Azelaic Acid: What Is It, How It Works, 5 Benefits and FAQs

The skincare world can be overwhelming, especially when finding effective acne treatments. Among many skincare ingredients, azelaic acid benefits those seeking healthier skin. Dr Justin Boey, Medical Director of Sozo Aesthetic Clinic, draws on his expertise in skincare and acne management to highlight the effectiveness of azelaic acid—a naturally derived ingredient known for its gentle yet impactful benefits. This guide will break down everything about azelaic acid, offering practical insights to help you make informed decisions for a healthier skincare routine.

What is Azelaic Acid?

Azelaic acid is a naturally occurring substance in grains like barley, wheat, and rye. It has become a staple ingredient in many skincare routines and is known for its gentle and effective properties. Unlike many other acids used in skincare, azelaic acid is known for being mild on the skin, making it suitable for various skin types. Its use in creams and gels helps treat several skin concerns, including acne and rosacea.

How Does Azelaic Acid Work?

Azelaic acid works through a variety of mechanisms to improve skin health. Firstly, it reduces the presence of Cutibacterium acnes, the bacteria responsible for acne, by inhibiting its growth and proliferation. This antibacterial action is crucial for preventing and managing breakouts.

Additionally, azelaic acid possesses anti-inflammatory properties, which help to calm irritated skin, reduce redness, and soothe conditions such as rosacea. Diminishing inflammation not only promotes a clearer and more even complexion but also plays a role in treating acne scars by minimising the potential for scar formation and lightening existing scars.

Furthermore, azelaic acid inhibits melanin production, the pigment responsible for skin colour. This function is particularly effective in lightening hyperpigmentation and fading dark spots. Through these combined actions, azelaic acid offers an approach to enhancing skin appearance and health, addressing issues from acne and rosacea to hyperpigmentation and acne scars.

5 Benefits of Azelaic Acid

When added to a skincare routine, azelaic acid can provide numerous benefits for the skin. Dr Boey highlights the following benefits:

1. Reduces Acne

One of the primary uses of azelaic acid is its ability to effectively reduce acne. It works by targeting the bacteria responsible for acne outbreaks and decreasing inflammation in the skin. Azelaic acid helps clear up existing blemishes and prevents new ones from forming, making it essential for individuals with persistent acne issues. Its gentle nature ensures it can be used consistently without irritating, offering a reliable and soothing solution for those struggling with acne-prone skin.

2. Treats Hyperpigmentation

Azelaic acid is also effective in treating hyperpigmentation, which refers to the dark spots that remain after acne has healed or other skin injuries have occurred. Azelaic acid promotes an even skin tone and reduces pigmentation irregularities by inhibiting the overproduction of melanin. This quality makes it a valuable ingredient for individuals looking to fade post-inflammatory marks, sun spots, acne scars, or other types of discolouration, ultimately leading to clearer and more balanced skin.

3. Anti-inflammatory Properties

The anti-inflammatory nature of topical azelaic acid is particularly beneficial for individuals with rosacea, a chronic skin condition characterised by facial redness and swelling. Regular application of azelaic acid can help reduce these symptoms, relieving the discomfort associated with rosacea. Calming and soothing the skin, azelaic acid improves the appearance. It enhances comfort for sensitive skin, making it easier to manage daily.

4. Gentle Exfoliation

Azelaic acid acts as a mild exfoliant, gently removing dead skin cells from the surface without the harshness of more aggressive exfoliants. This gentle exfoliating action improves the skin’s overall texture and helps prevent clogged pores, which can lead to further breakouts. This makes azelaic acid a good option for people with sensitive skin types who require a more delicate approach to exfoliation. It leaves the skin feeling smooth, refreshed, and rejuvenated.

5. Improves Skin Texture

With consistent use, azelaic acid can lead to noticeable improvements in the skin’s texture. It helps reduce redness and smooth rough patches, contributing to a more uniform and radiant complexion. Over time, regular application of azelaic acid results in healthier-looking skin that feels soft, supple, and rejuvenated.

Side Effects of Azelaic Acid

While azelaic acid is considered safe and effective for most skin types, some individuals may experience side effects, particularly when introducing it into their skincare routine. Here are some potential side effects to be aware of:

• Redness or Irritation: Initial application may cause mild redness or irritation, especially for individuals with sensitive skin. This usually subsides as the skin adjusts to the ingredient.
• Dryness: Some users may experience dryness or flaking, particularly if used with other drying acne treatments. Moisturising regularly can help alleviate this.
• Sensitivity: In rare cases, individuals might develop a heightened sensitivity to the sun, so it’s crucial to use sun protection when incorporating azelaic acid into daytime skincare.
• Tingling Sensation: A mild tingling or stinging sensation may occur upon application, which generally diminishes with consistent use. If discomfort persists, it’s best to consult an aesthetic practitioner.

