Azelaic acid for acne: Benefits, how to use and side effects

Fed up with stubborn acne that does not go away even after trying millions of hacks? It is time to give azelaic acid a try. This powerhouse skincare ingredient, derived from grains like wheat, barley, and rye, might not be as famous as salicylic or hyaluronic acid, but it is a game-changer for your skin. Azelaic acid helps stimulate the production of new skin cells, which can fade those pesky acne scars. Plus, its anti-inflammatory and antimicrobial properties make it a go-to solution for tackling acne and soothing eczema flare-ups. Know all the benefits of using azelaic acid for acne or breakouts.

What is azelaic acid?

Azelaic acid is a naturally occurring dicarboxylic acid found in grains like rye, barley, and wheat. “It is used in skincare products for its anti-inflammatory, antibacterial, and keratolytic properties. This makes it an effective ingredient in treating acne, rosacea, and hyperpigmentation by unclogging pores, reducing inflammation, and inhibiting melanin production,” explains dermatologist Dr Rinky Kapoor. Available in the form of gel, creams, moisturisers, and serum, it can also be applied topically and has plenty of benefits, including improving the tone and texture of your skin.

How does azelaic acid work on acne?

Topical azelaic acid is an effective treatment for addressing several factors that contribute to breakouts. Here’s how azelaic acid works for acne:

1. Has antibacterial properties

Azelaic acid targets and reduces the growth of acne-causing bacteria, such as Propionibacterium acnes. This fact is supported by a study published in the Italian Journal of Dermatology and Venereology, which highlights azelaic acid’s ability to inhibit bacterial growth.

2. Anti-inflammatory effects

The acid helps alleviate inflammation and calm the redness associated with acne. “This reduces the swelling and irritation often seen with breakouts, which may cause uneven skin tone,” says Dr Kapoor.

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3. Keratolytic and comedolytic action

Azelaic acid promotes the shedding of dead skin cells and prevents clogged pores, which are common triggers for acne. A study in Clinical, Cosmetic, and Investigational Dermatology reveals these properties help reduce the formation of blackheads and whiteheads.

4. Enhances skin cell turnover

By encouraging the natural process of skin cell turnover, azelaic acid helps in the removal of dead skin and prevents new acne lesions from forming.

5. Reduces hyperpigmentation

If some areas of your skin are darker than the others, you probably have hyperpigmentation. Azelaic acid inhibits the enzyme tyrosinase, which helps in fading post-acne pigmentation and dark spots, improving overall skin tone.

Overall, azelaic acid is an effective treatment for controlling and improving acne-prone skin.

Is azelaic acid better than salicylic acid for acne?

Salicylic acid and azelaic acid are both effective treatments for acne but they work differently. Dr Kapoor explains, “Salicylic acid, a beta hydroxy acid, exfoliates the skin and unclogs pores by dissolving dead skin cells and excess oil. This makes it particularly effective for treating blackheads and whiteheads. Azelaic acid, a dicarboxylic acid, reduces inflammation and kills acne-causing bacteria while also encouraging skin cell turnover.” It is especially beneficial for those with sensitive skin or who experience redness and post-acne marks.

For deep pore cleansing and oil control, salicylic acid is often more effective. However, for overall skin texture improvement and reducing redness, azelaic acid might be preferable. Both can be beneficial for combating acne or breakouts. However, do not think of combining these two ingredients.

How to use azelaic acid for acne?

When using azelaic acid for acne, the amount and method of application can vary depending on the form of the product. Here’s how to apply each product:

1. Azelaic acid cream or moisturiser

Begin by cleansing your skin and gently patting it dry. Apply a thin layer of the cream to the affected areas twice daily—once in the morning and once before bed. Ensure that the product is fully absorbed before applying any other skincare products.

2. Azelaic acid serum

Before using the serum, perform a patch test to check for any adverse reactions. Cleanse and dry your face thoroughly, then apply a few drops of the serum to a small area of your skin. Wait 24 hours to see if any redness or irritation occurs. “If there are no negative effects, apply a thin layer of the serum to your entire face. Use the serum after applying your moisturiser,” suggests Dr Kapoor.

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3. Azelaic acid gel

Often used to treat rosacea, the gel form should also be applied twice daily. Cleanse your face before application and apply a thin layer of the gel to the affected areas in the morning and evening.

Note: Azelaic acid can increase skin sensitivity and the risk of sunburn. Therefore, it is crucial to use a broad-spectrum sunscreen with at least SPF 30 during the day to protect your skin from UV damage.

What are the side effects of azelaic acid?

Azelaic acid is generally well-tolerated, but it can cause some side effects that you should be aware of:

• Burning or tingling sensation: This can occur shortly after application and is usually mild.
• Peeling skin: Skin may begin to flake or peel where the product is applied.
• Itchy or irritated skin: Some people may also experience itching or irritation.
• Dryness or redness: Azelaic acid can cause dry skin, which may be prone to redness where the product is applied.

These side effects are often due to the slow production of certain skin proteins caused by azelaic acid. This can lead to the breakdown of the outer layer of your skin and result in irritation. Moreover, using products with astringents, exfoliants, alcohol-based cleansers, or scrubs can exacerbate these issues.

Some less common side effects include:

• Soreness
• Severe redness
• Swelling
• Blisters and flaky skin
• Fever

If you experience any severe side effects or symptoms that do not improve, stop using azelaic acid and see a doctor.

Who should avoid azelaic acid?

“Azelaic acid should be avoided by those with severe allergies to it, extremely sensitive skin, open wounds, or active infections. Pregnant or nursing women should also refrain from using azelaic acid or consult a healthcare provider before use,” says Dr Kapoor. It is also best to avoid combining azelaic acid with other irritating products, like retinoids or strong exfoliants, to prevent increased irritation.