Pimples, blackheads, whiteheads, papules, and pustules are all manifestations of that dreaded affliction: acne.
Acne occurs when the skin’s pores become clogged or the hair follicles in the skin become blocked, usually from oil or dead skin cells. There are many reasons why this occurs, from hormones to stress, genetics, and environmental triggers. If you suffer from frequent acne breakouts, you are not alone. Acne affects 40-50 million Americans of all ages, races, and backgrounds!
Acne can occur anywhere on the body but usually manifests itself on the back, chest, shoulders, and face, where most of the body’s oil glands are. Facial acne often causes embarrassment and distress, and it’s no wonder there’s a massive demand for skincare products that can fight and prevent acne.
In the timeless quest for a clear complexion, azelaic acid offers hope to finally conquering acne.
What is Azelaic Acid?
Azelaic acid is an organic compound created naturally by yeast. It is commonly found in wheat, rye, and barley but can be produced in a lab setting and even by our own skin! Azelaic acid has antioxidant properties, is anti-inflammatory, and helps exfoliate the skin. It is used to treat acne vulgaris and papulopustular rosacea, though it will take a few weeks to see results.
Uses of Azelaic Acid for Acne
The properties of azelaic acid make it an excellent candidate to combat acne and rosacea. It has the benefits of:
- Antimicrobial properties to fight off acne-causing bacteria on the skin
- Anti-inflammatory properties to reduce skin redness and soothe irritation
- A natural exfoliator to deep-clean pores and clear off dead skin
- Reduces skin’s redness and brightens the skin tone
- It helps to fade the appearance of scarring from previous acne breakouts
- Smooths skin’s surface
Its antimicrobial properties are particularly effective in treating propionibacterium acnes, acne caused by c. acnes bacteria. These bacteria live in your skin’s hair follicles and pores and feed off the sebum that your skin produces. Fortunately, antimicrobial products, including azelaic acid, can stop these pimple-causing bacteria.
Prescription topical creams containing azelaic acid have a concentration of approximately 15% – 20% of the acid. You can find azelaic acid in cream, foam, and gel forms as topical acne treatments. Some of the over-the-counter products contain a lower concentration of the acid, which may not be as effective.
For the best results, follow this treatment process:
- Wash your skin with a mild cleanser and dry it. Avoid using harsh cleansers as it will be too harsh of a combination on your skin together with the azelaic acid.
- Take a pea-size amount of your azelaic acid gel or cream product. (Make sure your hands are clean! You don’t want to spread more bacteria to your face).
- Apply a thin layer to your acne-prone skin, gently rubbing it in.
- Let it dry.
- Use the product once or twice a day, as per your doctor’s instructions. If you have very sensitive skin, your doctor may recommend using it only once every other day. You can also mix it into your moisturizer if you find it drying out your skin too much.
- Once the azelaic acid is dry, you can apply your usual moisturizer, sunscreen, and cosmetics on top. If you are applying the acid during the day, it is essential to wear sunscreen on top to protect your skin from drying out.
It can take a few weeks to start seeing results, so don’t get discouraged if you don’t see an immediate improvement in your skin.
Azelaic Acid for Acne Scars
Not only can azelaic acid cure and treat active acne, but it can help heal your skin from scars due to previous acne breakouts. The acid spurs cell regrowth, which rids the skin of the old damaged cells and replaces it with new, healthy cells. This process can help fade the scars.
It also helps to prevent the overproduction of melanin, which gives skin its pigmentation or color. If you popped or scratched a pimple, the skin might have healed in a darker shade. Azelaic acid can help minimize discoloration.
Who Can Benefit from Azelaic Acid
Azelaic acid is safe to use on all skin types, although those with very sensitive skin should use it less frequently.
Anyone who has the following issues can benefit from azelaic acid:
- Skin prone to acne, including the occasional breakout, moderate acne, or extensive acne
- Skin prone to cystic acne, where the blocked pores lead to painful nodules and inflammation.
- Skin prone to rosacea, a chronic skin condition of reddened skin with pimples.
- Skin with hyperpigmentation (discoloration of the skin). Post-inflammatory hyperpigmentation occurs more frequently with darker skin tones. This condition leaves dark patches on the skin. You can apply an azelaic acid product to the discoloration to help it fade.
- Alopecia. Some doctors believe azelaic acid will help those suffering from hair loss by stimulating the hair follicles.
- Lentigo Maligna, a form of skin cancer, has shown responsiveness to this treatment.
It is safe to use up to twice a day and was even approved for pregnant women to use as part of the skincare routine.
