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Upkeep's Guide To Azelaic Acid

Another acid?! Here’s what makes her different from the rest.

April 10, 2023

While there are a lot of proven skincare ingredients out there for treating acne and irregular pigmentation, many of them have a downside. Retinoids, AHAs, BHAs, and benzoyl peroxide–they’re amazing, but they can all be irritating for sensitive skin. Wouldn’t it be great if there was a skincare ingredient that could address acne, breakouts, and pigmentation–without irritating skin? 

Fortunately, there’s azelaic acid. This tried-and-true ingredient has flown under the radar compared to its better known counterparts, but there are a lot of reasons why you should give it a try. Here’s everything you need to know about this versatile skincare ingredient. 

What is azelaic acid? 

Azelaic acid occurs naturally in grains like wheat, rye, and barley, and your skin’s microbiome produces it, too. It technically acts as an exfoliant. It’s available in gel, cream, and foam formulations, and has been in use to treat skin concerns for thirty years, so it is reliable and well-established. 

What does azelaic acid do to your skin?

  • Azelaic acid does many things to your skin and it’s kind of an MVP because of how much it does. Here are its main benefits: 
  • Treating mild-moderate acne: Azelaic acid prevents blackheads and exfoliates within pores, removing dead skin cells that cause clogged pores. Plus, it also has antimicrobial properties and is particularly good at killing a type of bacteria that causes a lot of acne. So it’s a great choice for mild to moderate acne (note: it’s not recommended as a first line treatment for cystic acne). 
  • Helps with scarring and pigmentation: Azelaic acid inhibits an enzyme called tyrosinase that’s responsible for irregular pigmentation, including from acne and melasma. And unlike hydroquinone, it’s considered safe and effective for darker skin tones, too. 
  • Anti-inflammatory. It neutralizes free radicals that cause irritation and inflammation. For this reason, it is sometimes used to treat conditions like rosacea and even psoriasis, which are caused by inflammation.  
  • It can help with keratosis pilaris. This annoying skin condition is caused by excess keratin, which clogs pores and leaves little bumps. Unlike acne, these bumps are hard, and they aren’t caused by an infection. Azelaic acid helps break down excess keratin, which reduces these pesky bumps. 
  • Safe for pregnancy. Unlike vitamin A derivatives, azelaic acid is considered safe for use during pregnancy and breastfeeding. 
  • Gluten free: if you’re concerned that azelaic acid is derived from grains like wheat, don’t worry–this ingredient is generally considered safe for those with gluten intolerance or celiac disease. It’s also often derived synthetically, meaning many products have no wheat or other grains at all. 

What should you not mix with azelaic acid?

Azelaic acid works well with many other skincare actives, like niacinamide, vitamin C, hyaluronic acid, AHAs, and retinoids. But if you have really sensitive skin, you may not want to apply AHAs or retinoids at the same time of day as the azelaic acid. If you can tolerate it, apply your AHA or retinoid first, followed by azelaic acid afterwards. And always use SPF, every day!

Is it ok to use azelaic acid every day?

Yes! Azelaic acid will give you best results if you use it once or twice daily. Still, we suggest ramping up your use slowly, since a small number of people (around 10%) can experience initial stinging or itching when they start use. Start with using it every other day–unless your dermatologist gives you other instructions for how often to use it. If you experience side effects that persist, stop using azelaic acid and contact your dermatologist. 

Azelaic acid vs glycolic acid: how are they different? 

It’s confusing to have so many “acids” on the market, but azelaic acid is not part of the AHA family. It’s a dicarboxylic acid, so it is part of a different family of chemicals.

How long does it take to see results from azelaic acid? 

Like many other treatments for acne, some consistency and patience is necessary. You may start to see results faster, but expect the treatment to take about 10-12 weeks to show its full effects. While prescription-strength formulations are stronger, OTC versions that are 10% azelaic acid are also very effective. 

The takeaway

If you’re looking for a less irritating skin care active to clear your skin, even out your skin tone, or treat rosacea, azelaic acid is worth trying!

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