Everything you need to know about azelaic acid, the ally of imperfect skin

Azelaic acid: a benchmark active ingredient

Azelaic acid, as its name suggests, belongs to the large family of acids, a dicarboxylic version. It is found in nature, in cereals such as barley, rye and wheat; it is part of their defense system... how well nature is made!

It was in 1978 that Dr. Marcella Nazzaro-Porro, a dermatologist at the Gallicano Dermatological Institute (Rome), first identified its depigmenting potential. Since then, numerous clinical studies published in scientific journals have confirmed its benefits for very common skin conditions.

For reasons of stability and efficacy, current cosmetic formulas incorporate a synthetic version.

The four proven benefits of azelaic acid on the skin

The most well-known property of azelaic acid is its keratolytic action: it gently exfoliates the outermost layer of the epidermis, removing dead cells responsible for dull complexion, clogged pores, and imperfections. But its benefits go far beyond that.

 
Anti-inflammatory action: redness and rosacea

When the skin is attacked, a complex defense mechanism is activated: the inflammatory reaction. To reduce this inflammatory response, azelaic acid neutralizes free radicals, thereby reducing oxidative stress in cells and thus the redness induced by inflammation, which are symptoms of rosacea.

Antibacterial action: acne and blemishes

Azelaic acid exerts a direct antimicrobial effect on P.acnes or Cutibacterium acnes (formerly Propionibacterium acnes), the bacterium responsible for the proliferation of acne. It helps maintain a healthy skin microbiota and prevent the formation of new comedones (2).
Azelaic acid therefore helps maintain a healthy microbiota.

Depigmenting action: brown spots and hyperpigmentation

Unsightly spots can appear following pimples, cuts or sun exposure. Azelaic acid inhibits tyrosinase, the key enzyme in melanin production, acting directly on hyperactive melanocytes at the origin of hyperpigmentation and melasma (3).

Keratolytic action: exfoliation and radiant complexion

By eliminating excess layers of dead cells, azelaic acid unclogs pores, refines skin texture, and reveals a radiant complexion. Unlike AHAs and BHAs, this exfoliation is very gentle and requires no rinsing.

What skin types is azelaic acid suitable for?

Azelaic acid has the particularity of being very well tolerated by all phototypes and skin types, including sensitive and reactive skin. It provides a gentle alternative to more aggressive active ingredients like retinoids or BHAs for skins that cannot tolerate them.

It is particularly recommended for people suffering from acne-prone skin (teens from 10 years old and adults), rosacea or couperose, post-inflammatory or sun-related pigment spots, and melasma (pregnancy mask).

Pregnancy and breastfeeding: azelaic acid is one of the few dermatological active ingredients considered compatible with pregnancy. Studies have not shown any significant risk with topical application. Nevertheless, it is recommended to seek advice from your doctor or dermatologist before use (4).

Azelaic acid for a clear skin routine

Azelaic acid is not photosensitizing and can therefore be used both morning and evening. It is ideally applied twice a day, on clean, dry skin, before your moisturizer.

For sensitive skin, it is preferable to introduce the active ingredient gradually: start with an application every other day for the first two weeks, then increase the frequency according to your skin's tolerance.

The secret to success? Consistency. The first results (more uniform skin, reduced redness, refined skin texture) usually appear after 4 to 6 weeks of regular use. For acne and hyperpigmentation, allow 6 to 8 weeks with a 15% concentration.

Don't forget the hands and décolleté, which often have pigment spots.

Checklist:

• check the concentration of the chosen product: at least 15% azelaic acid to be effective;
• do not neglect complementary active ingredients for a comprehensive action;
• test the galenic formulation: it effectively contributes to treatment adherence;
• a high proportion of natural ingredients and French manufacturing are a plus.

What active ingredients to combine or avoid with azelaic acid?

One of azelaic acid's strengths is its compatibility with most common active ingredients:

Side effects and precautions for use

Azelaic acid is generally well tolerated. Side effects are rare, mild and transient, especially during the first few weeks of use:

• Tingling or slight burning sensation in the first few minutes after application, which subsides with habit.

• Temporary redness or slight flaking, especially at high concentrations (15-20%).

• Possible skin dryness, compensated by a suitable moisturizing cream.

These reactions are normal and diminish with gradual introduction of the product. However, if irritation persists, it is advisable to space out applications and consult a dermatologist.

Contraindications: Do not apply to broken or irritated skin. Avoid contact with eyes and mucous membranes. Do not use in case of known hypersensitivity to azelaic acid or propylene glycol.

Most frequently asked questions:

Is azelaic acid dangerous?

No. At cosmetic (≤10%) and dermocosmetic (15%) concentrations, azelaic acid is very well tolerated. Side effects are rare, mild, and transient.

Can azelaic acid be used during pregnancy?

Yes. Azelaic acid is one of the few active ingredients compatible with pregnancy and breastfeeding. However, it is recommended to consult your doctor beforehand.

How long does it take to see results?

The first effects are visible after 4 to 6 weeks of regular use. For acne and spots, allow 6 to 8 weeks.

Does azelaic acid make skin photosensitive?

No. Unlike retinol or AHAs, azelaic acid is not photosensitizing. It can be used morning and evening, all year round.

From what age can it be used?

Azelaic acid can be used from the age of 10. It is well suited for adolescents suffering from acne.