You can use it in conjunction with alpha-hydroxy (AHA) acids, beta-hydroxy (BHA) acids, and retinol products.
As with all acne treatments, or any medication, there is a small risk of possible side effects of azelaic acid foam, cream, or gels.
The following side effects are not dangerous, but you should notify your doctor if they occur. Your doctor may adjust the amount or the frequency in which you use it. If you have sensitive skin, you may experience redness and dryness.
- Red skin
- Peeling skin
- Dry skin
- Itchy skin or a minor burning sensation
The following side effects are rare and require medical attention:
- Allergic reactions including a rash, hives, or swelling of the lips and mouth.
- Severe itching, burning, or swelling of the skin
- Skin tone lighter than rest of skin, particularly if you have darker skin.
If you are sensitive to gluten, ask your doctor before using it, as the acid can be derived from wheat and barley. Most doctors concur that it is safe to use as a significant amount of gluten cannot be absorbed through the skin, but it’s always best to confirm.
There are many acne treatment skincare products out on the market, but you need to find the one that is the right fit for your skin. Some products use a combination of different acids and treatment options to give your skin the most weapons in its fight against acne.
Azelaic acid can be used with other acne-fighting solutions such as salicylic acid and Retin A. It is sometimes combined with the other ingredients in skincare products.
- Benzoyl peroxide is a common ingredient in skincare as it kills acne-causing bacteria in the skin. While it is suitable for pimples, it does not work well on blackheads or whiteheads.
- Salicylic acid works best on blackheads and whiteheads. It works by drying out the excess oil in your skin.
- Tretinoin and acne: a derivative of vitamin A, Tretinoin is commonly prescribed by doctors for acne and to improve skin complexion. It is effective but may be too harsh for some people and cause redness, irritation, and, ironically, acne. You can look into less harsh retinoid creams if you experience these side effects.
The cost of tretinoin is expensive, which may be another reason to look into other retinoid creams first.
- Retin A is a brand of tretinoin, is one of the most popular and well-known treatments. Retin A results vary long-term, depending on your skin condition. However, it is not recommended to use Retin A long-term.
- Tranexamic acid is a new, innovative treatment in skincare. It helps reduce acne scars and fades skin discoloration.
- Admire My Skin Ultra Potent Brightening Serum contains a mixture of azelaic acid, salicylic acid, kojic acid, and vitamin C. It works to fade dark spots due to hyperpigmentation, treat age spots and melasma. It is vegan and free of parabens, gluten, and fragrances.
You should start seeing results within 2-4 weeks of use. It is recommended to take a break from using the serum every 60 days to prevent a rare side effect of ochronosis, a permanent darkening of the skin.
- Admire My Skin Clinically Effective Retinoid Cream is a powerfully effective retinoid cream that does not require a prescription. It gently exfoliates the dead skin layer to improve your skin’s tone and texture, diminish the appearance of wrinkles, and prevent acne breakouts. It is vegan and free of parabens, gluten, and fragrances.
Apply the cream to your face and neck once a day. If you’re using it in the morning, instead of using it before bedtime, be sure to wear sunscreen on top of the retinoid cream. You should see results in about six weeks.
- Finacea Foam is a topical prescription spray containing azelaic acid. It is a treatment for moderate to severe rosacea.
- There are several types of azelaic acid treatment, such as creams, foam, and gels, that are available and work to smooth out the skin, reduce fine lines and wrinkles, and control acne.
- Glycolic acid is an alpha-hydroxy that promotes skin exfoliation. It has seen great success in preventing acne breakouts by clearing them out in the blackhead stage. It prevents acne, reduces pore appearance, minimizes wrinkles, and evens skin tones.
It’s helpful to know that you can use more than one treatment in your skincare routine.
If your skin is prone to inflammation, your doctor may recommend using azelaic acid with benzoyl peroxide. For example, you can use azelaic acid topical treatment in the morning and tretinoin or topical retinoid product in the evening.
If you are not using any of them, start with one product for a few weeks until your skin acclimates, and then add in the second product. You don’t want to irritate or dry out your skin by starting on multiple treatments simultaneously.
Is Azelaic Acid the Magical Acne Cure?
While every person’s skin reacts differently, there is a good deal of evidence to suggest that azelaic acid will help get your acne under control and improve your skin’s tone. It is less harsh than some other acids and treatments, and it has minimal and rare side effects. Keep in mind that you’ll need to have some patience as it will take a few weeks to see results, but they will speak for themselves.