Glossary
A naturally occurring dicarboxylic acid produced by the yeast Malassezia furfur on human skin. Available in OTC (10%) and prescription (15-20%) formulations, azelaic acid treats acne, rosacea, and hyperpigmentation simultaneously through antimicrobial, anti-inflammatory, and melanin-inhibiting mechanisms.
Azelaic acid is one of the rare skincare ingredients that addresses three major concerns simultaneously. Acne: It kills Cutibacterium acnes bacteria and normalizes keratinization (reducing pore-clogging). Rosacea: It is FDA-approved for rosacea treatment, reducing the papules, pustules, and redness associated with papulopustular rosacea. Hyperpigmentation: It inhibits tyrosinase (the melanin-producing enzyme), selectively targeting overactive melanocytes while leaving normally functioning ones alone, making it particularly effective for post-inflammatory hyperpigmentation (PIH) and melasma.
Azelaic acid is pregnancy-safe (Category B, one of the very few acne and hyperpigmentation treatments safe during pregnancy). It does not cause photosensitivity (unlike retinoids and AHAs). It is well-tolerated by sensitive skin and rosacea-prone skin. It does not cause purging (unlike retinoids). It works synergistically with other actives (retinol, niacinamide, AHAs). These properties make it one of the most versatile and well-tolerated active ingredients in all of skincare.
OTC: Available at 10% in the U.S. (The Ordinary, Paula's Choice, others). Effective for mild acne, early hyperpigmentation, and general skin brightening. Prescription: 15% gel (Finacea, for rosacea) and 20% cream (Azelex, for acne). More potent for moderate concerns. Higher concentrations may cause initial tingling or mild stinging that typically resolves after 2 to 4 weeks of use.
Yes. Azelaic acid is well-tolerated for daily use, often twice daily. Unlike retinoids or AHAs, it does not typically cause significant dryness, peeling, or photosensitivity. Start with once daily application and increase to twice daily after 1 to 2 weeks if tolerated.
They address overlapping but different concerns. Azelaic acid excels at acne bacteria, rosacea, and selective hyperpigmentation treatment with minimal irritation. Retinol excels at collagen stimulation, deep wrinkle reduction, and overall skin texture improvement. Many dermatologists recommend using both: azelaic acid in the morning, retinol at night.
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