Azelaic acid: 10 things you need to know

Updated: May 7, 2020

One of my favourite skin peels to use in clinic is the Mesostetic Azelan peel; it’s a wonderful combination of 20% salicylic acid and 20% azelaic acid. Azelaic acid is seriously under-rated. For me, it’s the perfect go-to treatment to manage cases of acne and isn’t as irritating as some other acids like glycolic and TCA. Azelaic is currently a trending and upcoming ingredient in the skincare industry, available in gels, lotions and creams, on prescription and also in lower concentrations from brands like The Ordinary and Paula’s Choice. Also known as Dermaz99, Crema Pella Perfetta, Azepur99, Azetec 99, Skinoren, Azelac and Azelax, this holy grail ingredient can benefit almost anyone, and in this blog post, I explain why.

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It’s an organic compound

Azelaic acid is naturally found in grains like barley, wheat and rye and is a very stable, and effective ingredient. It is lab-engineered from an organic reaction that takes place from oleic acid. The side product of this is nonanoic acid (a form of yeast that lives naturally on normal skin) and the bacterial degradation from this product gives us azelaic acid.


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Azelaic acid is comedolytic

It has a unique ability of eating away at bacteria that lives in the skin’s pore by decreasing the production of keratin. It has also been clinically proven to reduce the bumps and swelling associated with acne conditions.


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It has been used for acne skincare prescriptions for a long time

For the past 25 years, azelaic acid has been used on prescription to treat moderate-severe acne conditions. Finacea gel contains 15%, whilst Skinoren cream contains a whopping 20%.


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Azelaic acid has clinic studies to prove its effectiveness for rosacea treatment

Unlike many other buzzword skincare ingredients available today, azelaic acid has been closely monitored and studied in-depth for its ability to treat numerous conditions, including rosacea. Metronidazole is usually the mainstream choice to treat stubborn cases of rosacea, yet a handful of clinical trials have highlighted that the use of azelaic acid can be just as effective for minimising bumps and reducing swelling. 


Rosacea causes redness on the face and sometimes swelling and pimples via prima

It can be just as effective as hydroquinone for treating hyperpigmentation

Azelaic acid has also demonstrated game-changing effects on lightening cases of pigmentation. Although this ingredient is specifically advised for treating cases of post-inflammatory pigmentation, it can also benefit other pigment conditions such as melasma, sun damage and age spots. A double-blind, randomised study concluded that a 20% concentrate of azelaic acid is the equivalent to using 4% hydroquinone. Another study showed that azelaic acid was showing more of a superior result on hyperpigmentation in comparison to test studies using 2% hydroquinone. This is because azelaic acid inhibits DNA synthesis and mitochondrial enzymes, inducing a toxic effect on melanocytes.

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Azelaic encourages cell renewal

This ingredient is an acid, and therefore one of the main function’s it has on the skin is exfoliation. Because azelaic encourages a desquamation process, it boosts cell renewal, creating a number of additional benefits. With regular use of this acid, this process kick-starts an improvement in the skin’s tone and texture, fine lines and hydration with regular use. Exfoliating acids like azelaic also enhance the effectiveness of the skincare you are using too.

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You can use it alongside other acids in your routine

This question is always worthy of asking when you are adding a new product into your routine, particularly if it’s an active ingredient. The answer is, yes, you can. Azelaic works notoriously well alongside salicylic acid to clear out breakouts and improve hyperpigmentation. Niacinamide and hyaluronic acid can also be used at the same time to boost hydration levels and maintain a healthy skin barrier.

How Niacinamide works in skincare

How does niacinamide work in skincare? Find out here.

Improvements can be seen in just a week

According to experts, slight improvement can be seen in just over a week of using azelaic acid. It is advised to use this ingredient for at least a month to gain a decent before-and-after result. If you don’t see an improvement, consider a higher concentration of product or use other acne-friendly ingredients such as salicylic and mandelic acid, retinol and niacinamide.

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Azelaic acid can cause sensitivity

Alike any acid-based skincare ingredient, azelaic acid can cause sensitivity in the skin. Within the first few days (sometimes weeks) of using azelaic, mild erythema and a hot sensation is common. Sensitivity towards UV light also increases so it is vital you wear an SPF every morning and top it up regularly, alongside using your azelaic formula. If you are concerned about a possible reaction occurring, it’s a good idea to test patch the product behind your ear and wait at least 24 hours to see what happens. If you experience any of the symptoms listed above, decide whether to either persist with using azelaic acid, reduce your use of the product or postpone completely depending on the severity of the reaction.

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There are still not enough studies to display the effectiveness of low-concentrated products

Despite the undeniable evidence of the capabilities prescription-strength azelaic acid has for treating conditions of acne, pigmentation and rosacea, there is still limited evidence to show how and if lower-concentration products can offer the same improvement. And yes, I am referring to brands like The Ordinary. It is important to know that brands like Paula’s Choice and Medik8 may be popular and have great online testimonials, but this should not replace clinical evidence for the overall efficiency of the product.


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Azelaic acid is a great formula to use if your concerns include unclogging blocked pores, reducing the appearance of redness and hyperpigmentation and improving the skin’s health. It’s a product you should ease into your routine and is perfectly safe to use alongside other acids, as long as you wear a physical SPF. Note that it is difficult to source products with a higher concentration of 10% azelaic acid and consider a prescription-strength product from your GP if you’re not seeing results. Did you learn anything new from this article or have anything you wish to add? Comment below or find me on Instagram.

#skincareingredients #productsforacne #azelaicacid #hyperpigmentation #Activeskincareingredients #whatisazelaicacid

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