Quick Comparison
| Azelaic Acid | Salicylic Acid | |
|---|---|---|
| Typical Concentration | OTC: 10% (The Ordinary). Prescription: 15% gel (Finacea for rosacea), 20% cream (Azelex for acne). Apply twice daily. Well-tolerated but may sting/itch initially. Full effects at 8-12 weeks. | Concentrations: 0.5-2% for daily use products (cleansers, toners, serums). Up to 30% for professional peels. Start with 0.5-1% every other day and increase. Leave-on products are more effective than wash-off. For body acne (back, chest): 2% is standard. |
| Application | Topical (gel, cream, serum). Slightly gritty texture in some formulations. Apply to clean skin. | Topical (cleanser, toner, serum, spot treatment, body wash, peel). Leave-on products provide better efficacy than wash-off. |
| Research Papers | 9 papers | 10 papers |
| Categories |
Mechanism of Action
Azelaic Acid
Azelaic acid exhibits multi-modal activity: (1) Tyrosinase inhibition—competitively inhibits tyrosinase selectively in hyperactive melanocytes (melasma, PIH) while sparing normal ones; may involve mitochondrial enzyme interference in dysregulated melanocytes. (2) Antimicrobial—bacteriostatic against Cutibacterium acnes by inhibiting bacterial protein synthesis. (3) Comedolytic—normalizes follicular keratinization, reducing hyperkeratinization and corneocyte cohesion; may modulate keratinocyte differentiation. (4) Anti-inflammatory—scavenges ROS, inhibits neutrophil free radicals, reduces pro-inflammatory cytokines. Inhibits 5-alpha-reductase in sebocytes, potentially reducing sebum. Multi-pathway activity explains efficacy in acne, rosacea, and hyperpigmentation. Safe during pregnancy.
Salicylic Acid
Salicylic acid (ortho-hydroxybenzoic acid) is a lipophilic beta-hydroxy acid—the ortho hydroxyl enables sebum and follicular lipid solubility, unlike water-soluble AHAs. It penetrates the pilosebaceous unit and induces desmolysis: disruption of desmosomal attachments and corneodesmosomes, accelerating desquamation of pore-clogging debris. Inside the follicle, it dissolves sebum and keratin plugs (comedolysis). Salicylic acid inhibits COX-1 and COX-2, reducing prostaglandin synthesis—the same anti-inflammatory mechanism as aspirin—decreasing erythema and swelling. Bacteriostatic against Cutibacterium acnes through membrane disruption and pH reduction. May reduce sebum production. Small size (138 Da) and lipophilicity enable follicular penetration to depths AHAs cannot reach.
Risks & Safety
Azelaic Acid
Common
Stinging, burning, itching on initial application (usually subsides within 2 weeks). Mild dryness.
Serious
None. Safe during pregnancy and breastfeeding.
Rare
Allergic contact dermatitis, hypopigmentation (rare at cosmetic concentrations).
Salicylic Acid
Common
Dryness, peeling, mild stinging. Over-use can compromise the skin barrier.
Serious
Salicylate sensitivity (rare) — avoid if allergic to aspirin. Not recommended in pregnancy at high concentrations.
Rare
Severe peeling from over-application.
Full Profiles
Azelaic Acid →
A dicarboxylic acid naturally produced by yeast on the skin. Azelaic acid is a true multi-tasker that treats acne, rosacea, and hyperpigmentation simultaneously. It is one of the few active ingredients considered safe during pregnancy, and it uniquely targets only abnormal melanocytes — meaning it brightens dark spots without lightening normal skin. Effective for both inflammatory acne and post-inflammatory hyperpigmentation (PIH).
Salicylic Acid →
The only beta-hydroxy acid (BHA) used in skincare. Salicylic acid is oil-soluble, meaning it can penetrate into pores and dissolve the sebum and dead skin that cause blackheads and acne. This makes it fundamentally different from AHAs (which only work on the skin surface). It also has direct anti-inflammatory properties, reducing the redness and swelling of acne lesions.