I first learned about azelaic acid about three years ago when it started blowing up on Reddit as the “underrated holy grail” ingredient for reducing redness, and improving skin texture. I did not use it at first because I was already using a lot of other acids and did not want to make my skin worse than a chemical peel. But the more I researched it, the more I realized it’s not like the other acids I was using.
Most people think of it as being similar to glycolic or salicylic because of the word ‘acid’ in the title. However, azelaic acid is completely different. It is a dicarboxylic acid that naturally occurs in grains like wheat and barley. It works to soothe overactive melanocytes, which are the cells responsible for pigment production, and reduce inflammation. It also has antibacterial properties, which is the reason dermatologists often prescribe it for acne and rosacea. However, unlike AHAs or BHAs, azelaic acid does not exfoliate. It is gentler on the surface and works more on the underlying issues.
Surprisingly, azelaic acid does not speed up cell turnover like glycolic acid or retinol. Azelaic acid is a softer and gentler option as it does not cause irritation like (for example) retinol, however it will take you longer to see results. I have seen some brands promote azelaic acid as a brightening ingredient and while this may be true, it gives the false perception that you will get glass skin in two weeks. Azaleic acid may assist in shedding post-inflammatory hyperpigmentation (the dark spots that occur after a breakout) but this is a long and arduous process, we are looking at months instead of days.
The biggest mistake hype culture surrounding azelaic acid gets wrong is the concentration. Over the counter products containing azelaic acid have a maximum concentration of 10%, however, prescriptions can have 15-20%. There is a large difference between the two. I have tried various serums that contain 10% and do nothing, and I have tried 15% prescription formulas and seen fading of stubborn acne marks. The challenge is that many brands simply put “azelaic acid” on the ingredient list but don’t specify the percentage. If azelaic acid is listed below the preservatives, you may not be getting enough to make a difference.
Azelaic acid can pill on your skin. This could mean that little clumps will form, with or without your knowledge. This is particularly true if you apply it under sunscreen or under makeup before it has had enough time to fully absorb. I learned this lesson the hard way after it looked like I had a bunch of eraser shavings on my face during a meeting. On top of that, it doesn’t mix well with primers that have more silicone in them. I started putting it on at night only, and that fixed most of the problem.
If you have issues with redness, rosacea, or dark spots from post-acne that you struggle to treat with retinol or vitamin C, you should consider trying azelaic acid. It’s also great because it is one of the only actives that is safe to use during pregnancy (although you should still check with your doctor). You might experience some tingling which is normal because it’s still an acid. I experienced it and it went away after about a week. You might want to patch test if your skin is very sensitive or compromised. In that case, consider using it every other night at first.
Azelaic acid has been part of my routine for about a year now, because of my annoying red marks after breakouts. I had very low expectations because I tried niacinamide before, and it didn’t do much for me. Six weeks from when I started using it, I could see marks fading faster than before. They weren’t gone instantly, but it was a noticeable difference. I was really surprised at how much it improved overall texture; my skin just looked a lot smoother despite that not being my goal for using azelaic acid. The downside is that it’s boring. There’s no glow or dramatic change. You just wake up one day, and your skin looks better than it did months ago.
I’d suggest The Ordinary Azelaic Acid Suspension 10% because of its price and lack of added ingredients. It’s about $13 and is a good way to see how your skin handles azelaic acid before going to the derm. For stronger options, you’ll need a prescription.
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