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All About Azelaic Acid

By The Nava Team

May 24, 2021

Azelaic acid. It may sound like a forgotten punk record, but it’s actually an inflammation-fighting exfoliant that can help prevent acne, soothe rosacea, and improve your complexion. 

So why haven't you heard of it? 

Read on to learn more about this multi-talented material and discover why you should consider adding it to your personalized skin care regimen.

What Is Azelaic Acid?

Azelaic acid is a topical exfoliating treatment that can do everything from zap zits to reduce inflammatory rosacea lesions and diminish dark spots. In short, it’s one skin care’s unsung heroes.

Think of it like this: If your complexion was a summer music festival, heavy hitters such as salicylic acid and retinol would be the headliners. Azelaic acid would be the under-the-radar but no-less-brilliant act four lines down on the official poster. It’s a versatile and prolific skincare agent that deserves a much larger following.

The Scientific Skinny

Azelaic acid is a dicarboxylic acid that’s produced by yeast. This process happens naturally on your skin, but azelaic acid can also be made from grains such as barley, wheat and rye or manufactured in a lab. This lab-synthesized form is the one found most often in skincare products due to its uber-stability and effectiveness. Despite what its origins suggest, azelaic acid is gluten-free.

What Does Azelaic Acid Do?

Azelaic acid is a bit of an overachiever when it comes to enhancing your complexion. In addition to deeply exfoliating your skin, it can:

  • Decongest clogged pores
  • Minimize bacteria growth
  • Reduce inflammation
  • Soothe irritation
  • Decrease keratin
  • Fade hyperpigmentation by inhibiting tyrosinase
  • Fight melasma
  • Offer antioxidant benefits

It’s effective against inflammatory acne as well as comedonal acne. What’s more, because it’s a tyrosinase inhibitor, it also combats the dark spots that some men and women experience after a breakout finally goes bust.

More dermatologists are also turning to azelaic acid to treat rosacea. In addition to inhibiting the reactive oxygen species that cause rosacea to thrive — and possibly doing it more gently than metronidazole does, to boot — azelaic acid unclogs pores and fights inflammation, thereby decreasing redness. It’s also effective in preventing any secondary forms of infection.

How Do You Use Azelaic Acid?

Azelaic acid is applied topically, and it’s available in creams, foams and gels. Most dermatologists recommend that, whatever form you fancy, the strength should sit somewhere in the 15% to 20% range. Over-the-counter products containing a smaller dose of azelaic acid are available as well, although for best results, a prescription is typically required.

Most topical agents require you to apply them twice a day to clean, dry skin. (Masks containing azelaic acid should be used less frequently.)

If you use other products as part of your skincare routine, such as hyaluronic acid, apply those first to help your skin expand and more easily absorb the azelaic acid. Then let it soak in, ideally for 15 minutes, to avoid smearing. This is especially important if you’re using it as a spot treatment to fade darker areas.

After letting your azelaic acid settle in, apply your moisturizer as usual, and don’t skimp on the sunscreen. Azelaic acid doesn’t boost your risk of a gnarly sunburn, but forgoing sun protection is a quick way to reverse all the benefits the solution offers.

It’s safe to apply makeup after the cream, foam or gel has dried completely. Don’t bandage the area or otherwise cover it unless your dermatologist has instructed you to wrap things up. When not in use, store your azelaic acid at room temperature and away from direct light.

A Note About AzA and BHAs

Azelaic acid is a stable molecule, which means that it can get along with virtually any skincare ingredient you stick in front of it. That said, some dermatologists caution against combining azelaic acid with salicylic acid or other beta hydroxy acids because it may cause excessive dryness and irritation. For those who have oily or combination skin, however, tag-teaming your acne with azelaic and salicylic acid can be particularly effective.

What Are the Side Effects of Azelaic Acid?

Side effects are rare. The most common is some form of minor skin irritation, such as:

  • Itching
  • Redness
  • Tingling
  • Stinging
  • Burning
  • Dryness
  • Peeling

According to various studies, these side effects typically improve with time as your skin adjusts to treatment.

Even rarer are more extreme versions of the above, such as blistering, swelling and scaly or crusty skin. If you experience any of these unpleasant symptoms, seek medical advice promptly.

That’s what azelaic acid may do in rare cases. Here’s what it won’t do:

  • Raise your risk of sunburn
  • Increase your resistance to antibiotics
  • Reduce your skin’s oil production
  • Bleach or stain your skin or clothes

Who Should Use Azelaic Acid (and Who Probably Should Not)?

If you have eczema, discuss with your dermatologist whether azelaic acid is right for you. In some instances, it can irritate the skin and lead to mild dermatitis. There is also concern that, in rare instances, azelaic acid may cause asthma symptoms to worsen.

Got sensitive skin in general? Not a problem: Start with a single application every other day. Then increase applications over time. Alternatively, perform a patch test on the back of your arm before applying your foam, cream or gel to more sensitive areas, such as your face or neck, where the skin is thinner.

Otherwise, azelaic acid is suitable for use on all skin types. It’s safe for long-term use, and you can combine it with virtually all other skincare ingredients.

Smokers and those with sun damage can also benefit from azelaic acid, although the benefits may be muted. For healthy skin, it’s imperative to wear sunscreen, stay out of the sun when it’s at its most potent (roughly 10 a.m. to 4 p.m.) and ditch the smoking habit, whether nicotine, vaping, or marijuana.

Unlike many other acne treatments, azelaic acid is a Class B drug that is safe for those who are pregnant and/or breastfeeding. That said, it’s always wise to consult your OBGYN before starting any new prescription medication.

How Long Does Azelaic Acid Take To Work?

Here’s the short answer: A while. Like most targeted skincare treatments, azelaic acid can take several weeks to be effective. Prescription products typically produce visible results in roughly two months. OTC products, meanwhile, often take twice as long. If three months have passed and you’ve noticed zero change, contact your doctor.

Because of the patience involved, most dermatologists prescribe azelaic acid in conjunction with other acne fighters and/or hyperpigmentation treatments. The most effective of these is a customized skincare regimen. Nava MD offers personalized prescription treatment plans that are convenient and affordable. After completing a free consultation online, a clinician examines your responses and formulates a solution tailored specifically to your unique skin care needs — and one that will work in harmony with azelaic acid to produce results. No in-office visit is required, and because Nava MD works with its own pharmacy to fill orders, costs are kept low.

Azelaic acid is a skincare general’s secret weapon. From fighting dark spots to taming acne, it’s a product that’s as versatile as it is gentle. When you’re ready to banish blemishes for good, visit Nava MD to start your free consultation.


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Disclaimer : This article is not intended as medical advice. It is intended for general informational purposes and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions. Dial 911 in case of a medical emergency.