Despite being a miracle worker, Azelaic acid (AzA) has been swept under the radar for years. As an avid user (2 years and counting) of AzA, I’m glad it’s finally getting the recognition it deserves. In this post, we’ll be covering everything you need to know about Azelaic Acid and answering your FAQs. Sit back and enjoy!

What does Azelaic Acid do for the skin?

A lot! AzA works on the surface of the skin to yield several benefits–

• anti-inflammatory (soothes redness and pain. Used to treat rosacea)
• antibacterial (destroys acne-causing bacteria)
• keratolytic (unclogs the pores and smoothens the skin texture)
• brightening (reduces the production of melanin in overactive melanocytes)
• antioxidant (correct and prevent the damage caused by free radicals)

Does it exfoliate the skin?

Yes, because exfoliation involves the shedding of matured skin cells on the surface of the skin to reveal fresh, smoother skin. A well-formulated Azelaic acid product does just that.

Can it replace AHAs and BHAs in your routine?

No, because it doesn’t loosen the bonds that hold the skin in the way that traditional chemical exfoliants like Alpha-hydroxy acids (AHA) and beta-hydroxy acids (BHA) do. From personal experience, azelaic acid is not as effective as glycolic, lactic, and salicylic acid when it comes to exfoliation.

Yes, if you don’t have major breakouts, white- and blackheads to deal with. Persistent use of AzA might provide just enough exfoliation for your skin.

Can I use it alone to treat hyperpigmentation?

Practically, it’s best to approach hyperpigmentation from multiple pathways (increase skin cell turnover, reduce/inhibit melanin production and transfer, protect from UV rays) to yield effective results. Although AzA is a tyrosinase inhibitor, on its own it does not tick all the boxes and may not be effective in treating severe hyperpigmentation.

AzA (at 20%) has been compared to 4% hydroquinone in tackling melasma, and both yielded similar results. From personal experience, AzA performs better on post-inflammatory hyperpigmentation (PIH) when combined with other tyrosinase inhibitors (lightening agents) like Kojic acid either in a formula or when layered. AzA when used on its own evened out my overall complexion but not much effect on the stubborn dark spots.

Azelaic acid 20% review Ezanic gel reviewCan it be used to treat manage acne?

Azelaic acid works on both comedo and inflammatory papulo-pustular acne. It has antibacterial properties meaning that it destroys the acne-causing bacteria (P. acnes). AzA (at 15 – 20%) has been researched and proven to be effective on cystic acne. Due to its keratolytic properties, it also prevents the formation of comedones.

It has been used widely by dermatologists to successfully manage acne. It works best when combined with other acne-fighting ingredients such as adapalene, sulfur, and salicylic acid. It can also be a gentle alternative to benzoyl peroxide and antibiotics. Of course, discuss with your clinician to determine what treatment option is best suited for your skin.

Can sensitive skin use it?

Azelaic acid is generally well tolerated and safe to use on all skin types including sensitive, however, context matters. For instance, a product formulated with other soothing agents in a cream or gel base may not sensitize the skin as much as one formulated in a suspension base without any soothing agents. Concentration matters too. Anything above 10% should be used under medical supervision. It’s totally normal to experience slight tingling and/or redness when applying AzA. Finally, don’t forget to patch test.

Is it safe for pregnant & lactating women?

Azelaic acid is safe for pregnant and lactating moms. As a matter of fact, it’s one of the go-to treatments when managing acne and other skin concerns in pregnant and breastfeeding women. Be sure to check with your OB-GYN.

Can Azelaic Acid be used with Niacinamide?

Absolutely, as long as your skin tolerates it! Although AzA pairs well with a lot of ingredients, it’s best to look for them in one formulation to avoid possible irritation and pilling from layering. A good example is the Naturium Azelaic Topical Acid 10% and Azelaic Acid Emulsion 10%. If you can’t get your hands on one and must layer, remember to do patch test the combination on a small area of your face first.

Can it replace Niacinamide in my routine?

Well, it all depends on your skin concerns. Given that both have had their “it” ingredient moment and share similarities such as anti-inflammatory, antioxidant, de-pigmenting; let’s take a look at their unique properties. Niacinamide regulates oil production, boosts the production of ceramides, and helps to repair the skin. Azelaic acid is antibacterial. If acne and hyperpigmentation are your primary concerns, AzA will probably be a better alternative. If oil/sebum control is your primary skin concern, Niacinamide may be a better option as AzA doesn’t do much in that department except when formulated as Potassium Azeloyl Diglycinate (its water-soluble derivative). See Naturium Azelaic Topical Acid 10%.

Can it be combined with AHAs/BHAs in a routine?

Together they make a powerhouse for reducing excess sebum, white- and blackheads, and improving the texture and tone of the skin. They can be used together (if your skin tolerates the combo) or on alternate days/alternate routines (e.g. Azelaic Acid- AM and glycolic acid- PM). Better still, a product that combines them. An example is the Paula’s Choice Azelaic Acid Booster which is formulated with 10% AzA and 0.5% salicylic acid.

Can Azelaic Acid be combined with retinoids?

AzA plays well with retinoids and it is generally safe to combine the two. Studies have shown the benefits of combining them in tackling acne and melasma. Personally, I’ve not really explored the combination. The few times I tried to combine retinol with AzA in the same routine, I didn’t experience irritation but pilling (that’s on the product formula though).

How often should I use Azelaic Acid?

AzA can be used daily, both morning and evening. Depending on the other actives in your routine and the tolerance of your skin, you could tweak the application to two to three times a week.

Does the concentration matter?

Yes, concentration matters. Prescription-strength versions are more effective than OTC products because they contain higher concentrations of AzA. Anything above 10% is not considered as OTC and only available on prescription in some countries. AzA at 15% is FDA-approved for the treatment of inflammatory papules and pustules of mild to moderate rosacea. Most studies on AzA are based on 15 – 20% but some benefits of AzA can still be obtained from OTC formulations.

What AzA products would you recommend to a friend?

Based on personal experience, The Ordinary Azelaic Acid 10% Suspension and Ezanic Azelaic Acid 20% Gel. The former is OTC strength while the latter requires medical supervision. Both products are favorites and have been reviewed on this blog. Click on the link attached to each product for more details.

Would you recommend applying it before or after moisturizer?

AzA can be applied either before or after your moisturizer. When using The Ordinary AzA Suspension, for instance, I apply it after my moisturizer to prevent pilling and to reduce the irritation. When using the Ezanic AzA gel, I apply it either before or after my moisturizer, both work just fine. Some products (like the Paula’s Choice Azelaic Acid Booster) can be mixed with your moisturizer.

Can I use it to spot treat when experiencing breakouts?

From my experience, it’s not a fast-acting solution to breakouts like salicylic acid, sulfur, or benzoyl peroxide. It’s best for preventive care/management. It may reduce the redness instantly due to its profound anti-inflammatory property but that’s about it for SOS.

Is Azelaic Acid natural?

Azelaic acid is a naturally occurring dicarboxylic acid that can be obtained from wheat, rye, and barley. It is a by-product of a kind of yeast that lives on our skin. The AzA used in skincare formulations is often lab-engineered to maximize stability and efficacy.

Do I really need Azelaic Acid?

If you struggle with rosacea, yes, although, it’s up to you and your clinician to decide. Otherwise, if you have products in your routine that address the benefits of AzA listed, you don’t “need” it.

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