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).
Concentration & Usage
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.
Application
Topical (gel, cream, serum). Slightly gritty texture in some formulations. Apply to clean skin.
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99%+ purity · third-party lab tested
Mechanism of Action
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.
Ingredient Interactions
Both reduce melanin production through different pathways and both are anti-inflammatory. This combination is pregnancy-safe and effective for hyperpigmentation, rosacea, and acne.
See our full Ingredient Interactions Guide for more combinations and timing strategies.
Regulatory Status
Prescription at 15-20% (Finacea, Azelex) in the US. OTC at 10% or less. Some countries allow higher OTC concentrations.
Risks & Safety
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).
Compare Azelaic Acid With
Research Papers
9Published: October 6, 2023
AI Summary
Topical azelaic acid (AA) is indicated for acne and rosacea, but there is some evidence for its use for other dermatological conditions.
Published: April 30, 2020
AI Summary
It is common in adolescents and primarily affects sebaceous gland-rich areas. The clinical benefit of the topical acne treatments azelaic acid, salicylic acid, nicotinamide, sulphur, zinc, and alpha-hydroxy acid is unclear.
Published: May 29, 2024
AI Summary
Acne vulgaris commonly affects adults, adolescents, and preadolescents aged 9 years or older.
Published: August 4, 2022
AI Summary
Alternatively, low-dose isotretinoin can be recommended. For topical treatment, ciclosporin eye drops, azithromycin, ivermectin or metronidazole are suggested.
Published: November 22, 2021
AI Summary
Acne vulgaris is an inflammatory disease of the pilosebaceous unit of the skin that primarily involves the face and trunk and affects approximately 9% of the population worldwide (approximately 85% of individuals aged 12-24 years, and approximately 50% of patients aged 20-29 years). Acne vulgaris ca
Published: September 7, 2024
AI Summary
Photoaging is a process of the architecture of normal skin damaged by ultraviolet radiation. The authors aimed to understand the mechanism and level of evidence of different commonly used cosmeceuticals used to treat photodamaged skin.
Published: December 13, 2025
AI Summary
There is ambiguity regarding the topical cosmetic ingredients preferred for common skin complaints.
Published: November 30, 1987
AI Summary
Its beneficial effect on various forms of acne (comedogenic, papulopustular, nodulocystic) has been clearly demonstrated. Particularly important is its action on abnormal melanocytes, which has led to the possibility of obtaining good results on melasma and highly durable therapeutic responses on lentigo maligna.
Published: December 7, 2023
AI Summary
Azelaic acid (AZA) is a naturally occurring saturated dicarboxylic acid whose topical application has found multiple uses in dermatology. In this review, we will present the mechanism of action and pharmacokinetics of AZA.
Frequently Asked Questions
What is Azelaic Acid used for?
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).
What are the side effects of 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).
How is Azelaic Acid administered?
Azelaic Acid is administered via topical (gel, cream, serum). slightly gritty texture in some formulations. apply to clean skin..
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