Azelaic acid (AA) is a commonly used drug for treating acne. It’s effective in reducing pimples and blemishes in various ways. It exfoliates the skin, which promotes new skin cell growth, and has antibacterial properties, which help kill harmful bacteria on the skin.[1]
Azelaic acid has been used for several years to treat mild to moderate acne. It’s considered a mild ingredient, meaning it’s well tolerated by people with sensitive skin and doesn’t cause many side effects.
How does Azelaic Acid work?
Acne can be a complicated condition to treat, as it’s usually caused by multiple factors. Azelaic acid can be an effective treatment for acne because it works in a few ways, tackling the different causes. AA can also treat active acne, inflammation and post-acne hyperpigmentation, making it an effective treatment. Here’s a short list of its properties:
Anti-inflammatory: Excess oil on the face can block your pores, resulting in inflammation and acne. AA can help reduce oil production, which helps reduce inflammation.[1]
Antibacterial: Acne-causing bacteria can cause inflammation, pimples, and whiteheads. AA can kill bacteria that cause acne and help treat bacterial infections.[1]
Antioxidative: Reactive oxygen species (ROS) are chemicals that can cause dark spots and hyperpigmentation. AA can reduce these chemicals, helping fade the marks left by acne. [1]
Anti-keratinisation: Keratin is a protein that forms the outer layer of your skin. But too much keratin production can cause comedones (skin-coloured spots) and block the pores causing pimples. AA slows down the growth of the cells, which helps reduce comedones and acne. [1][2]
In addition to treating active acne, AA can reduce hyperpigmentation. Hyperpigmentation often occurs after a spot has healed. It’s sometimes referred to as scarring, and is usually red and dark. AA can block tyrosinase, an enzyme needed for melanin production, effectively helping treat dark skin spots without affecting the natural colour of your healthy skin.[1]
What doses of Azelaic Acid are there?
Azelaic acid is available as a 15% cream. It’s usually applied twice a day, morning and evening.
This page was written by The Treated Content Team.
This page was medically reviewed by Dr. Joseph Palumbo on August 21, 2024. Next review due on August 21, 2027.
How we source info.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
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How to use Azelaic Acid
Before using Azelaic Acid, gently clean your face with water and pat dry thoroughly. Apply a pea-sized amount onto your finger and apply a thin layer to the affected area. Massage gently until absorbed. Wash your hands after use.
Use twice daily, preferably once in the morning and once in the evening.
How long does Azelaic Acid take to work?
It can take around four weeks before you start to see improvements in your acne. For the best results, though, it usually takes several months of consistent use.
When starting treatment with azelaic acid, you might notice your skin worsens initially. If this happens, don’t panic; it’s usually a good sign that the treatment is working. With most acne treatments, your skin goes through a process called ‘purging.’ This process essentially brings all the impurities underneath your skin (like germs and oil) to the surface to remove them. Once this process is over, your skin will look clearer.
This page was written by The Treated Content Team.
This page was medically reviewed by Dr. Joseph Palumbo on August 21, 2024. Next review due on August 21, 2027.
How we source info.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
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Azelaic acid isn’t suitable for everyone, and there are some things that you need to be aware of when using it.
Here’s all the official info on it. If anything is unclear, let our clinician know, and they can talk with you about it.
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Azelaic Acid: FAQ
Have something specific you want to know? Search our info below, or ask our experts a question if you can’t find what you’re looking for.
How does Azelaic Acid compare with other treatments for acne?
Answer:
Azelaic acid is a chemical exfoliant that helps cleanse your skin of blemishes and marks. Other treatments in this category include glycolic acid (a mild exfoliant) and salicylic acid, which works deeper in your skin than azelaic acid.
Another option for acne is retinoids, which are a derivative of vitamin A. They work by increasing cell turnover, removing dead skin cells, and promoting the production of collagen and new skin cells, resulting in fresher skin.[1] Retinoids are available in various strengths, ranging from adapalene to isotretinoin (Accutane), which is an oral retinoid treatment.
Sometimes, your clinician might recommend a combination of both retinol and azelaic acid for a broader approach.
Are there similar treatments to Azelaic Acid?
Answer:
Azelaic acid is the generic version of Finacea. They both contain the same active ingredient at the same concentration of 15%. There isn't much difference between them except in price and packaging. It’s entirely up to you to choose the branded or generic version, but most of the time the generic one is cheaper.
There is a stronger version of azelaic acid called Skinoren which contains the same active ingredient, it's a little stronger and it's a gel rather than a cream.
Does azelaic acid cause purging?
Answer:
Purging is the process of clearing your skin from the inside out. It pushes the ‘gunk’ from your skin to the surface. As a result, you might notice more pimples and blemishes when you first start using the treatment. It’s quite a normal process with many acne treatments, so try not to worry.
If you're concerned about purging or feel your skin isn’t getting better after a couple of weeks, contact your clinician online.
Is azelaic acid safe during pregnancy?
Answer:
Yes, azelaic acid is considered a safe treatment for pregnant women. But in any case, your clinician will check that the product is safe and suitable for use before allowing you to use it.
Our experts continually monitor new findings in health and medicine, and we update our articles when new info becomes available.
Aug 21, 2024
Published by: The Treated Content Team.Medically reviewed by: Dr. Joseph Palumbo, Senior Medical Adviser
How we source info.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
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Dr. Joseph Palumbo
Senior Medical Adviser
Joseph joined Treated in 2023, and is one of the lead doctors providing prescribing services for the platform.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
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