Azelaic Acid
What it is
Azelaic acid is a naturally occurring saturated dicarboxylic acid produced by Malassezia furfur yeast and found in cereal grains. It exhibits a multi-modal mechanism of action: competitive inhibition of tyrosinase (reducing melanin synthesis), antibacterial activity against Cutibacterium acnes, normalisation of keratinisation, and anti-inflammatory effects through inhibition of reactive oxygen species. This diverse pharmacological profile makes it uniquely suited for conditions where inflammation, hyperpigmentation, and abnormal keratinisation coexist.
What it helps with
- Targeting Cutibacterium acnes and reducing comedone formation
- Inhibiting melanin biosynthesis to fade hyperpigmentation
- Modulating inflammatory pathways in rosacea and acne
- Normalising follicular keratinisation without excessive desquamation
- Reducing post-inflammatory erythema and discolouration
- Providing antioxidant protection against free radical damage
Common concerns it addresses
Best for
Clinical suitability
- First-line option for mild to moderate papulopustular rosacea
- Suitable for acne treatment during pregnancy and lactation
- Appropriate for Fitzpatrick skin types IV-VI due to lower hypopigmentation risk
- Indicated for patients who cannot tolerate benzoyl peroxide or retinoids
- Beneficial as maintenance therapy following successful acne treatment
Use with caution
- Initial application may cause transient stinging, burning, or itching
- Those with very sensitive skin should introduce gradually
- Combination with other exfoliating agents may increase irritation potential
Not ideal for
- Primary treatment of comedonal acne (better addressed with retinoids or salicylic acid)
- Those seeking rapid results — consistent use over weeks is required
- Patients who experience persistent burning beyond the adjustment period
How it's commonly used
Over-the-counter formulations typically contain 10% azelaic acid, while prescription preparations are available at 15-20%. Apply to cleansed skin once or twice daily, depending on tolerance. Initial mild stinging or itching is common and typically resolves within 2-4 weeks of continued use. Unlike many acne treatments, azelaic acid does not significantly increase photosensitivity, though SPF remains essential when treating pigmentation.
Pairs well with
Clinic note
Azelaic acid is among our most prescribed topical agents for patients presenting with acne and concurrent pigmentary concerns. Its favourable safety profile — including suitability during pregnancy — distinguishes it from many alternative treatments. For rosacea patients, we frequently recommend azelaic acid as first-line therapy due to its dual anti-inflammatory and antimicrobial properties. Prescription-strength formulations are often necessary for optimal outcomes in stubborn cases.
Ingredient-focused product examples
Clinically curated examples featuring this ingredient. These are optional references to help guide your product research.
Clarifying Azelaic Serum
Targeted treatment formulated to address breakouts and reduce the appearance of post-acne marks without over-drying.
View productRedness Relief Cream
Soothing moisturiser designed to calm visible redness and support skin prone to rosacea or sensitivity.
View productThis content is provided for educational purposes and does not replace personalised medical advice. Individuals with skin conditions, those who are pregnant, or those undergoing dermatological treatments should seek professional guidance before introducing new active ingredients.
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