Is this the first time you encounter the term azelaic acid? I wouldn’t be surprised. As you might have noticed by reading our blog - or just browsing skincare and beauty journals in general, some substances are more popular than others.
For example, when it comes to treating signs of aging such as pigmentation, wrinkles, or scars and acne breakouts, the consensus is that four “miracle” acids are all you need: glycolic acid, salicylic acid, lactic acid, and hyaluronic acid. Glycolic acid (which is an AHA - alpha hydroxy acid) is a very efficient exfoliator, for example, masterfully sweeping away all the dead skin cells cluttering our skin. For something similar to glycolic acid, but milder, you are often recommended lactic acid (also an AHA).
For a deeper and more thorough cleaning regimen, we (and others) have recommended salicylic acid as well. Salicylic acid (a BHA, or beta hydroxy acid) “melts down” the oily links between dead skin cells, and being oil-soluble, cleans pores from inside. Finally, there is the gentle, amazing, and natural hyaluronic acid, which offers all sorts of subtle, but noticeable benefits for a younger looking skin.
And now for something different. What of azelaic acid, and why should you care? Let’s see.
What if there’s a dermatologically approved acid that sort of combines all the benefits from the acids mentioned above? Sounds incredible, doesn’t it? However, it is true - azelaic acid is exactly that. Dermatologists put azelaic acid up there with the best treatments for acne breakouts, and especially when one wants to treat their consequences too.
But don’t let the word “acid” throw you off. Azelaic acid is pretty natural, and occurs in many plants, particularly in grains such as rye, wheat, barley and so on. Azelaic acid has found use in skincare and dermatology because it possesses a number of anti-inflammatory and antimicrobial properties. Those properties make azelaic acid a very good treatment for skin conditions such as rosacea, acne, and various other forms of topical or atopical dermatitis. Additionally, azelaic acid is a pretty efficient cleansing agent, wiping your skin clean of dead skin cells, and unclogging your pores from all the random dust, sebum (skin oil) and bacteria.
However, azelaic acid sort of takes its time, which is the reason why you rarely hear about it. People want more immediate results, which makes skincare companies promote harsher substances like salicylic acid, glycolic acid and the rest. However, azelaic acid isn’t entirely gentle as well, because its side effects include dryness, your skin flaking and peeling off, and sensations of burning.
In skincare, azelaic acid usually comes in products in the shape of creams, gels, foams, and so on. Sometimes, azelaic acid is used in prescribed medications or in tandem with stronger acne treatments, and those options usually contain a greater concentration of the acid. But rest assured, azelaic acid can be found in many skincare products that can be purchased over-the-counter, albeit with smaller concentrations.
Okay, now we know what azelaic acid is as well as where to find it, but… Why? What makes azelaic acid suitable for treating acne and its aftermath - such as damaged skin and scars?
Well, azelaic acid has many benefits. For a start, it’s very good for cleaning your skin and unclogging your pores. That means that azelaic acid is a substance that can prevent the appearance of acne, since clogged pores are basically the first link in the chain of processes that cause acne. Once clogged, they can turn into whiteheads (closed comedones) or blackheads (open comedones), and once they become infected or inflamed, what you have on your hands is a proper acne inflammation.
In addition to cleaning your skin from all the dead skin cells, the skin oil and the random dirt, azelaic acid, as we mentioned, has powerful anti-inflammatory properties too. By applying it to your skin, azelaic acid defuses the inflammatory and auto-immune responses of your body, calming it down and soothing your skin. In turn, the soreness, the sensitivity, the pain, and the redness subside. All right, so maybe you have acne, but you don’t have to suffer so much from it, right? Azelaic acid is your friend.
Another subtle, but gradually powerful property of azelaic acid is that it boosts a number of processes on your skin, making your skin renew itself faster. In case you didn’t know, our skin has a natural, spontaneous way of exfoliating itself. That process is called desquamation, and during it, old skin cells die, then get broken up and cleared out, while new skin cells replace them, and eventually (so to speak) end their term. Azelaic acid optimizes this process, making your skin renew itself faster, which means a quicker reduction of wrinkles, and a lesser likelihood for the formation of scars.
