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Benefits Of Topical Azelaic Acid and How To Use It

What Is Azelaic Acid?

Azelaic acid is a dicarboxylic acid compound having anti-inflammatory and antioxidant characteristics that have been used to treat acne vulgaris, papulopustular rosacea, and other skin disorders.

Azelaic acid is produced naturally by the yeast Malassezia furfur. Azelaic acid is available in a 20% concentration as Aziderm,  Skinoren cream, Acnederm lotion, and Azclear lotion. A 15% azelaic acid gel preparation, Finacea gel, has also been approved for use in the United States for rosacea and in various European nations for both rosacea and acne.

Azelaic acid has the following characteristics:

  • Antibacterial – It inhibits protein synthesis, which slows the growth of bacteria in the follicle (for example, Cutibacterium acnes, also known as Propionibacterium acnes).
  • Keratolytic and comedolytic – by limiting the proliferation and differentiation of human keratinocytes, it improves the disruptive growth of skin cells lining the follicle.
  • Anti-inflammatory – decreases inflammation by eliminating free radicals; particularly, blocks mitochondrial oxidoreductases and lowers neutrophil production of proinflammatory oxygen derivatives.

Azelaic Acid For Rosacea:

Azelaic acid is anti-inflammatory without being very irritating. It alleviates the redness and pimples associated with rosacea. According to one study, using 15% azelaic acid twice a day for 12 weeks was more effective than the control group in reducing rosacea symptoms; other studies found that azelaic acid was better than metronidazole, frequently used topical rosacea medication, in reducing redness and bumps.

Furthermore, azelaic acid may improve rosacea and acne skin by removing bacteria that cause skin diseases.

Azelaic Acid For Melasma And Hyperpigmentation:

Azelaic acid is also beneficial for removing dark spots caused by melasma or hyperpigmentation at higher concentrations of 15-20%. It works by preventing free radicals as well as tyrosinase, an enzyme required for melanin formation.

Topical azelaic acid treatments‘ lightening effects target just abnormal melanocytes, allowing them to remove dark patches without damaging the surrounding skin. A 24-week study of a 20% concentration treatment revealed that it significantly decreased the severity of postinflammatory hyperpigmentation while causing only minor side effects.

Azelaic Acid For Acne:

According to one research, azelaic acid may help treat acne by increasing skin cell turnover (which keeps pores clear), eliminating the C. acnes bacteria that causes pimples, and decreasing inflammation.

When patients rated their acne improvement after using several topicals, the study discovered that azelaic acid was less effective than benzoyl peroxide but as effective as tretinoin (Retin-A) in clearing acne. However, unless you are pregnant, azelaic acid is not the first-line medication for acne in dermatology treatment. There are few anti-acne treatments at the moment, so azelaic acid is an excellent choice for keeping skin clear.

Azelaic Acid For Acne Scars:

Azelaic acid is used to treat acne scars in addition to active outbreaks. Azelaic acid promotes cell turnover, which helps reduce the severity of scarring. It also inhibits melanin production, your skin’s capacity to generate pigments that change the tone of your skin.

If you’ve tried various topical treatments for scarring or slow-healing blemishes, it is time for azelaic acid.

Is Azelaic Acid Safe To Take While Pregnant?

Pregnant women may use azelaic acid, which is slightly absorbed into their bloodstream. As a result, it is a safer option than other topicals such as retinoids. In addition to azelaic acid, the American College of Obstetricians and Gynaecologists recommends that topical benzoyl peroxide, topical salicylic acid, and glycolic acid can be beneficial to treat acne during pregnancy.

Furthermore, because of hormonal changes during pregnancy, melasma tends to increase during this time. Because the number of skin brighteners that are appropriate to use during pregnancy is limited, azelaic acid can be your go-to.

How To Use Azelaic Acid:

Azelaic acid is available as a gel, foam, and cream for application to the skin. It is often used twice a day, in the morning and evening. Use azelaic acid at the same times every day to help you remember to use it. Follow the directions on the prescription label, and if you have any questions, ask your doctor or pharmacist. Azelaic acid must be used exactly as it is directed. Avoid applying more or less of it, or use it more often than recommended by your doctor.

Avoid getting azelaic acid in the eyes or mouth. If you get azelaic acid in your eyes, rinse thoroughly with water and consult your doctor if your eyes become irritated.

The foam made from azelaic acid is flammable. Avoid open fires and flames.

Follow the following steps to apply it in the form of a gel, foam, or cream:

  • Wash the affected skin with warm water and a mild soap or soapless washing lotion, then dry it with a soft towel.
  • Ask for a cleanser recommendation from your doctor, and avoid using alcoholic cleansers, tinctures, abrasive astringents, and peeling agents, particularly if you’re suffering from rosacea.
  • Before using, gently shake the azelaic acid foam.
  • On the affected skin, apply a thin layer of gel or cream. Massage it into your skin carefully and thoroughly. Apply a thin coating of foam to the entire face, with attention to the cheeks, chin, forehead, and nose.
  • Remove any bandages, dressings, or wrappings from the affected area.


Your doctor must monitor your progress regularly to look for any adverse effects.

Consult your doctor if your acne does not improve after 4 weeks or worsens. Consult your doctor if your rosacea does not improve within 12 weeks or worsens.

This medication may trigger allergic reactions, such as angioedema, which can be fatal and necessitate immediate medical intervention. If you experience itching skin, difficulty breathing, or hive-like swelling on the face, eyelids, lips, tongue, neck, hands, legs, feet, or genitals after using this medication, contact your doctor immediately.


  1. (n.d.). Azelaic Acid. A Review Of Its Pharmacological Properties And Therapeutic Efficacy In Acne And Hyperpigmentary Skin Disorders. Retrieved from
  2. (n.d.). The Versatility Of Azelaic Acid In Dermatology. Retrieved from Journal of Dermatological Treatment :
  3. (n.d.). Postinflammatory Hyperpigmentation. Retrieved from
  4. (n.d.). Topical Azelaic Acid, Salicylic Acid, Nicotinamide, Sulphur, Zinc And Fruit Acid (Alpha‐Hydroxy Acid) For Acne. Retrieved from
  5. (n.d.). Skin Conditions During Pregnancy. Retrieved from