Doctor’s Note: Your Easy + Essential Guide to Azelaic Acid

As dermatologists, we love azelaic acid! It helps fight acne, reduce dark spots, and calm redness. Azelaic acid works well in both morning and evening routines, making it a great choice for clearer, even-toned skin.

Watch our video on the right or read the highlights below!

Azelaic Acid

at a Glance

What it is: A natural acid found in grains.

Key Benefits: Reduces acne, dark spots, and redness.

Best For: Acne, rosacea, dark spots, sensitive skin.

How to Use: Apply after cleansing, before moisturizer, morning or night.

Concentration: 10-15%. Start lower if new to it.

What is Azelaic Acid?

Azelaic acid is a natural ingredient found in grains like wheat, barley, and rye. It’s made for skincare because it helps with many skin problems. It can treat acne, redness from rosacea, and dark spots, while also making your skin smoother.

Check out how Azelaic Acid compares to Vitamin C, Retinol, and Niacinamide!

Who Should Use Azelaic Acid?

Azelaic acid is generally well-tolerated and can be used by most skin types. It’s particularly beneficial for those with:

Acne-Prone Skin

Azelaic acid helps clear acne by fighting the bacteria that can cause breakouts. It also lowers inflammation, which reduces redness and swelling.

Sensitive Skin

Azelaic acid is gentle, making it safe for sensitive skin. It's even helpful for people with rosacea.

Redness + Rosacea

Azelaic acid's anti-inflammatory properties make it helpful for people with rosacea, a condition that causes redness and visible blood vessels. It can soothe irritated skin and reduce redness.

Dark Spots + Melasma

Azelaic acid helps lighten dark spots, like post-acne marks and melasma. It works by slowing down melanin production, which evens out skin tone over time.

How Does Azelaic Acid Work?

Azelaic acid works in a few important ways:

Antibacterial Properties: Azelaic acid targets Propionibacterium acnes, the bacteria that commonly cause acne. By reducing these bacteria on the skin, azelaic acid lowers the risk of clogged pores and breakouts.

Anti-Inflammatory Effects: One of azelaic acid’s main benefits is its ability to fight free radicals and calm inflammation. This makes it useful not only for acne but also for conditions like rosacea, where inflammation is a major concern.

Melanin Inhibition: Azelaic acid works to reduce the formation of melanin, the pigment responsible for dark spots. By interfering with melanin production, azelaic acid helps fade existing spots and prevents new ones from forming.

Gentle Exfoliation: Although it’s not as strong as other exfoliants, azelaic acid helps to shed dead skin cells, improving skin texture and clarity over time.

Azelaic Acid Spectrum

Azelaic acid (AA) comes in different strengths, typically ranging from 5% to 20%:

Azelaic acid comes in different strengths, from 5% to 20%. Over-the-counter products with 5-10% are great for beginners or those with sensitive skin and work well for mild acne, redness, and dark spots. Prescription-strength formulas with 15-20% are stronger and treat severe acne or tough dark spots, but they can cause dryness or irritation. Start with a lower strength and increase slowly if needed.

Best Azelaic Acid

If you're looking for good azelaic acid products, there are several great options to consider. Paula's Choice BOOST 10% Azelaic Acid Booster is a lightweight formula that helps improve skin texture and even out skin tone. Naturium offers two excellent choices: the Azelaic Topical Acid 10%, which combines azelaic acid with niacinamide and vitamin C for enhanced brightening effects, and the Azelaic Acid Emulsion 10%, a soothing and hydrating formula ideal for sensitive skin. For a budget-friendly option, The Ordinary 10% Azelaic Acid Suspension is a popular pick, though some users find its texture a bit "gritty." Each of these products has unique benefits, making them great additions to your skincare routine.

The Ordinary Azelaic Acid

Texture: Cream-gel
Concentration: 10%
Silicone Base: Enhances application and creates a smooth finish.
Best For: Dullness, hyperpigmentation, and acne-prone skin
Note: Some report a “gritty” feel. Silicone may cause pilling under makeup. Best used at night.

Facetheory Azelaic Acid

Texture: Cream-gel
Concentration: 15%
Salicylic Acid: Exfoliates and unclogs pores
Green Tea Extract: Calms and provides antioxidant protection
Colloidal Oatmeal: Soothes irritation
Best For: Acne-prone, redness, uneven skin tone

Peach Slices Azelaic Acid

Texture: Gel-like serum
Concentration: 10%
Niacinamide: Calms skin + strengthens barrier
Allantoin: Soothes and softens skin
Licorice Root Extract: Brightens skin tone
Best For: Redness, sensitive skin, hyperpigmentation

Naturium Azelaic Acid

Texture: Cream
Concentration: 10%
Niacinamide: Calms skin + strengthens barrier
Vitamin C: Brightens and improves skin tone
Best For: Uneven skin tone, redness, and sensitive skin

Paula's Choice Azelaic Acid

Texture: Cream-gel
Concentration: 10%
Licorice Extract: Brightens skin tone
Salicylic Acid: Exfoliates and unclogs pores
Best For: Hyperpigmentation, redness, acne-prone skin

How to Use Azelaic Acid

The Ordinary Azelaic Acid Skincare Routine

Cleanse Your Skin: Wash your face with a gentle cleanser to remove dirt and oil. Pat your skin dry with a clean towel.
Apply Azelaic Acid: Take a small amount of azelaic acid and apply it to the areas you want to treat. Start with a thin layer to test your skin's reaction. Over time, you can gradually increase the amount if needed.
Begin with Once Daily Use: Apply azelaic acid once a day, preferably in the evening. If your skin tolerates it well, you can slowly increase to twice daily—morning and night.
Follow with Moisturizer: After applying azelaic acid, wait a few minutes, then apply a moisturizer to keep your skin hydrated and reduce any potential dryness or irritation.
Protect with Sunscreen During the Day: Since azelaic acid can make your skin more sensitive to the sun, apply a broad-spectrum sunscreen with at least SPF 30 every morning. Reapply during the day if you’ll be outside.