The synthesis of melanin, also known as melanosynthesis, is in charge of regulating our skin color. By producing more melanin, or less, this process makes our skin darker, or lighter. This is especially important if you’re struggling with blemishes, hyperpigmentation, dark spots, or other types of discoloration. But what does this mean, especially in regards to azelaic acid and its effects? Well, since it slows down, and sometimes freezes the production of melanin, azelaic acid is especially well suited for people who want to combat dark spots, hyperpigmentation and preventing discoloration and long-term scarring.
Basically, azelaic acid has lightening effects on your skin, acting as a sort of skin bleacher, or whitener. Azelaic acid stops the multiplication of discolored skin cells, keeping our skin close to its natural color. This property to slow melanosynthesis, along with azelaic acid’s anti-inflammatory properties (inflammation makes our skin more damaged, and therefore darker), makes it very effective at preventing the appearance of scars or the darkening of your skin.
Since it is a powerful anti-inflammatory agent, azelaic acid can be a very effective treatment for alleviating symptoms of rosacea. Since rosacea is basically complicated and exacerbated by the inflammatory processes that drive it, by reducing inflammation, azelaic acid can reduce the redness and unpleasant sensations. Additionally, by calming the body down and reducing the inflammation, azelaic acid can also reduce the occasional swelling that rosacea causes.
As we mentioned in the introductory section, azelaic acid comes in many shapes and forms on the marker. Most skincare companies include azelaic acid in products that come in the form of foams, gels, or creams. And regardless of the shape of the product, the basic instructions for using azelaic acid are roughly the same.
First, it’s important that you should wash your face. You can either use warm water, or a mild soap, but it’s important to make sure that the area you want to treat with azelaic acid is as clean as possible. After you’re done washing your face, pat it dry with a dry, clean towel.
Then take the product that contains azelaic acid, and apply a small amount over the desired area. You should rub it in gently, making sure that it comes into very good contact with your skin.
After applying azelaic acid this way (or a product that contains it) you should leave the area alone and let it dry. There’s no need to cover the area with plasters or bandage, just let the azelaic acid work its magic. A word of caution though: never use deep cleansing cleansers or astringent products or substances when using azelaic acid. Doing so can cause damage to your skin and hurt, and you don’t want that.
As for the frequency for using azelaic acid, it can vary from person to person. While some people can use it up to twice a day, using it once a day should be enough. Your best bet is to follow the instructions that come with the product, and try not to overdose yourself. Of course, if you experience any side effects, you should stop using the product right away. To make sure that you won’t injure yourself, it is always wise to perform a patch test before using a product.
Most people won’t experience any side effects when using a product that contains azelaic acid, due to the small concentrations. However, if you use too much of the product, regardless of its instructions, or alternatively, if you have sensitive skin, you may experience the following side effects:
Azelaic acid can cause:
While most of these, especially dry skin can be managed, in rare cases, azelaic acid can cause more serious side effects:
If by any chance you experience any of these serious side effects, you should stop using azelaic acid immediately, and see your doctor and dermatologist. Provided that you didn’t use azelaic acid to shower yourself and didn’t drink it, those reactions can be a symptom of an underlying, serious medical condition.
In order to avoid these kinds of reactions and check how your skin will react to azelaic acid, you can always do a patch test before using it as we mentioned above.
Additionally, you should use sunscreen whenever you are using azelaic acid. Azelaic can make your skin slightly thinner, which can make your skin more sensitive to sunlight, and with it, sunburns and hyperpigmentation.
All of that taken into account, azelaic acid is still milder, albeit slower, acid than salicylic acid or glycolic acid. Azelaic acid is a natural substance found in grains such as wheat, rye, barley and so on. It is generally safe to use, and it cleans your skin and pores thoroughly. Azelaic acid is often used in combination with more serious acne treatments, like Accutane or Retin-A medications, and is effective at treating acne, acne scars, rosacea, uneven skin tone, and other skin conditions. In case you are not sure if you should use azelaic acid, it’s always the best idea to discuss the issue with your doctor and dermatologist.
This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances, and its goal is to offer a general view of the subject. In case you are suffering from a severe case of acne, you should consult with a dermatologist or a certified medical professional.