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

Kirsten Nunez, M.S.
Author: Expert reviewer:
April 28, 2020
Kirsten Nunez, M.S.
Contributing writer
By Kirsten Nunez, M.S.
Contributing writer
Kirsten Nunez is a health and lifestyle journalist based in Beacon, New York. She has a Master of Science in Nutrition from Texas Woman's University and Bachelor of Science in Dietetics from SUNY Oneonta.
Apple Bodemer, M.D.
Expert review by
Apple Bodemer, M.D.
Dermatologist
Dr. Apple Bodemer is board certified in both Dermatology and Integrative Medicine. She is an associate professor of dermatology at the University of Wisconsin-Madison School of Medicine and Public Health, and sits on the editorial board of the Journal of Integrative Dermatology.

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. 

What is azelaic acid?

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.

The skin benefits of azelaic acid

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

1.

It can help treat acne.

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

2.

It soothes rosacea.

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.

3.

 It brightens dull skin.

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. 

4.

It reduces hyperpigmentation.

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.)

5.

Helps manage inflammation

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.

Side effects

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.

How to use azelaic acid

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. 

Best products with azelaic acid

Paula’s Choice 10% Azelaic Acid Booster

$ 39
Paula’s Choice 10% Azelaic Acid Booster

Peach & Lily Redness Relief Azelaic Acid Serum

$20
Peach & Lily Redness Relief Azelaic Acid Serum

Naturium Azelaic Acid Serum 10%

$20
Naturium Azelaic Acid Serum 10%

FAQ about azelaic acid

Is it okay to use azelaic acid everyday?

Not only is it okay to use azelaic acid everyday, it’s encouraged twice daily. Dermatologists note that 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 board-certified dermatologist Jessie Cheung, M.D.. It should also be applied in a very thin film, adds board-certified dermatologist Loretta Ciraldo, M.D., FAAD.

Is azelaic acid better than retinol?

Azelaic acid and retinol perform different functions, have different benefits, and are recommended for different needs. One is not “better” than the other—it only depends on the usage. Azelaic acid is ideal for those with rosacea, redness, and often-inflamed skin. Retinol, on the other hand, is commonly used for aging concerns, such as fine lines, dark spots, and improving collagen production. They are both used for treating acne. 

Does azelaic acid remove dark spots?

As a gentle exfoliating agent, azelaic acid is ideal for evening out your complexion. The acid can also combat hyperpigmentation by inhibiting tyrosinase, an enzyme necessary for melanin production. Hyperpigmentation results from the overproduction of melanin, but a treatment like azelaic acid can help slow things down.

The takeaway

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.

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