Overview
What is it?
Azelaic acid is a naturally occurring acid found in grains like wheat, rye, and barley. It is commonly used as a topical treatment for acne due to its antibacterial, anti-inflammatory, and comedolytic (pore-unclogging) properties. It is available in creams, gels, and foams, making it easy to apply directly to the skin.
How does it work?
Azelaic acid works by targeting multiple causes of acne. It reduces the growth of *Propionibacterium acnes*, the bacteria responsible for acne, and decreases inflammation in the skin. Additionally, it helps unclog pores by preventing the buildup of dead skin cells, which can lead to blackheads and whiteheads. Its antioxidant properties also help reduce redness and irritation associated with acne .
What are the benefits?
Azelaic acid is effective for treating both non-inflammatory acne (blackheads and whiteheads) and mild to moderate inflammatory acne (pimples and pustules). It is also beneficial for reducing post-inflammatory hyperpigmentation (dark spots left after acne heals). Unlike some other acne treatments, azelaic acid is considered safe for use during pregnancy and lactation, making it a preferred option for many individuals .
Effectiveness
What does the research say?
Research shows that azelaic acid is effective in reducing acne lesions and improving skin texture. While it may be slightly less effective than benzoyl peroxide in some cases, it is comparable to other treatments like tretinoin and clindamycin. It is often used in combination with other acne treatments to enhance its effectiveness and reduce the risk of antibiotic resistance .
Side Effects
Mild skin irritation
Mild skin irritation, such as redness or stinging, is common when first using azelaic acid. This usually subsides as the skin adjusts to the treatment .
Dryness
Dryness may occur, especially in individuals with sensitive skin. Using a moisturizer can help alleviate this side effect .
Itching
Itching is a less common side effect but can occur in some users. If persistent, it is advisable to consult a dermatologist .
Scaling
Scaling or flaking of the skin may happen, particularly in areas where the product is applied. This is usually mild and temporary .
Burning sensation
A burning sensation may be experienced upon application, especially if the skin is already irritated or sensitive. This typically resolves with continued use .
Evidence
Clinical Studies & Trials
[1] Guidelines of care for the management of acne vulgaris.
This paper provides guidelines for managing acne vulgaris, a common skin condition affecting adolescents and adults.
View study[2] Management of Acne Vulgaris: A Review.
This review discusses the global prevalence of acne vulgaris and its impact on mental health and quality of life.
View study[3] Acne treatment review and future perspectives.
This paper reviews current acne treatments, including azelaic acid, and discusses future advancements in acne therapy.
View study[4] Topical azelaic acid, salicylic acid, nicotinamide, sulphur, zinc and fruit acid (alpha-hydroxy acid) for acne.
This meta-analysis compares the effectiveness of azelaic acid with other topical treatments for acne.
View study[5] Management of Acne in Pregnancy.
This review evaluates the safety and efficacy of acne treatments, including azelaic acid, during pregnancy.
View study[6] The versatility of azelaic acid in dermatology.
This review highlights the diverse uses of azelaic acid in dermatology, including its role in treating acne and rosacea.
View study[7] Treatment of Acne Vulgaris During Pregnancy and Lactation: A Narrative Review.
This review discusses the safety and efficacy of azelaic acid and other treatments for acne during pregnancy and lactation.
View study[8] Treatment of Acne in Pregnancy.
This paper outlines safe and effective treatments for acne during pregnancy, including azelaic acid.
View study[9] Azelaic acid: Properties and mode of action.
This review explores the properties and mechanisms of azelaic acid in treating acne and other skin conditions.
View study[10] Azelaic Acid: Evidence-based Update on Mechanism of Action and Clinical Application.
This paper provides an evidence-based update on the clinical uses and mechanisms of azelaic acid.
View study[11] Acne vulgaris.
This review discusses the use of azelaic acid in managing acne vulgaris, focusing on its antiseptic and comedolytic properties.
View study