All you need to know about azelaic acid

If you struggle with acne, you've likely explored various face washes, moisturizers, and treatments that contain active ingredients like benzoyl peroxide and vitamin C. However, there's an underrated ingredient called azelaic acid that often goes unnoticed. In addition to its acne-fighting properties, azelaic acid helps unclog pores, even out skin tone, and lighten dark spots and acne scars. We consulted dermatologists to understand how azelaic acid works and how you can incorporate it into your skincare routine.

How does Azelaic Acid work?

According to dermatologists, azelaic acid acts as a tyrosinase inhibitor, which helps even out skin tone and prevents and treats hyperpigmentation conditions such as melasma. It can also lighten post-inflammatory hyperpigmentation caused by acne, including dark spots (which are most often seen in people who have darker skin tones) and red scars   (most commonly seen on fair skin tones). Azelaic acid works by inhibiting tyrosinase, the enzyme responsible for melanin production.

Additionally, azelaic acid acts as an antibacterial antioxidant, reducing inflammation, unclogging pores, and treating acne. Compared to other acne-fighting ingredients like salicylic acid and adapalene, azelaic acid is milder, making it suitable for sensitive skin, acne, and rosacea.

Azelaic acid can be prescribed at 15% and 20% strengths, which have more research support. However, you can also purchase over-the-counter options with strengths up to 10%. Combining a lower strength over-the-counter option with other ingredients that fight acne can be more effective than using azelaic acid alone.

How to choose the azelaic acid products

While shopping for OTC products that contain azelaic acid, the following factors should be considered by our experts:

Concentration: While prescription-strength products are often better than OTC versions because they have higher concentrations of azelaic acid, OTC products that have a 10% strength or lower can still be effective, our experts told us.

Formulation: Though typically available as a serum, you can also find it in cleansers, face masks, creams and gels.

Additional ingredients: Depending on the specific skin concerns you’re trying to target, consider products that pair azelaic acid with skin brightening ingredients like niacinamide and vitamin C, as well as hydrating ingredients like hyaluronic acid.

Who should use azelaic acid — and who should avoid it?

Azelaic acid is a gentle and safe option for individuals with sensitive skin, teenagers, and those who are pregnant or breastfeeding, according to our experts.

However, it is important to exercise caution if you have very sensitive skin, as some individuals may experience stinging, burning, or even hyperpigmentation when using this ingredient. In such cases, it's advisable to be vigilant and observe how your skin responds.

It's worth noting that azelaic acid may not be as effective for individuals with severe cystic acne. While it can help with the pigment left behind after an acne lesion clears, it may not penetrate deep enough into the skin to have a significant impact on deeper cystic acne. For more severe acne, our experts recommend stronger ingredients such as benzoyl peroxide or retinoid gels like adapalene.

In summary, azelaic acid is a suitable option for those with sensitive skin and mild to moderate acne. However, individuals with very sensitive skin should proceed with caution, and those with severe cystic acne may need to explore alternative treatments. It's always a good idea to consult with a dermatologist to determine the best course of action for your specific skin concerns.   

How to Use Azelaic Acid

You can incorporate azelaic acid into your skincare routine by using it once or twice a day. It's recommended to start with once a day at night and monitor your skin's tolerance. If your skin responds well, you can gradually increase usage. Azelaic acid can be used together with a gentle cleanser, moisturizer, and sunscreen in the morning.

While azelaic acid doesn't increase sensitivity to the sun like other acids, it's still advisable to wear sunscreen to protect your skin from UV light, as even low levels can promote pigmentation.

It's generally safe to use azelaic acid alongside other soothing and brightening ingredients like niacinamide ((a natural anti-inflammatory) and hyaluronic acid. However, it's advisable to avoid using it with other acids like salicylic acid or glycolic acid to minimize the risk of dryness and irritation. Ideally, eliminate other irritating things from your routine, or at least separate them so that you can use one thing in the morning and another at night.

How long does azelaic acid take to work?

When it comes to the effectiveness of azelaic acid, the timeline for seeing results can vary. If you are using prescription-strength azelaic acid, you may start to notice some improvement within six weeks to three months. However, for over-the-counter products containing azelaic acid, it may take longer, typically around three to four months, to see visible improvements.

It is important to note that azelaic acid's impact on brightening the skin, lightening dark spots, and reducing hyperpigmentation can be slow and gradual. Depending on your specific skin concerns and the concentration of azelaic acid in the product you are using, it may take six months to a year to see significant effects, and even then, the results may be minimal.

Although azelaic acid is considered a milder option for sensitive skin, it may not be as potent as other acne-fighting ingredients. Some individuals may find that it doesn't work as well for clearing up their skin compared to stronger alternatives. It's important to manage expectations and understand that individual responses to azelaic acid can vary. If you have any concerns or questions about the effectiveness of azelaic acid for your specific skin concerns, it's always advisable to consult with a dermatologist.   

Conclusion

Azelaic acid is a powerful ingredient in skincare due to its ability to unclog pores, reduce inflammation, even out skin tone, and lighten dark spots and acne scars. It's a mild option suitable for sensitive skin, acne-prone skin, and rosacea. By incorporating azelaic acid into your skincare routine and using it alongside compatible ingredients, you can achieve clearer, more radiant skin.