendations:

Azelaic10 Serum

A favorite amongst my patients, I love this product for those with rosacea or acne along with hyperpigmentation. It’s lightweight yet hydrating using a blend of Azelaic Acid 10%, Hyaluronic Acid, and Arbutin to even skin tone, reduce hyperpigmentation, treat breakouts, smooth texture, and calm redness.  Gentle enough to use up to twice daily or pair with other skincare actives.  A clean product that’s fragrance free without sensitizing ingredients. 

Glytone Enhance Brightening Complex

Lightweight formula combining 12% Azelaic Acid with 3% Glycolic Acid making it a great option for those with hyperpigmentation.  It also helps brighten skin tone and smooth skin texture. Given Azelaic acid and glycolic acid are considered safe at the concentrations in this product, it’s a good option in those who are pregnant or breastfeeding, but it’s important to first check with your doctor.  

The Ordinary’s Azelaic Acid 10%

This is an affordable option in a lightweight lotion formula to help reduce discoloration and breakouts, while brightening the skin’s complexion.  It’s gentle enough to use twice daily or pair with other actives.

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Dr. Azadeh Shirazi, MD is a Board-Certified Dermatologist.

Specializing in medical, surgical, and cosmetic dermatology, Dr. Shirazi received her undergraduate and medical degrees from the University Of Kentucky College of Medicine. After doing a Research Fellowship at Harvard Medical School at the Wellman Center for Photomedicine, she completed her residency training in Dermatology and Cutaneous Surgery at the prestigious Mayo Clinic in addition to completing her training in dermatology and cosmetic surgery at the University of California San Diego.

She has received multiple research scholarships from iconic institutions including Harvard University and the University Of Texas Southwestern Medical Center and has several peer-reviewed publications to her name.