Skincare acids are a motley crew. But one, in particular, needs the same publicist as hyaluronic acid or even glycolic acid.
Azelaic acid is a science-backed ingredient for skin that is sensitive and acne-prone, or if pigmentation and mild to moderate rosacea are concerns.
After years in the shadows as an elusive ‘if you know, you know’ skincare ingredient, word is spreading about the many ways to use it.
Driven largely by TikTok, search around azelaic acid is seeing upwards of 52 million views – even Hailey Bieber has posted a video praising its benefits for soothing perioral dermatis.
Echoes of this hype can also be seen on the high street with Boots launching its own multi-tasking azelaic acid cream.
That said, it's not a straightforward skincare hero. The fact that azelaic acid is a mild exfoliator, but also moonlights as an anti-inflammatory, can be confusing when it comes to slotting it into your regime.
Below, our experts explain what makes azelaic acid such a hard-working ingredient, how to incorporate it alongside your other skincare actives and what skin types will benefit most from using it.
What is azelaic acid?
Azelaic acid is an acid derived from grains such as rye, wheat and barley. It is also produced naturally by yeast that lives on healthy skin.
When it comes to skincare products, though, it is typically chemically engineered in a lab to ensure it is as stable and effective as possible.
Azelaic acid benefits: for perioral dermatitis
In a recent TikTok video, Hailey Bieber can be seen zooming in on tiny red bumps on the lower half of her face, otherwise known as perioral dermatitis (POD). In a caption she says, “Azelaic Acid is found to be effective in treating the inflammation caused by POD”.
And she's right. While a low dose of azelaic acid can dial down redness and spots, cosmetic dermatologist Dr Sam Bunting also recommends initially using it on alternate days until your skin gets used to it.
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Azelaic acid for acne
Azelaic acid has anti-bacterial properties, meaning it can break up the blockages in your pores that lead to breakouts. It is also an anti-inflammatory, meaning it takes the heat out of angry spots, reduces the swelling and flattens the size.
Studies show that azelaic acid also regulates skin cell turnover. This is important for two reasons. It keeps pores clear of debris and tackles what consultant dermatologist Dr Anjali Mahto calls “hyperkeratinisation” – a key issue for acne sufferers that basically refers to the abnormal shedding of skin cells.
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Azelaic acid benefits: for rosacea
Azelaic acid gels are often prescribed by dermatologists for the treatment of rosacea. Because it's an anti-inflammatory, red and irritated patches of skin are soothed.
One study found that the topical application of a 15% azelaic acid gel on rosacea-prone skin reduced what is known as the ‘serine protease activity’ that causes inflammation. It also treated the redness, raised bumps and pustules.
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Better still, "it is one of the few topicals that is safe to use during pregnancy and breastfeeding, allowing women to continue treating their rosacea or acne, which can flare up during this period," explains Dr Ejikeme.
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How azelaic acid can help your skin
- It can help to fade acne scars.
Azelaic acid is known to block the enzyme tyrosinase. This causes excess melanin production in the skin and shows up as dark brown or red discolouration. "As a tyrosinase inhibitor, azelaic acid can also be used to fade lingering acne marks and treat hyperpigmentation," says Dr Ifeoma Ejikeme, founder of the Adonia Medical Clinic.
- It can help to prevent dark patches, known as pigmentation.
Azelaic acid is a powerful antioxidant with skin-brightening properties, making it "a good option for reducing pigmentation often associated with pregnancy,” says Dr Mahto.
- It can gently exfoliate.
Azelaic acid isn't an ‘acid’ in the traditional sense of the word because it doesn't break down the bonds between skin cells, causing them to peel away. It's also a large molecule that is harder for the skin to absorb, making it less irritating. According to Dr Ejikeme, azelaic acid is a milder exfoliator than resurfacing alpha-hydroxy acids (AHAs) including glycolic, lactic and mandelic acids, which makes it a good choice for dry or sensitive skin.
How to use azelaic acid for the best results
- Azelaic acid is available in different concentrations. “It can be obtained over the counter in strengths of 10%, or on prescription - Finacea (15%) and Skinoren (20%),” says Dr Mahto. One study published in the Journal of Medical Sciences revealed that all 40 participants who used a 10% azelaic acid gel saw their mild to moderate acne improve after just eight weeks.
- Apply azelaic acid to clean skin before moisturiser.
- A 10% over-the-counter formula can be applied every day all over your face or to affected areas only.
- For prescription products, follow your doctor's instructions and the manufacturer's guidelines.
What should you not mix with azelaic acid?
With so many active ingredients being used in skincare formulas, it has never been more important to consider whether certain ingredients are safe to use in tandem with others.
