What Is Azelaic Acid? 5 Skin Care Benefits For Acne + Rosacea

Amid well-known acids like glycolic and hyaluronic, azelaic acid is an underrated skin ingredient that deserves so much more attention. So what is azelaic acid? It's a gentle yet powerful chemical exfoliant, offering benefits for common skin woes like dullness, acne, and more. Here, learn why azelaic acid should be on your radar. 

Azelaic acid is an acid that naturally comes from wheat, barley, and rye. It can also come from Malassezia furfur—a yeast that's naturally found on the skin—or created in a lab for use in skin care products (aka a safe synthetic). It's a dicarboxylic acid, which means it's in a different class than AHAs or BHAs.

You can get azelaic acid as a prescription or over-the-counter (OTC) treatment. Prescription medication has a concentration of 15 or 20%, while OTC versions usually have 10% or less. (In fact, prescription-strength azelaic acid is one of the most common treatments from derms for mild to moderate rosacea.) The latter can be difficult to find, though. As a lesser-known skin care ingredient, azelaic acid is only starting to gain popularity in the beauty space.

Although azelaic acid isn't as popular as AHAs and BHAs, this ingredient boasts its own unique list of impressive skin benefits:

Azelaic acid can neutralize 1Propionibacterium acnes1 (P. acnes), the bacteria that infects pores and causes acne. It works by blocking thioredoxin reductase, an enzyme that P. acnes needs to make its DNA.

The acid also has anti-keratinizing effects, which means it "breaks up dead cell plugs that cause clogged pores, blackheads, and whiteheads," says board-certified dermatologist Loretta Ciraldo, M.D., FAAD. Hello, happy pores!

Additionally, a small study2 found that azelaic acid can help regulate the sebaceous glands in women with acne-prone skin. This effect could help combat excess sebum, one of the biggest culprits behind acne breakouts and sebum plugs. 

Azelaic acid is beneficial for rosacea, an inflammatory skin condition characterized by red flushing (in lighter-skinned individuals), dusky discoloration (in darker-skinned individuals), swelling, very small acne-like bumps, and sensitivity to skin care products.

According to board-certified dermatologist Jessie Cheung, M.D., in rosacea, "neutrophils release proteases that break down collagen and elastin, contributing to swelling and flushing." However, azelaic acid can inhibit the function of these neutrophils3, thus reducing inflammatory symptoms.  

For rosacea that causes acne and excess oil, the sebum-controlling effects of azelaic acid could pitch in too. This effect was observed in one study4, where azelaic acid gel significantly improved inflammatory lesions in people with rosacea.

To give your skin a glowy pick-me-up, use azelaic acid. "In lieu of a scrub or polish, naturally derived acids like azelaic will penetrate pores and dissolve impurities," explains licensed esthetician Elizabeth Donat.

This assists your skin's natural cell turnover rate, helping remove dead skin cells that otherwise accumulate and contribute to a lackluster complexion.

Furthermore, azelaic acid increases collagen and elastin deposits in the top layer of the skin. This is a noteworthy effect, as both collagen and elastin are needed to keep your skin healthy and resilient.

 And, get this: While azelaic acid suppresses overactive sebaceous glands, it also increases sebum secretion5 in super-dry areas—which boosts the skin's natural hydration and reduces dullness. Essentially, if your sebaceous glands are out of whack, azelaic acid will help normalize them. 

As a gentle exfoliating agent, azelaic acid is ideal for evening out your complexion.

It pushes "pigmentated cells up and out more quickly so spots [can] fade," says Donat. The acid can also combat hyperpigmentation by inhibiting tyrosinase6, an enzyme necessary for melanin production. (According to Ciraldo, hyperpigmentation results from the overproduction of melanin, but a treatment like azelaic acid can help slow things down.)

Research indicates that azelaic acid7 has “profound anti-inflammatory and antioxidant benefits,” which contributes to many of the benefits listed above. It has the ability to neutralize free radicals, which then stops the inflammatory process.

Compared to other acids, azelaic acid is less likely to cause side effects like burning, stinging, or tightness. But if side effects do occur, they're typically mild and short-lived. 

Rarely, azelaic acid can cause hypopigmentation, or the lightening of skin pigment. According to Ciraldo, this may be more noticeable in people with deeper skin tones. "If you do have any problems, stop [using] it and apply a soothing gel like aloe to inflamed or hypopigmentated areas," she says.

Typically, azelaic acid is meant to be used twice a day. "But if your skin is sensitive, try starting it once every other day, as you may get dry and irritated," says Cheung. It should also be applied in a very thin film, adds Ciraldo.

And if you're layering with other products? "Apply your other exfoliant first," suggests Cheung, to get your skin ready to receive the azelaic acid. Then, apply your moisturizer as usual. 

Also, always wear sunscreen anytime you're using exfoliating agents such as azelaic acid. "Skin is more prone to sunburn when it is exfoliated, [which] will only aggravate conditions like acne and rosacea," notes Donat. 

If you're looking for a gentle chemical exfoliant, try adding azelaic acid to your routine. You can find it in products like serums, creams, and gels. In general, it can be safely layered with other exfoliants—but it's still a good idea to avoid overexfoliating your skin. When in doubt, start with a small amount and frequency to let your skin gradually adjust. Read on for more tips on dealing with red, "ruddy" skin.