Azelaic acid is an unsung hero in the world of skincare ingredients that simply doesn’t get the fanfare it deserves. It’s a favourite amongst skin health professionals thanks to its gentleness and versatility, and is a great option if your skin is sensitive, acne and/or rosacea-prone, or shows signs of hyperpigmentation.
In fact, azelaic acid is so effective that it’s often prescribed by dermatologists in higher percentages to treat acne and rosacea. So how can this secret superstar ingredient help your skin? Here, we explain everything you need to know about azelaic acid, from the many benefits to how to use it correctly.
What is azelaic acid?
Azelaic acid is a byproduct of a yeast that lives naturally on our skin. Specifically, it’s a ‘dicarboxylic’ acid and can be found in grains, like rye, wheat and barley. When it comes to skincare, azelaic acid is often chemically engineered in a lab to ensure that it’s as stable and effective as possible.
What does azelaic acid do?
Azelaic acid is a powerful ingredient to treat acne-prone skin because it helps to regulate cell turnover, has antibacterial properties and reduces inflammation, which are the contributing factors that can lead to the onset of acne.
One study found that azelaic acid can reduce follicular hyperkeratinisation (the abnormal shedding of skin cells, or irregular skin cell turnover), which is a key issue for those suffering with regular breakouts.
Azelaic acid also helps to stop our hormone levels (specifically excess testosterone) from activating the skin’s oil glands to produce excess oil, which – together with irregular skin turnover – causes blockages in the skin. Acne bacteria then invades the pores and inflammation sets in.
Azelaic acid is also known as a ‘tyrosinase inhibitor’ – tyrosinase is an enzyme that activates the skin’s melanocytes to produce pigment when it detects that the skin is inflamed (this can be a result of UV exposure or trauma). Often this pigment is irregularly distributed, leading to hyperpigmentation.
A well-known and strong antioxidant, azelaic acid is also a cell communicator that ensures the skin cells in the epidermis are behaving correctly.
What are the benefits of using azelaic acid?
Azelaic acid is a real overachiever. It’s a versatile skincare ingredient that has a number of different benefits:
- Regulates cell turnover to ensure dead cells are sloughing away from the skin, rather than accumulating on the surface and clogging the pores. By normalising the rate of skin shedding, our skin becomes radiant and glowing. This also helps to ensure a strong skin barrier and maintain hydration.
- Fights acne: It has antibacterial properties, and is reported to kill off the P. acnes bacteria, which leads to the development of acne.
- Reduces inflammation and soothes irritation. It also prevents active, inflamed breakouts from acne and rosacea.
- Evens skin tone: It controls sebum production and inhibits tyrosinase – an enzyme that activates the skin’s melanocytes to produce and irregularly distribute pigment when it detects inflammation, leading to hyperpigmentation.
- Azelaic acid has shown to help with sebum control, thus minimising inflammation, rosacea and acne breakout.
- It’s one of the few treatment options for acne, rosacea, clogged pores, or pigmentation that is generally safe for pregnant women. Please speak with your GP or dermatologist about this.
- It’s a strong antioxidant that can help to prevent cellular and tissue damage.
What skin types can benefit from using azelaic acid?
Azelaic acid is a milder exfoliant than other alpha hydroxy acids (AHAs), including glycolic, lactic and mandelic acids, which makes it a good choice for dry or sensitive skin.
It works well for all skin types, but specifically anyone with acne or rosacea-prone skin and those suffering with hyperpigmentation would hugely benefit from integrating it into their regime.
As with all superstar ingredients, it’s important that they are used as part of an effective and targeted regime. Also, using formulations with supporting ingredients to attack particular concerns from multiple angles gives the best possible results.
It’s also one of the few topical ingredients that are safe to use during pregnancy and breastfeeding, allowing women to continue treating their acne or rosacea, which can flare up at this time.
How should you integrate azelaic acid into your regime?
When looking for a formula to try, it’s important to understand the percentage of azelaic acid in the product and build up your limit gradually. Most products range from five to 20 percent on prescription – for example, Skinoren and Finacea are both types of azelaic acid that are often prescribed by doctors for acne and rosacea.
One study found that topical application of a 15% azelaic acid gel on rosacea-prone skin reduced the serine protease activity responsible for inflammation and treated the redness, raised bumps and pustules.
You can also get over-the-counter skin care products with a concentration of 10% or less, and azelaic acid continues to deliver results even at lower concentrations. A 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.
Doctors will typically use prescribed azelaic acid with other topical medications to ensure that conditions such as acne and rosacea are treated from different angles.
If you’re using an over-the-counter formula, integrate it into your regime by applying a thin layer of the product to clean, dry skin twice a day, morning and night. For someone with sensitive skin, it can be used once every other day, instead.
If you’re using a formula that has been prescribed, it’s best to follow the advice of your doctor when it comes to application. Be sure to ask questions about how to begin use and how to build up your skin’s tolerance levels, as well as any possible side effects. Compliance is key for prescription formulas to work, so it’s important to understand what a normal and expected skin reaction can look like so that you don’t give up.
When you start using it for the first time, it can feel a little prickly when applied causing slight irritation and a little shedding. However, it is much more gentle than other medicated creams such as tretinoin or adapalene.
It’s best to apply a pea or marble-sized amount of the product you’re using – whether it’s a foam, gel or cream – to your face and neck after cleansing. To help the azelaic acid absorb more effectively, we recommend applying your AHA (for example, glycolic or lactic acid), BHA (salicylic acid) first to encourage deeper penetration, which is necessary in order to reach the epidermal junction and the sebaceous glands and effectively treat acne, rosacea and hyperpigmentation. You can then follow with an antioxidant serum and your sunscreen, in the mornings.
Are there any products you should avoid when using azelaic acid?
Azelaic acid blends well with many other skincare ingredients, but some formulations have exfoliating properties, so take care if you’re using other acids. To avoid over-exfoliating, stick to one resurfacing ingredient and increase slowly unless advised differently by a doctor.
We also recommend combining azelaic acid with other supportive ingredients. Niacinamide is great for everything from hyperpigmentation to barrier repair, while antioxidants like vitamin C help to protect the skin and increase collagen.
Applying and reapplying SPF diligently is essential when using azelaic acid, as all acids can make our skin more sensitive to the sun and the exposure to UV rays can undo all of the ingredients’ hard work.
Like any exfoliating ingredient, there is a chance that the skin can flare up and become red – that’s why, when starting to use a new acid, we recommend going slow and only starting one active at a time to prevent irritation unless you are being coached through this by a professional. Of all the acids, though, azelaic acid is usually well tolerated and has minimal side effects.
In fact, because azelaic acid is so gentle, it may not be the best choice if you have severe acne – always consult with your clinical facialist or skin specialist, who may have stronger skincare acids that they recommend using alongside other targeted ingredients for a more powerful and comprehensive treatment. They can also make a referral to a dermatologist for stronger medication options, such as systemic medication.
How long does it take to see results?
Once you start using products containing azelaic acid as part of an overall skincare regime designed to achieve optimum skin health, you should see a noticeable improvement within 12 weeks. In fact, a study found that in this time frame, those who used a 20% azelaic acid cream saw their mild to moderate acne decrease by 53%.
It’s important to look after the skin and all its processes with specific products within a comprehensive regime – whilst azelaic acid is a superstar ingredient, it isn’t the answer to achieving optimum skin health on its own.
If you would like advice on how a skincare regime, together with targeted facials and treatments, get in touch to book a consultation and we can provide a tailored plan that’s focused on your skin alone.