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azelaic acid for skin

Why don’t more people know about Azelaic Acid?!

This little gem has been dermatologists’ best-kept secret for decades. They’re using it to treat all kinds of skin problems, from stubborn dark spots to inflamed cystic acne and unpredictable rosacea.

It’s one of those rare ingredients that does the job without irritating skin and leaving it a red, flaky mess. Even sensitive skin can use it.

And it’s finally making its way onto the virtual shelves of our favourite skincare stores. Should you grab a bottle, pronto?

That depends. Here’s everything you need to know about Azelaic Acid in skincare: what it is, what it does, and who should use it:

What Is Azelaic Acid?

Azelaic acid is derived from grains, such as barley, wheat and rye. It’s also made by the healthy bacteria that live on your skin.

Still, few brands use it because it’s tricky to formulate with. Do it wrong and you’re left with a grainy texture no one would touch with a 10 foot pole, let alone put it on their skin.

But, if you do it right, your skin is in for a treat. Here’s how it benefits skin.

P.S. Azelaic Acid has a trade name: Azalex.

Can Azelaic Acid Treat Acne?

Yes, yes, yes! Azelaic Acid is an effective treatment for all kinds of acne, including:

  • Bacterial acne
  • Big and painful “under the skin” pimples
  • Fungal acne

It works in several ways:

  • Anti-bacterial: It reduces P.Acne, the bacteria that gives you bacterial acne. The best part? Bacteria don’t grow resistant to it.
  • Anti-inflammatory: Acne is an inflammatory disease. When you reduce inflammation, you heal it faster.
  • Anti-keratinizing: A fancy way of saying it prevents the build-up of dead skin cells, so they can’t fall into your pores and give you breakouts.
  • Reduces fatty acids content: Fatty acids keep your skin soft and supple. But too much of the wrong kind can feed acne. By reducing them, Azelaic Acid creates an inhospitable environment for bacteria and fungi.

Great! But, how does Azelaic Acid compares to traditional – and harsh – acne treatments, like Benzoyl Peroxide? Here’s what the research shows:

If you’re looking for a gentler way to treat your acne, or want to exhaust all options before trying Accutane, give Azelaic Acid a go.

Related: Adult Acne: Why It Happens And How To Treat It

Want an affordable skincare routine for acne that works? Subscribe to my newsletter below and receive The Ordinary Acne Skincare Routine Cheatsheet (it includes product recommendations too):

Can Azelaic Acid Treat Melasma, Hyperpigmentation, And Dark Spots?

Hyperpigmentation happens when your skin produces too much melanin (the pigment that gives skin its colour). It looks liked darker patches of skin here and there.

What causes it? Hormones. Pregnancy. Unprotected sun exposure. Age. Heck, even pimples can leave dark spots behind.

The gold standard treatment for hyperpigmentation is hydroquinone. There’s no doubt it works. But it’s not without side effects. It can cause dryness, irritation, and even permanent blue discolouration in darker skin tones.

Hydroquinone is so harsh, some countries have banned it altogether. In others, you need a prescription to get your hands on it. In the US, you can find it OTC, but only in concentrations up to 4%.

Enter Azelaic Acid. A 2011 study shows that twice daily application of 20% Azelaic Acid may be more effective than 4% Hydroquinone – and has none of its harsh side effects.

This study is not without its shortcomings (it was an open trial). But other, better structured studies, support these findings. Again and again, research shows Azelaic Acid works as well as Hydroquinone at treating melasma and hyperpigmentation.

Related: Does Hydroquinone Cause Cancer?

Can Azelaic Acid Treat Rosacea?

Rosacea is a chronic skin condition that’s often misunderstood for acne. Symptoms include facial redness, dilated capillaries, erythema and, sometimes, pimples and whiteheads.

The worst part? It’s very hard to treat… or even just keep under control. But Azelaic Acid is up to the job.

The same properties that bust acne make Azelaic Acid an effective treatment for papulopustular rosacea (the type of rosacea that looks like acne).

Studies show that 15% Azelaic Acid significantly decreases erythema and inflamed lesions in 6 months. Nothing works overnight, ladies! But, you can speed up healing by using it with antibiotics.

Related: How To Deal With Rosacea

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Is Azelaic Acid An Effective Exfoliant?

Most people think Azelaic Acid is an exfoliant. Like Salicylic Acid (BHA) or Glycolic Acid (AHA). That’s sort of true… But it’s not the whole story.

If properly formulated, Azelaic Acid has an exfoliating effect. But it’s not as powerful as other acids out there. So, don’t throw your Salicylic Acid serums out just yet.

Instead, use them together. Some Azelaic Acid products contains exfoliating acids, too, to supercharge their performance.

Plus, as you know now, Azelaic Acid benefits skin in ways exfoliating acids can’t.

Related: AHAs VS BHA: Which One is Right For You?

In What Concentrations Is Azelaic Acid Effective In Skincare Products?

Most of the research on Azelaic Acid was done on prescription products that use a 15-20% concentration. But that doesn’t mean that it’s useless in smaller doses.

If you’re just starting out with Azelaic Acid or only have mild acne or discolourations, a 10% dose is more than enough to see results.

But if you’re dealing with more severe concerns – think cystic acne or stubborn dark spots -, it’s best to see a dermatologist and get higher, prescription-only concentrations.

Related: Stages Of Acne: How Severe Is Yours And How Do You Treat It?

Should You Use Azelaic Acid?

If you have sensitive skin and are dealing with acne/dark spots/rosacea, Azelaic Acid is a must.

If you’re dealing with these conditions and your skin isn’t sensitive, but you still want to use the gentlest treatment you can find, switching to Azelaic Acid makes sense.

If you’re not dealing with any of these issues, you DON’T need Azelaic Acid. You don’t achieve clear, flawless skin by using what’s popular. You get it by using what’s right for you.

What Are The Best Skincare Products With Azelaic Acid?

How To Use Azelaic Acid

First off, do a patch test first. Azelaic Acid is gentle, but you want to make sure that it (or anything else in the formula) won’t irritate your skin.

All good? Great! Apply a pea-sized amount of Azelaic Acid on affected skin after cleansing. If it’s a bit too harsh for you, try applying it on top of your moisturiser instead. It’s usually better tolerated this way.

PRO TIP: Opt for gel formulas whenever you can. They petter penetrate your skin and give you better results.

Related: How To Introduce New Skincare Products In Your Routine The Right Way

Does Azelaic Acid Have Any Side Effects?

Azelaic Acid is very gentle and well-tolerated even by sensitive skin. That’s what makes it such a good alternative to traditional acne, rosacea, and hyperpigmentation treatments.

But, everyone’s skin is different. In some rare cases, Azelaic Acid may cause dryness or sting a little upon application. But it’s still better than its harsher alternatives (trust me, if Azelaic Acid bothers you, anything else will destroy your skin).

P.S. Azelaic Acid is naturally present in your body, so it’s considered safe during pregnancy, too.

The Bottom Line

Azelaic Acid is a gentle, yet effective treatment for acne, rosacea, and hyperpigmentation. It works just as well as traditional, harsher remedies – but without their side effects. For sensitive skin, it’s a must-have.

About Gio

Hi, I'm Gio. I'm a no-nonsense, tell-it-like-it-is skin coach and writer on a mission to help you achieve your best skin day ever - every day. I bust skincare myths and debunk marketing jargon to help you figure out what's worth the splurge and what's best left on the shelf - using science, not hype. I also offer skincare consultations to help you create the best skincare routine for your unique needs.