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Azelaic Acid in Skin Care

Azelaic acid in skin care

Azelaic acid (AA) is a popular and effective ingredient used primarily for its skin lightening, tyrosinase inhibition, anti-inflammatory and antiaging properties in skin care. It is found in skin creams, lotions and serums and in prescription rosacea medications and is used to treat dark spots, acne, rosacea, wrinkles, and other conditions with many studies supporting its use.

It is safe with very low chance of allergies.

This blog is all about the benefits, uses, and important facts related to azelaic acid in skin care. Take the Baumann Skin Type quiz to see if this ingredient is right for you!

What is azelaic acid?

What is Azelaic acid?

Azelaic acid is a naturally occurring dicarboxylic acid found in many plants like grains or oats. (7)

Many dicarboxylic acids are used in products designed for skin lightening, rosacea, and acne treatments. (4)

It has a low pH, and is used in many cleansers and exfoliators.

The INCI name for AA is azelaic acid acid. Other names it is known by include:

  • 1,7-Dicarboxyheptane
  • 1,7-Heptanedicarboxylic Acid
  • Anchoic Acid
  • Lepargylic Acid
  • Nonanedioic Acid

Benefits

Azelaic acid is well known for its anti-inflammatory, exfoliating, and skin lightening benefits. (1)

It is a very good skin lightening ingredient and can be found in many hyperpigmentation treatments. (7)

It can lighten skin both by inhibiting tyrosinase and by damaging melanin producing cells in the skin called melanocytes.(10)

It is effective on naturally light and/or dark skin tones as part of a hyperpigmentation treatment plan. (5)

AA has a low pH which means it is a good exfoliant in many cleansers and anti-aging products. (6)

Soothing anti-redness ingredients like azelaic acid are good for many inflammatory skin conditions like eczema or rosacea. (12)

Antimicrobial benefits have also been observed in azelaic acid, meaning it can eliminate many kinds of bacteria. (14)

Its low pH makes the skin less hospitable to acne causing bacteria.

Side effects of azelaic acid

Side-effects and safety

Azelaic acid is safe to use in many kinds of skin care products. Because it has a low pH, it can cause some mild stinging after applying.

It should not be used when your skin stings because the low pH can cause a burning sensation.

AA does not have any other common causes of concern or notable side effects, with very low chances of allergy.

The EWG gives rinse-off azelaic products a score of 1-2. The risk of leave on products is minimal when used on small areas such as the face.

There is a very low risk of allergy to azelaic acid, but only mild reactions light redness or inflammation are common.

Overall, azelaic acid is a good ingredient with few safety concerns, but you should always shop by your skin type to make sure you're only buying the right products for your skin.

Pregnancy

It is unknown if azelaic acid is safe to use during pregnancy. In the prescription form of azelaic acid called Finacea, the FDA states that "There are no adequate and well-controlled studies of topically administered azelaic acid in pregnant women. The experience with FINACEA® Gel, 15%, when used by pregnant women is too limited to permit assessment of the safety of its use during pregnancy." (15) If you choose to cosmetic face serums or creams with this ingredient while pregnant, only use a small amount on the face only. Do not use on large areas of the body.

It is also recommended that babies under two years old avoid azelaic acid because it can irritate their skin, and has a higher risk of systemic absorption.

Toxicity

Azelaic acid is an natural ingredient derived from wheat, barley and rye.  It is considered a clean ingredient. Organic forms of this plant derived ingredient do exist.

Retinol vs azelaic acid

 Ingredients you can you use together with azelaic acid

Can you use azelaic acid with retinol?

Retinol is in the family of retinoid compounds, while azelaic acid is a dicarboxylic acid.

They can be used together in anti-aging, acne, and skin lightening skin care routines.

They are both exfoliants which can smooth fine lines and increase collagen production: using more than 3 types of exfoliants in the skin care routine can lead to over-exfoliation.