These side effects are generally mild and manageable, but monitoring how your skin responds and adjusting your usage accordingly is always important. It is also advisable to conduct a patch test to ensure compatibility. Consulting with an aesthetic practitioner or a professional, such as Dr Justin Boey, can provide additional guidance tailored to individual needs.

Who is Suitable to Use Azelaic Acid?

Azelaic acid benefits various skin types, especially those with specific dermatological issues. It is particularly effective for individuals with acne-prone skin, as it targets acne-causing bacteria, reduces inflammation, and helps prevent the formation of acne scars. The compound’s anti-inflammatory properties also relieve those suffering from rosacea, reducing redness and swelling and providing a soothing effect that improves skin comfort and appearance.

Azelaic acid’s mild exfoliating properties for sensitive skin allow effective skincare without causing irritation or excessive dryness. This promotes a healthier skin barrier, making it a gentle yet effective component of a skincare routine.

Who Should Avoid Azelaic Acid

While azelaic acid is generally well-tolerated, certain individuals may need to exercise caution:

• Severe Skin Conditions: Those with severe skin conditions or allergies should consult an aesthetic practitioner before integrating azelaic acid into their regimen to ensure it won’t aggravate existing issues.
• Pregnant or Nursing Individuals: Pregnant or nursing individuals should always consult their healthcare provider before starting any new skincare treatment, including azelaic acid.

How to Use Azelaic Acid in Your Skincare Routine

Azelaic acid is generally recommended for once or twice daily use, tailored to your skin’s sensitivity and the product concentration. Start with nightly applications to assess your skin’s response, and if well-tolerated, gradually increase to morning use as well.

Azelaic acid products typically come in concentrations ranging from 10% to 20%. For beginners, starting with a lower concentration is advisable to allow your skin to gradually build tolerance. Those with more severe skin concerns like persistent acne or rosacea may benefit from higher concentrations. Still, these should be used under professional guidance.

Below is the step-by-step guide on how to use azelaic acid in your skincare routine:

1. Cleanse your skin thoroughly.
2. Apply a thin layer of azelaic acid cream to the affected areas.
3. Follow with a moisturiser to lock in moisture and soothe the skin.
4. Apply sunscreen as the last step, especially if using azelaic acid during the day.
5. Continue this routine consistently, adjusting frequency and concentration as needed.

Common Mistakes to Avoid

• Overuse: Applying too much azelaic acid or combining it with multiple actives can lead to irritation. Always introduce new products gradually.
• Skipping Sunscreen: Failing to use SPF can negate the positive effects of azelaic acid and may lead to further pigmentation issues.
• Inconsistent Usage: Irregular application won’t yield results. Aim to incorporate it regularly into your routine.
• Neglecting Hydration: Skipping moisturiser can cause dryness, particularly when starting a new acid treatment. Keep skin hydrated to support its barrier function.

Azelaic Acid vs. Other Skincare Acids

Feature	Azelaic Acid	Salicylic Acid	Glycolic Acid
Source	Grains	Willow Bark	Sugar Cane
Primary Benefit	Anti-inflammatory	Exfoliant	Exfoliant
Suitable for	Sensitive Skin	Oily/Acne-Prone Skin	All Skin Types
Additional Benefit	Lightens Pigmentation	Clears Pores	Brightens Skin
Common Side Effect	Mild Irritation	Dryness/Peeling	Sensitivity

Prescription vs. Over-the-Counter Azelaic Acid

Azelaic acid products are available both over-the-counter (OTC) and by prescription. OTC options typically contain up to 10% concentration, which is ideal for mild concerns. Prescription azelaic acid offer higher concentrations for more severe conditions. Choosing between the two depends on the severity of your skin issues. Consulting with a professional can help determine the appropriate course of action.

Is it Okay to Use Azelaic Acid Every Day?

Yes, azelaic acid can be used daily, particularly for those who tolerate it well. Begin with a patch test, then gradually introduce it into your routine. Monitor your skin’s response and adjust frequency as necessary. Daily application can enhance its benefits, leading to clearer skin over time.

When to Stop Using Azelaic Acid?

If you experience persistent irritation, increased redness, or any adverse reactions, it may be necessary to stop using azelaic acid gel or cream. Listening to your skin and adjusting your routine accordingly is crucial. Consulting a professional for advice can help manage and troubleshoot any issues.

Conclusion

Azelaic acid treatment presents a versatile and gentle option for those dealing with acne, hyperpigmentation, and rosacea. It offers numerous benefits, from reducing acne to improving skin texture. While generally safe, monitoring your skin’s response and consulting a professional to tailor its use to your needs is important. For those seeking to enhance their skin care routine, azelaic acid is a worthy consideration.