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Azelaic acid is the treatment your skincare routine is missing

Netdoctor (UK) logo Netdoctor (UK) 30/06/2020 Medically reviewed by words by Annie Hayes, Dr Roger Henderson
a close up of a person: Azelaic acid is a gentle exfoliator that helps to treat acne, reduce redness and soothe inflammation. We explain the benefits of azelaic acid and how to use it. © JGI/Jamie Grill Azelaic acid is a gentle exfoliator that helps to treat acne, reduce redness and soothe inflammation. We explain the benefits of azelaic acid and how to use it.

Azelaic acid is the latest dermatologist-approved ingredient to appear over-the-counter, celebrated for its redness-reducing, pore-unblocking, hyperpigmentation-tackling powers.

Produced naturally by yeast that lives on your skin, this exfoliating acid is mild enough to use on stressed-out skin while effectively targeting problem areas. It's been touted as an unsung beauty hero, especially for acne-prone skin, thanks to its antibacterial and inflammation-fighting properties.

We asked Dr Shaaira Nasir, consultant dermatologist at Sk:n; Dr Alexis Granite, consultant dermatologist at the Cadogan Clinic; and Dr Nitasha Buldeo, scientist and founder of Organic Apoteke, for the lowdown on this superstar skincare ingredient:

What is azelaic acid?

Azeleic acid is a natural byproduct of yeast that lives on your skin, and it belongs to a family of acids called dicarboxylic acids. 'It's obtained from grains such as barley, wheat and rye,' says Dr Buldeo. 'When used in skincare products, it is typically lab-engineered for maximum stability and effectiveness.'

This acid is applied topically to your skin and can be found in over-the-counter spot treatments, face washes and toners, says Dr Nasir. 'Prescribed azelaic acid is usually in cream or gel form and at a higher percentage,' she says. Medical prescriptions include Azelex and Finacea.

'Azeleic acid is relatively mild compared to some other acids, especially in over-the-counter formulations, so it can be effective but will likely need to be used over longer periods of time,’ says Dr Granite. 'Higher strengths of azeleic acid – 15 and 20 per cent – as available in prescription topicals are more effective, but again may only work up to a point in terms of treating pigmentation.'

Azeleic acid benefits

'Azeleic acid has the same effect as a leave-on exfoliant,' says Dr Buldeo. It has several benefits:

  • Breaks down dead skin cells
  • Clears pores
  • Reduces hyperpigmentation
  • Anti-inflammatory

Azelaic acid for acne

Azelaic acid prevents, soothes and treats acne, making it a great all-round acne treatment option. It's antibacterial, and therefore clears pores of bacteria, preventing a breakout. It also reduces inflammation, calming the skin when a flare-up occurs. Plus, its a keratolytic, 'meaning it breaks down dead skin cells,' says Dr Nasir. Azelaic acid encourages cell turnover, accelerating your skin's healing process and minimising the risk of acne scars forming.

Azelaic acid for hyperpigmentation

Azeleic acid acts directly on the root cause of hyperpigmentation 'by inhibiting an enzyme called tyrosinase, which is involved in the production of melanin (skin pigment)' says Dr Granite. 'It also helps suppress the growth of abnormal melanocytes implicated in skin conditions such as melasma.'

Azelaic acid for rosacea

Its antibacterial and anti-inflammatory properties make azelaic acid useful in the treatment of rosacea, by decreasing the swelling and redness of the skin.

Are there any side effects?

Azelaic acid is a gentler option than cult beauty favourites alpha-hydroxy-acids (AHAs) and beta-hydroxy-acids (BHAs). However, if you have very sensitive skin, it may cause irritation, says Dr Nasir.

If you experience any of the following, stop using azelaic acid immediately and consult your doctor or dermatologist.

  • Burning or tingling skin
  • Dryness
  • Redness
  • Peeling

As it's a mild exfoliant, azeleic acid can make the skin more sensitive to sunlight, 'so wearing sunscreen during the day is highly recommended while using any products containing this ingredient,' says Dr Granite.

a hand holding a cell phone: Azelaic acid: your guide © Bill Diodato Azelaic acid: your guide

'Use azaleic acid with caution in conjunction with other exfoliating agents such as other acids – glycolic, salicylic – and retinols, as combinations may cause the skin to become more irritated,' she adds.

How to apply azeleic acid

Generally, products containing azeleic acid are meant to be used once or twice daily – also depending on what other products and acids you are incorporating into your routine, says Dr Granite. This is especially true if you're using the acid to treat acne breakouts, or frequently use 'deep-cleansing' facial cleaners and toners.

When you apply any azeleic acid treatment – be it over-the-counter or otherwise – be sure to wash your face and hands before applying the product. Azeleic acid can be applied:

  • Directly after washing your face – as a toner, before moisturising.
  • As a leave-on treatment, such as a serum or cream.
  • If using a prescription cream, follow the instructions given to you by your doctor.

'It's best to apply azeleic acid formulations to clean, freshly washed skin for maximal efficacy,' Dr Granite continues. 'I would recommended starting with it once daily at night and then working up to twice daily if needed as tolerated.'

Azeleic acid products can take some time to take effect. If you are using azaleic acid to treat hyperpigmentation, assess the results 'after four to six months of use,' she says. 'If the pigmentation is still persistent, you may want to increase to a prescription strength or try other ingredients.'

Last updated: 30-06-2020

Gallery: What Is Papulopustular Rosacea? 4 Dermatologists Explain Why You May Be Mistaking Rosacea For Acne (PopSugar)


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