Medically reviewed by Aimee Paik, MD
Written by Daley Quinn
Last updated 8/2/2021
Whether you’re an azelaic acid expert or have never even heard of the ingredient before, there’s so much to learn when it comes to this under-the-radar, superstar ingredient. Azelaic acid has been recently making its way into many new skincare products on the market, and for good reason—it can treat multiple concerns while being pretty gentle on the skin, too.
“Azelaic acid is a topical agent that has many great skin benefits—it unclogs pores, decreases skin inflammation, and lightens hyperpigmentation,” explains Dr. Aimee Paik, a board-certified dermatologist and Medical Director of Apostrophe. “Azelaic acid is a gentle product that is well-tolerated, and is used to treat rosacea, acne, post-inflammatory hyperpigmentation, and melasma.”
Azelaic acid is a rather gentle ingredient and isn’t as strong as some other, more powerful ingredients (like tretinoin) used to target acne. For that reason, azelaic acid “is well-suited for those with sensitive skin who have a hard time tolerating tretinoin,” says Dr. Paik.
When it comes to rosacea, azelaic acid is actually more effective than tretinoin in treating skin inflammation and redness associated with rosacea. “It has been shown to have equivalent skin lightening effects as hydroquinone 4% when used twice a day for four months,” says Dr. Paik.
While yes, azelaic acid is pretty gentle on the skin, it does come with a few side effects. “Azelaic acid can cause a mild burning sensation when first starting treatment—this effect tends to last for 10 minutes or less and usually subsides within a couple of weeks,” says Dr. Paik. “This minor discomfort is usually well-tolerated and does not mean your skin is being damaged.” Additionally, azelaic acid might cause mild dryness at the beginning of treatment, but it should go away with regular use of moisturizers.
Another huge plus about azelaic acid is that it’s one of the few ingredients that’s pregnancy-safe. Azelaic acid can be found in many skin care products available over-the-counter, but the strongest form of azelaic acid, which comes in a 15% strength, is available by prescription only. “It’s recommended to use a thin layer over the entire face once or twice a day,” suggests Dr. Paik.
Unlike other active ingredients, where you might have to be more careful mixing them together as they could cancel out each other’s efficacy (looking at you, retinol and Vitamin C), there aren’t any specific ingredients you need to avoid with azelaic acid, for fear that it won’t work effectively. “It’s compatible with most skincare products including benzoyl peroxide and tretinoin,” says Dr. Paik. “The limiting factor will be skin irritation—irritating over-the-counter skincare products should be minimized until azelaic acid is well-tolerated, after which they can cautiously be added back in.”
Since azelaic acid could be a bit irritating upon first use, Dr. Paik recommends avoiding other irritating skin care ingredients, such as salicylic acid or AHAs, when starting azelaic acid. But it’s best to speak with your Apostrophe provider for their specific recommendation for you. “Like most topical medications, it takes time to see azelaic acid’s effects—regular use for 2-3 months is needed before its benefits are truly seen.”
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