Both retinoids and azelaic acid help increase collagen production, but retinoids are much more effective at increasing skin collagen and azelaic does not protect collagen as well as retinoids do.

Producing more collagen means you will smooth fine lines and wrinkles. and improve skin thickness, strength and texture.

Retinoids are great for concerns like wrinkles, photoaging, and acne, but can irritate dry or sensitive skin and cause retinoid dermatitis.

Azelaic acid in skin care has soothing properties but it's low pH can also irritate the skin.

Difference between retinol and azelaic acid for skin aging

Retinol prevents aging by turning off genes that break down collagen.

AA is an antioxidant, while retinoids are not. (16)

Retinoids are better at treating skin aging than azelaic acid long term, but Azelaic acid has faster benefits.

How to use azelaic acid together with retinol?

Apply azelaic acid in the AM before your moisturizer or before the retinol step in your evening skin care routine.

If your skin is irritated from retinoids or if you are just beginning a retinol, do not use azelaic acid because you may over-exfoliate leading to skin stinging and irritation.

Best oils to use with azelaic acid

Best Oils to use with AA

Dry skin types need extra skin moisturization, and azelaic acid does not have moisturizing properties. For this reason, dry skin types may want to combine AA with natural oils like:

For specific conditions

Azelaic acid can be used to treat many conditions where anti-inflammatory, non-comedogenic, antimicrobial, or antioxidant ingredients would be helpful.

Some of the most common conditions azelaic acid is used to treat include acne, hyperpigmentation, rosacea, and wrinkles,

Acne

Azelaic acid is antimicrobial and contains no comedogenic fatty acids, meaning it can be a great addition to many acne products. (1)

The best acne routines include antimicrobial, exfoliating, and soothing elements while not adding extra oil onto the skin.

For those reasons, azelaic acid could be great for your acne routine, depending on your Baumann Skin Type.

Azelaic acid for hyperpigmentation

Azelaic acid is best known for its capabilities in skin lightening. (7)

It expresses two mechanisms for lightening skin:

Being a competitive tyrosinase inhibitor means it is fairly effective at stopping melanin production signals on its own, unlike many natural oil based tyrosinase inhibitors which only really work in combination with other ingredients.

Melanocytes are structures in the skin responsible for producing melanin, skin pigment. Because azelaic acid can interfere directly with melanocytes, it is very effective at treating dark spots.

Azelaic acid is used in treatments of many kinds of hyperpigmentation including melasma, post inflammatory hyperpigmentation, and sun damage.

Rosacea

Azelaic acid also expresses soothing anti-inflammatory properties which have been shown to have benefits in rosacea treatments. (1)

Inflammation is one of the four major barriers to skin health and should be calmed to prevent skin aging and post inflammatory hyperpigmentation.

Wrinkles

As a low pH exfoliant, azelaic acid can smooth skin and stimulate collagen production, it also decreases inflammation and therefore is great in the prevention and treatment of wrinkles.(1,6)

When used as a part of your skin lightening routine, azelaic acid can commonly be found combined with other ingredients like retinoids other anti-aging ingredients like:

What are azelaic acid gels?

Azelaic acid Gel

Gels are water based skin care products, meaning they absorb into the skin much faster than oil based products.

Gels are also safer to use on acne prone skin, as they do not contain oils which can sometimes clog pores or overhydrate skin.

Since azelaic acid is often used in acne treatments and cleansers, clean, quick absorbing gels are often the best way to deliver the ingredient.

Azelaic acid serum

Serums are usually productions with extremely high concentrations of their active ingredient. For this reason, serums are among the most expensive skin care products.

Because serums are very concentrated, ingredients like azelaic acid which have profound effects even in low concentrations become more effective.

Azelaic acid serums can be expected to more aggressively perform the same functions as azelaic acid in other products, this can mean more potent skin lightening effects, more anti-inflammatory properties, and fewer bacteria on the face.

Is it an exfoliator?

Yes, azelaic acid is an exfoliator. Specifically, it is a low pH chemical exfoliator which works by dissolving attachments between cells.

