What Does Azelaic Acid Do And Why Is It Used In Skincare?

What Does Azelaic Acid Do And Why Is It Used In Skincare?

If you’re looking for solutions to skincare concerns like hyperpigmentation or melasma, you may be wondering if azelaic acid is right for you. Read on to learn about how azelaic acid works and how it can help melasma and hyperpigmentation.

What is azelaic acid?

Azelaic acid is derived from a yeast that lives on normal skin. It is used to treat a variety of skin conditions due to its many skincare benefits, including:

  • Melasma and hyperpigmentation: Inhibits tyrosinase and reduces free radical production, which are necessary to make melanin. Melanin is a biological pigment that is created by the skin to protect itself from UV damage, which can result in dark spots on the skin.
  • Rosacea: Has anti-inflammatory properties which reduce the redness and swelling characteristic of this condition.
  • Acne: Topical applications promote efficient skin shedding and decrease keratin production. Its antibacterial properties also prevent pores from getting infected, which can cause acne.

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Prescription strength vs over-the-counter formulations for hyperpigmentation

Azelaic acid topicals come in gels, creams, or foams and may be used as a monotherapy or in combination with other skincare ingredients. Azelaic acid products are available over-the-counter at concentrations of 10% or less. While this may address minor issues like blackheads and brighten your complexion, it is not a concentration potent enough to address serious acne or hyperpigmentation issues.

To treat hyperpigmentation, prescribed concentrations are usually 15-20%. A study showed a 20% concentration caused a decrease in the appearance of postinflammatory hyperpigmentation after 24 weeks with mild and temporary side effects (Davis).

Several other studies reflect that azelaic acid is a safe and effective treatment for melasma. It is important to note that azelaic acid only affects abnormal melanin production, which means surrounding skin will not be affected by treatments (Bandyopadhyay).

This ingredient is often used in combination therapies to treat melasma. Other ingredients may include glycolic acid or retinoids, which help achieve the desired results more quickly.

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What are common side effects of azelaic acid?

The side effects of azelaic acid are typically mild and temporary as the skin adjusts to treatment. People with sensitive skin or eczema are more likely to experience side effects. Common side effects in the treatment area include:

  • Dryness, itchiness, redness
  • Burning, stinging, tingling
  • Redness or tenderness

If side effects don’t subside or get worse, you should consult your dermatologist about what to do next.

Some people may be allergic to azelaic acid, which may result in serious side effects. If you have any of the following symptoms, you should stop using the product immediately and seek emergency medical treatment:

  • Difficulty breathing, swallowing, or hoarseness of breath
  • Swelling of the eyes, lips, throat, tongue, or face
  • Hives or rash

Best practices when using azelaic acid

Regardless of whether you are using azelaic or another type of acid, some lifestyle changes can help increase the likelihood of success with your treatment for hyperpigmentation.

These include:

  • Avoiding UV damage by using broad spectrum sunscreen, wearing protective clothing, and avoiding the sun during peak hours
  • Avoiding personal care products containing irritants such as fragrances and perfumes
  • Talk to your doctor about skincare routines to make sure no other products you use have ingredients that could counteract the effects of this ingredient


Brandon Kirsch

Brandon Kirsch, MD, FAAD, is a board-certified dermatologist specializing in clinical drug development and medical innovation. He is the founder of Kirsch Dermatology in Naples, Florida and is also the Chief of Dermatology at the Naples Community Hospital. Kirsch Dermatology Website Dr. Kirsch started his career as a lawyer and holds law degrees from the University of Western Ontario (LL.B.) and Georgetown (LL.M. Securities and Financial Regulation). Dr. Kirsch completed his pre-medical studies at the University of Pennsylvania, medical school at Brown University, internship at the Mayo Clinic (Florida) and dermatology residency at the University of North Carolina. In partnership with the Mayo Clinic, he filed to patent a novel topical composition for the treatment of skin hyperpigmentation that he co-developed and also oversaw a successful pilot study of the formulation. Dr. Kirsch has experience with therapeutic drug development programs from pre-clinical to Phase 3 studies. He is licensed to practice medicine in California, Colorado, Florida, and North Carolina and law in New York and Ontario.

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