How Azelaic Acid Became The Star Of Acne-Fighting Skin Care

Acids in skin care are among the top go-tos in formulas meant to exfoliate, brighten, or even out the complexion. While superstars like hyaluronic, salicylic, and glycolic are the more popular of the acid bunch, you shouldn’t sleep on azelaic acid, which has a host of skin-boosting benefits.

Azelaic acid is a compound that’s naturally found in milk, sourdough bread, rye, and other grains, explains Dr. Marisa Garshick, M.D., a board-certified dermatologist with MDCS Dermatology. It’s a commonly recommended ingredient by dermatologists because it can help achieve numerous skin goals. The most notable? Treating acne.

“It’s truly an acne-fighting ingredient, and it’s a great option for people who don’t want to take either oral or topical antibiotics,” says Los Angeles-based board-certified dermatologist Dr. Shirley Chi, M.D. “It’s a natural antibacterial, so it’s not as harsh on the skin.” Though retinol is another staple in dermatologist-approved acne treatments, Garshick notes azelaic acid is often recommended as an alternative to sensitive skin types who are unable to tolerate the vitamin A derivative.

You’ll encounter the acid as an active ingredient in plenty of over-the-counter skin care products, but there is also prescription-grade azelaic, says Garshick. The medical-grade product comes in creams with a 15% or 20% concentration while formulas on the shelves tend to have about 10%.

Either way, the ingredient is known to be gentle and well-tolerated for most complexions. “It’s safe for the most sensitive skin types,” says Chi, who classifies it as a “gentle cousin” of niacinamide, another complexion-soothing MVP. Depending on the specific product and formulation, Garshick says azelaic acid can usually be used once or twice daily. Not only that, but Chi adds that it pairs well with other skin care ingredients, so it’s easy to work into your beauty routine. That being said you should still exercise caution with any new ingredient — remember to always patch test first and introduce it to your skin slowly.

Intrigued by the gentle acne fighter? Keep reading for the azelaic acid benefits you should know about.

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1. It Has Exfoliating Properties

Garshick explains that one of azelaic acid’s most touted benefits is its mild exfoliative properties. “It has the ability to gently exfoliate the skin to help eliminate dead skin cells and unclog pores, leaving the skin feeling soft and smooth,” she explains. While it isn’t a direct exfoliant, it functions similarly to retinol by promoting regular cell turnover. Because of that, it also helps to control your skin’s oil production.

2. It Fights Acne

As mentioned before, azelaic acid’s most renowned trait on its beautifying resume is its ability to treat acne (it’s been FDA-approved for this, too, says Chi). Mainly, it quashes pimples due to its antibacterial and anti-inflammatory properties. Unlike more harsh acne-fighting ingredients, however, azelaic acid is so gentle that it won’t mess with your skin’s natural microbiome, says Chi — so your protective barrier of healthy bacteria can still thrive and do its job regulating your skin’s natural processes.

3. It Reduces Redness

Another benefit of the acid is its incredible ability to reduce redness, especially in regards to rosacea and acne. “It helps with redness in acne because of its pigment clarifying properties,” says Chi. Studies have shown it reduces erythema in skin, too, which is a form of redness that stems from inflamed or injured blood capillaries.

4. It Helps Calm Rosacea

Another key perk of using azelaic acid? “It’s often used to help people with rosacea or redness-prone skin,” Garshick says. This is one reason why the ingredient stands out on the beauty shelves: “Azelaic acid’s anti-inflammatory property is useful for rosacea sufferers since many other acne remedies actually promote redness,” says Dr. Loretta Ciraldo, M.D. FAAD, a Miami-based board-certified dermatologist and founder of Dr. Loretta Skincare.