The skin naturally exfoliates itself during a process called desquamation, but ingredients like azelaic acid help cleanse the skin evenly and in a controlled manner.

Exfoliating is an important part of many skin care regimens. Take our quiz to find out which exfoliators, if any, are right for your custom skin care regimen!

Products

Level up your skin care knowledge with medical advice from dermatologists

Here are some of the best references on Azelaic acid in skin care:

  1. Baumann L.S., & Rieder E.A., & Sun M.D.(Eds.), (2022). Baumann’s Cosmetic Dermatology, 3e. McGraw Hill. https://dermatology.mhmedical.com/content.aspx?bookid=3200&sectionid=266613978
  2. Verallo-Rowell VM, Verallo V, Graupe K, Lopez-Villafuerte L, Garcia-Lopez M. Double-blind comparison of azelaic acid and hydroquinone in the treatment of melasma. Acta Derm Venereol Suppl (Stockh). 1989;143:58-61.
  3. Baliña LM, Graupe K. The treatment of melasma. 20% azelaic acid versus 4% hydroquinone cream. Int J Dermatol. 1991;30(12):893-5.
  4. Lowe NJ, Rizk D, Grimes P, Billips M, Pincus S. Azelaic acid 20% cream in the treatment of facial hyperpigmentation in darker-skinned patients. Clin Ther. 1998;20(5):945-59.
  5. Kakita LS, Lowe NJ. Azelaic acid and glycolic acid combination therapy for facial hyperpigmentation in darker-skinned patients: a clinical comparison with hydroquinone. Clin Ther. 1998;20(5):960-70.
  6. Passi S, Picardo M, De Luca C, Breathnach AS, Nazzaro-Porro M. Scavenging activity of azelaic acid on hydroxyl radicals "in vitro". Free Radic Res Commun. 1991;11(6):329-38.
  7. Fitton A, Goa KL. Azelaic acid. A review of its pharmacological properties and therapeutic efficacy in acne and hyperpigmentary skin disorders. Drugs. 1991;41(5):780-98.
  8. Nazzaro-Porro M. The use of azelaic acid in hyperpigmentation. Rev Contemp Pharmacother. 1993;4(415):223.
  9. Nguyen QH, Bui TP. Azelaic acid: pharmacokinetic and pharmacodynamic properties and its therapeutic role in hyperpigmentary disorders and acne. Int J Dermatol. 1995;34(2):75-84.
  10. Pathak MA, Ciganek ER, Wick M, Sober AJ, Farinelli WA, Fitzpatrick TB. An evaluation of the effectiveness of azelaic acid as a depigmenting and chemotherapeutic agent. J Invest Dermatol. 1985;85(3):222-8.
  11. Leibl H, Stingl G, Pehamberger H, Korschan H, Konrad K, Wolff K. Inhibition of DNA synthesis of melanoma cells by azelaic acid. J Invest Dermatol. 1985;85(5):417-22.
  12. Akamatsu H, Komura J, Asada Y, Miyachi Y, Niwa Y. Inhibitory effect of azelaic acid on neutrophil functions: a possible cause for its efficacy in treating pathogenetically unrelated diseases. Arch Dermatol Res. 1991;283(3):162-6.
  13. Passi S, Picardo M, Zompetta C, De Luca C, Breathnach AS, Nazzaro-Porro M. The oxyradical-scavenging activity of azelaic acid in biological systems. Free Radic Res Commun. 1991;15(1):17-28.
  14. Leeming, J. P., Holland, K. T., & Bojar, R. A. (1986). The in vitro antimicrobial effect of azelaic acid. British Journal of Dermatology, 115(5), 551-556.
  15. https://www.accessdata.fda.gov/drugsatfda_docs/label/2005/021470s003lbl.pdf
  16. Jones, D. A. (2009). Rosacea, reactive oxygen species, and azelaic acid. J Clin Aesthet Dermatol, 2(1), 26-30.

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