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DON'T… mix azelaic acid with more acids: "It is exfoliating so take care if you are using other acids," warns Dr Ejikeme. “To avoid over-exfoliating the skin, stick to one resurfacing ingredient and increase slowly unless advised differently by your doctor.”
DON'T… use with ‘deep-cleansing’ face washes. You should avoid using astringents at the same time as azelaic acid to avoid dry, red and sore skin.
DO… combine azelaic acid with niacinamide: "It's good to combine azelaic acid with other soothing and brightening ingredients like niacinamide or antioxidants," adds Dr Ejikeme – advice that is especially beneficial for those experiencing patches of uneven skin tone.
Azelaic acid vs retinol
Azelaic acid and retinol work very differently, and both have their own pros and cons.
Azelaic acid is great for reducing inflammation. But it is also gentle, so it may not be the best choice for those with severe acne if you use it as a standalone treatment.
Retinol speeds up cell turnover, which can cause peeling and redness during the initial bedding-in stage, but it is a proven aid for severe acne.
There is a compromise, though. Dr Ejikeme believes that azelaic acid partners well with retinoids when used at different times of day: azelaic acid as a serum in the morning and a retinoid cream at night.
Everyone's skin is different, so always consult your dermatologist, who may recommend a stronger skincare acid or more potent topical treatment.
Azelaic acid vs salicylic acid
According to Dr Bunting, azelaic acid and salicylic acid are both excellent for treating acne-prone skin. In fact, she encourages her patients to use them in tandem with her Dr Sam's Flawless Neutralising Gel.
She recommends salicylic acid at 2% for those with very oily skin and angry breakouts. Once a patient is out of the acute acne phase and their skin is looking better, she suggests they switch to azelaic acid for “future preventative action”.
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Azelaic acid side effects
"Of all the acids, azelaic acid is usually well tolerated with minimal side effects," Dr Ejikeme notes. However, like any exfoliating ingredient, there is the chance that skin could flare up and become red.
"When starting an acid, I usually recommend you go slow and only start one active at a time to prevent irritation to the skin," she adds.
And finally, while SPF should already be an integral part of our everyday skincare regime, Dr Ejikeme explains that it's even more important to diligently apply it when using azelaic acid. "All acids can make skin more sensitive to the sun," she says.
13 Best azelaic acid products for calmer, brighter skin
Prepare for skin that boasts clearer pores and a more radiant gleam with this supercharged blend of salicylic acid, azelaic acid and barrier-boosting ceramides.
Salicylic acid and liquorice join forces with azelaic acid to unclog pores and boost its skin-brightening prowess.
With a high percentage of azelaic acid at a low price, this gel-cream is a good entry point product. It does, however, contain silicone so if blocked pores and congestion are an issue, this may not be the right formula for you.
This watery exfoliant leans on azelaic acid, lactic acid and BHAs to tackle an uneven tone and make dull skin look lit.
Yes, this moisturiser is pricey, but the formula, which boasts 3% azelaic acid, arbutin, niacinamide and hydrating squalane, is good at dealing with post-inflammatory hyperpigmentation, especially in dark skin tones.
Applied overnight, acne-fighting azelaic and salicylic acids ensure that even the angriest looking chin-hugger has shrunk by morning. And all without leaving skin crispy and raw.
Created with rosacea in mind, this fast-absorbing serum delivers a double whammy of anti-inflammatory azelaic acid to dial down redness and a green-tinted formula to help mask flushed skin.
A double threat of azelaic acid and zinc PCA protects against spot-forming bacteria and balances oil levels – all for under £10.
Algenist's team of scientists has harnessed the power of a 100% pure, algae-derived vitamin C to join azelaic acid in creating a more even skin tone.
A hit with social media's skin-fluencers, use this blend of salicylic, mandelic and azelaic acids to decongest your skin after a big night out. Also good: hyaluronic acid swoops in to replace lost moisture and plump up fine lines.
If you're time poor, these pads will do all the heavy lifting. Fruit-derived AHAs exfoliate, while skin-soothing azelaic acid and liquorice root step in to reduce the size of spots.
If you're a Beauty Pie member you can walk away with this instant soother for a purse-friendly £22. Made in Japan, clinical ingredients including azelaic acid and niacinamide meet traditional calming ingredients such as sakura and centella asiatica for less redness in just one week.
A Swiss army knife of creams, this Boots version can be dabbed onto spots, red cheeks and patches of pigmentation while its cooling gel/cream formula feels deliciously refreshing.
For more from Fiona Embleton, GLAMOUR's Associate Beauty Director, follow her on @fiembleton.