5. It Helps With Hyperpigmentation

The trouble isn’t over once your active acne lesions have subsided. There is then the aftermath — hyperpigmentation, dark spots, and/or scarring. This is another avenue where azelaic acid thrives. As a refresher, hyperpigmentation is a result of the overproduction of melanin, explains Ciraldo. “Tyrosinase is an important enzyme in melanin production, and azelaic acid is an inhibitor of it — so it blocks the formation of excess pigment,” she says. In other words, the acid prevents the creation of new discoloration while also improving existing marks.

Shop Azelaic Acid Beauty Products

A Soothing Serum

For a very straightforward azelaic acid product, try Naturium’s topical treatment. Besides the star of the formula, the serum also contains niacinamide for extra-soothing perks along with coffee seed extract to help brighten.

An Overnight Pimple Paste

This pimple paste works for both active breakouts and older ones that have left behind a literal mark. Aside from azaleic acid, this overnight treatment contains clay and sulfur, both of which help absorb excess oil that can lead to further breakouts.

A Brightening Serum

4.5.6 Skin is a customizable beauty line created specifically for melanin-rich skin tones. The Sevenly Delight serum combines azelaic acid with six other hyperpigmentation fighters, including vitamin C and alpha arbutin, to even out your complexion.

A Multitasking Face Mask

Azelaic acid is combined with another super powerful anti-inflammatory, turmeric, for this complexion-boosting mask. The mask packs a one-two punch of calming down redness while also gently sloughing away the dead skin cells that can lead to breakouts.

A Routine Booster

If you don’t need to harness the full spectrum of azelaic acid benefits by incorporating it into your daily routine, consider a booster. Whenever your skin needs a little more TLC to work on dark spots or an uneven complexion, mix a couple of drops with your usual moisturizer or serums for an added skin-brightening oomph.

A Facial In A Bottle

Overnight masks and facials are a literal way to catch beauty sleep. Allies of Skin says that this can be used nightly, but pepper it into your routine according to your skin goals. Azelaic acid is combined with peptides to stimulate collagen, niacinamide to regulate oil production, and caffeine for a boost in circulation for a healthy glow.

Studies referenced:

Charnock, C. (2004). Evaluation of the antibacterial efficacy of diesters of azelaic acid. Eur J Pharm Sci. https://pubmed.ncbi.nlm.nih.gov/15066659/

Chilicka, K. (2020). A Comparison of the Effectiveness of Azelaic and Pyruvic Acid Peels in the Treatment of Female Adult Acne: A Randomized Controlled Trial. Scientific Reports. https://www.nature.com/articles/s41598-020-69530-w

Jones, D. (2009). Rosacea, Reactive Oxygen Species, and Azelaic Acid. The Journal of Clinical and Aesthetic Dermatology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2958186/

Katsambas, A. (1989). Clinical Studies of 20% Azelaic Acid Cream in the Treatment of Acne Vulgaris. Comparison With Vehicle and Topical Tretinoin. Acta Dermato-Venereologica. https://pubmed.ncbi.nlm.nih.gov/2528257/

Lee, Y. (2019). Potential Role of the Microbiome in Acne: A Comprehensive Review. J Clin Med. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6678709/

Levy, L. (2012). Management of Acne Scarring, Part II: A Comparative Review of Non-Laser-Based, Minimally Invasive Approaches. American Journal of Clinical Dermatology. https://pubmed.ncbi.nlm.nih.gov/22849351/

Passi, S. (1989). [Mechanism of azelaic acid action in acne]. G Ital Dermatol Venereol. https://pubmed.ncbi.nlm.nih.gov/2534550/

Worret, W. (2006). [Acne therapy with topical benzoyl peroxide, antibiotics and azelaic acid]. J Dtsch Dermatol Ges. https://pubmed.ncbi.nlm.nih.gov/16638058/

Experts:

Dr. Marisa Garshick, M.D., board-certified dermatologist with MDCS Dermatology

Dr. Shirley Chi, M.D., Los Angeles-based board-certified dermatologist

Dr. Loretta Ciraldo, M.D., FAAD, a Miami-based board-certified dermatologist and founder of Dr. Loretta Skincare.