Azelaic acid is one of those hot ingredients with data showcasing its ability to help tackle major skin concerns such as hyperpigmentation, acne, and even rosacea. However, the challenge with this ingredient is that in order to achieve these benefits you’ll need a LOT of it in your skincare (read: major formula challenges for chemists). The other difficulty is that it’s also regulated so you typically would need a prescription to get those higher concentrations (15-20%) and won’t be able to purchase more than a 10% azelaic acid topical as a cosmetic.
Still, that doesn’t mean 10% azelaic acid can’t be helpful to your routine! We see this ingredient as a great addition to a comprehensive routine. In this guide, we’ll go through the science behind azelaic acid, how to use this ingredient in your routine, and review the 10% azelaic acid products to choose from.
The Science Behind Azelaic Acid
Azelaic acid is a dicarboxylic acid that’s naturally found in wheat and rye. This ingredient has been tied to a lot of beneficial properties such as being an anti-microbial, anti-comedonal, and anti-inflammatory. This active happens to have a sizeable amount of studies behind it, and we’ll go through them briefly here:
Azelaic acid and hyperpigmentation:
There are two notable studies that looked as azelaic acid for hyperpigmentation. One study had 52 subjects with darker skin tone apply 20% azelaic acid for 24 weeks. After 16 weeks of use, the pigmentary intensity score had significantly decreased and after 24 weeks overall global improvement was significantly higher. Another study compared twice daily use of 20% azelaic acid to 5% tranexamic acid on 60 subjects with acne-related post inflammatory hyperpigmentation. Both treatments showed significant reduction in pigmentation at the 4, 8, and 12 week mark and ultimately both performed on par.
Azelaic acid and acne:
20% azelaic acid has been clinically tested to be an effective treatment for mild to moderate forms of acne showing overall improvement, reduction in lesion count, and reduction of severity of acne. It’s even been found to be comparable to 6 months use of 0.05% tretinoin and 2 months use of 5% benzoyl peroxide.
Azelaic acid and rosacea:
There’s consistent evidence that the use of azelaic acid has shown overall improvement in rosacea patients and helps reduce both erythema and lesion count. It’s important to remember that there are multiple types of rosacea, which means your rosacea will ultimately require a diagnosis by your derm to establish a solid treatment plan. However, 15% & 20% azelaic acid has been looked at to treat symptoms of roscea. 15% azelaic acid once a day has been found to reduce erythema, reduce lesion count, and improve overall severity after 12 weeks of use. Another study had 33 subjects use 20% azelaic acid (Skinoren) for 9 weeks and continued to monitor post-treatment for another 4 weeks. Subjects used Skinoren twice a day and found that azelaic acid significantly reduced the number of inflammatory lesions and showed an overall significant improvement in rosacea.
How to Use Azelaic Acid in Your Skincare Routine
As you can see, there is a decent amount of data behind azelaic acid and its multiple benfits. But this all pertains to a much higher azelaic acid concentration than readily available in cosmetics in the US. This doesn’t mean we can’t use the 10% azelaic acid products, but would be used more as a supplemental active the complement your routine, especially for complicated skin conditions such as hyperpigmentation.
To use 10% azelaic acid in your routine, we recommend applying it both day and night. Apply these azelaic acid topicals after your toner/serum step (formulas that predominantly are water-based). Another advantage of this order of application is that it helps with the potential stinging that you can initially experience when applying azelaic acid.
Four 10% Azelaic Acid Products Put to the Test!
If you’re wondering which azelaic acid product to use, we tested the four most popular options available in the US.
*Click photo for product info. Link is through Shop My Shelf. All opinions are our own and we don't have partnerships with any of the brands above. However, we do receive a small commission for using our affiliate link. Thank you for feeding a chemist!
The Ordinary’s 10% Azelaic Acid Suspension: This is probably the most classic form of azelaic acid. This formula is suspended in silicone to make a lotion/paste-like consistency with the classic silicone finish. While the texture and application were good, we found the product to be drying over time and we experienced the most stinging out of the four products we tried.
Emulsion is just a technical term for formulas with both water and oil components. Think lotions and creams!
Paula’s Choice 10% Azelaic Acid Booster: This lotion texture contains salicylic acid and other notable soothers like allantoin and bisabolol. Unfortunately, this was our least favorite of the three emulsions. We found the texture to be quite heavy and found the finish to leave a residue. We also experienced the most stinging of the three as well.
Naturium’s Azelaic Acid: We found this texture to be light and we experienced minimal stinging. Some notable ingredients included are niacinamide, allantoin, and hyaluronic acid. This formula also includes silica for the dry skin types that are conscious of this ingredient (like Gloria). For what it’s worth, Victoria’s oily skin tolerated this formula well.
The Inkey’s 10% Azelaic Acid: We found this formula to be a very minimalistic, lightweight texture with very little initial stinging. In addition to azelaic acid, this formula also includes 0.3% allantoin, which is a solid amount of this potent soothing active. We recommend this formula for those who are looking for a no-frills azelaic acid solution to supplement their routine.
What is azelaic acid and what does it do for skin?
Azelaic acid is a synthetic acid that has been found to help treat acne, rosacea, and hyperpigmentation at high concentrations (~15-20%).
How do I use azelaic acid in my routine?
Since you can only purchase 10% concentrations of azelaic acid in the US, azelaic acid products will not have the same level of efficacy as touted in research. However, azelaic acid is still a beneficial addition and we recommend using it after your water-based serums morning and night.
Is there a recommended azelaic acid product?
Currently azelaic acid is found in two types of formulas: suspensions & emulsions. We’ve tested The Ordinary, Paula’s Choice, Naturium, and Inkey’s formulas and found Naturium and Inkey to have the better textures with minimal initial stinging.
King, S, Campbell, J, Rowe, R, Daly, M-L, Moncrieff, G, Maybury, C. A systematic review to evaluate the efficacy of azelaic acid in the management of acne, rosacea, melasma and skin aging. J Cosmet Dermatol. 2023; 22: 2650-2662. doi:10.1111/jocd.15923
Aj Carmichael, R Marks, Ka Graupe & Rp Zaumseil (1993) Topical azelaic acid in the treatment of rosacea, Journal of Dermatological Treatment, 4:sup1, S19-S22, DOI: 10.3109/09546639309082150
Graupe K, Cunliffe WJ, Gollnick HP, Zaumseil RP. Efficacy and safety of topical azelaic acid (20 percent cream): an overview of results from European clinical trials and experimental reports. Cutis. 1996 Jan;57(1 Suppl):20-35. PMID: 8654128.
Lowe, Nicholas J., et al. "Azelaic Acid 20% Cream in the Treatment of Facial Hyperpigmentation in Darker-Skinned Patients."
Sobhan, Mohammadreza1; Talebi-Ghane, Elaheh2; Poostiyan, Elnaz3,. A comparative study of 20% azelaic acid cream versus 5% tranexamic acid solution for the treatment of postinflammatory hyperpigmentation in patients with acne vulgaris: A single-blinded randomized clinical trial. Journal of Research in Medical Sciences 28(1):18, April 2023. | DOI: 10.4103/jrms.jrms_443_22