By following these steps, you can safely add azelaic acid to your skincare routine and give your skin time to adjust.

Azelaic Acid Cleanser?!

Azelaic acid cleansers are uncommon because azelaic acid doesn’t dissolve well in water, which is a key ingredient in most cleansers. Since cleansers are typically water-based, it’s difficult to include azelaic acid effectively. Instead, azelaic acid works better in leave-on products like serums or creams. These products use oil-based or gel formulas that help the acid absorb into the skin and stay long enough to provide its benefits.

How to Combine Azelaic Acid with Active Ingredients

Azelaic acid works well with many skincare products to help with dark spots, acne, and uneven skin. When used carefully with other ingredients, it can make your skin healthier while avoiding irritation. Here are some good combinations:

Azelaic Acid and Niacinamide: These two are a great pair. Niacinamide calms redness and strengthens your skin, while azelaic acid helps with dark spots and acne. You can use them together or one after the other.
Azelaic Acid and Glycolic Acid: Glycolic acid removes dead skin cells, and azelaic acid fights bacteria and calms your skin. Use glycolic acid at night and azelaic acid in the morning, or switch days to avoid irritation.
Azelaic Acid and Retinol: Retinol helps your skin make new cells faster, while azelaic acid reduces redness and fades spots. Use azelaic acid in the morning and retinol at night. Start slow to prevent irritation.
Azelaic Acid and Tretinoin: Tretinoin boosts skin renewal, helping azelaic acid work better. This combination is good for tough acne or melasma. Use tretinoin at night and azelaic acid in the morning to avoid dryness.
Azelaic Acid and Salicylic Acid: Salicylic acid clears clogged pores, and azelaic acid reduces redness and kills bacteria. Use salicylic acid in the morning and azelaic acid at night, or alternate days.
Azelaic Acid and Vitamin C: Both can lighten dark spots, but vitamin C also protects your skin. To avoid irritation, use azelaic acid in the morning and vitamin C at night, or switch days.

These combinations can help you get better results from azelaic acid while keeping your skin calm and healthy.

Prescription Azelaic Acid

Azelaic acid is also available in prescription form, commonly under the brand name Finacea (15%), which is often used to treat rosacea. Finacea is typically a foam that you apply twice daily. It’s a good option for people who don’t see enough improvement with over-the-counter azelaic acid products.

While Finacea is primarily prescribed for rosacea, it can also be used for stubborn cases of acne and melasma. If over-the-counter options aren’t providing enough relief, prescription-strength azelaic acid may be a good choice, especially for those with sensitive, rosacea-prone skin.

Finacea = 15% Azelaic Acid Foam

Azelaic Acid Before and After

Potential Side Effects of Azelaic Acid

While azelaic acid is generally gentle, some people might experience mild side effects, including:

Dryness and Flaking: Slight dryness or flaking may occur, especially if you have dry skin. Using a good moisturizer can help reduce this.
Stinging or Tingling: A mild tingling sensation is common when you first start using azelaic acid, but this usually goes away as your skin gets used to it.
Increased Sensitivity to Sun: Azelaic acid can make your skin more sensitive to sunlight, so wearing sunscreen during the day is important.

These side effects are usually temporary and can be managed with proper skincare.

Azelaic Acid FAQs

Can I use azelaic acid with retinol?
Yes, azelaic acid can be used with retinol. Use azelaic acid in the morning to reduce redness and dark spots, and apply retinol at night to improve cell turnover. Start slow to avoid irritation.

Can I use azelaic acid with salicylic acid?
Yes, azelaic acid and salicylic acid can work together for oily or acne-prone skin. Use salicylic acid in the morning to clear pores and azelaic acid at night to fight bacteria and inflammation. Alternatively, use them on alternate days if you experience irritation.

Can you use glycolic acid with azelaic acid?
Yes, but use them carefully to avoid irritation. Apply glycolic acid at night for exfoliation and azelaic acid in the morning to calm inflammation and improve skin tone. Another option is to alternate their use on different days.

Can you use azelaic acid with hyaluronic acid?
Absolutely! Azelaic acid and hyaluronic acid pair well. Hyaluronic acid hydrates the skin, which helps minimize dryness or irritation from azelaic acid. Apply hyaluronic acid after azelaic acid in your routine.

How to stop azelaic acid itching?
If azelaic acid causes itching, try using a smaller amount or applying it less frequently to let your skin adjust. Follow with a moisturizer to reduce dryness, and avoid using harsh products that could make your skin more sensitive. If itching persists, consult a dermatologist.

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