Meet azelaic acid: It’s a naturally occurring acid found in barley, wheat, and rye¹—and a multitasking ingredient in the skincare world. Simply put, it’s kind of a big deal. After all, it has a whole slew of benefits. 

Your skin is an ecosystem that thrives when natural processes (like skin cell production) and native organisms (like bacteria) stay in balance. Azelaic acid helps maintain your skin’s microbiome, correcting imbalances that can contribute to acne.

It’s also useful in treating skin concerns like post-inflammatory hyperpigmentation, uneven skin tone, and melasma.² Azelaic acid is truly a talented multitasking ingredient that’s great for many skin types, even rosacea-prone skin! 

Wondering about the ideal dose of azelaic acid for your acne or rosacea? Get started with your Custom Formulaᴿˣ today.*

So, if your skin goals include a clear complexion and even tone, azelaic acid might be right for you. Below, we’ll tell you everything we’ve learned from our licensed dermatology providers about what azelaic acid is, how it works, what it can treat, and how to add it to your skincare routine. They’re happy to share their knowledge with you!

What is azelaic acid?

Azelaic acid is a skincare ingredient that occurs naturally in several whole grains. Technically speaking, it’s a naturally occurring dicarboxylic acid,³ but it’s almost always synthetically formulated when used in skincare products. 

It has a mild exfoliative effect and helps to unclog pores and combat bacteria that can cause acne.⁴ It also reduces redness and fades dark spots like melasma and post-inflammatory hyperpigmentation.⁵ These are just some of the reasons we included it as a possible ingredient in our Custom Formulaᴿˣ. 

As a topical treatment, it can battle acne, clogged pores, redness, and hyperpigmentation.⁶  One potential benefit of this ingredient is that azelaic acid may be gentler than other exfoliating ingredients like alpha-hydroxy acids (AHAs) and beta-hydroxy acids (BHAs).

Azelaic acid’s brightening effect works by inhibiting the skin's melanin production.⁷ When pigment-producing skin cells called melanocytes become overactive, it can cause hyperpigmentation concerns ranging from post-inflammatory hyperpigmentation to melasma. Azelaic acid selectively controls hyperactive melanocytes, making it an effective treatment.⁸ 

Given all the potential benefits of azelaic acid, it's just natural that it is one of the ingredients we use in Custom Formulaᴿˣ (ingredients subject to medical consultation).

Benefits of azelaic acid

Topical azelaic acid has been shown to have numerous skincare benefits. They include the following effects:

▪️ Anti-inflammatory: Soothes skin to reduce redness 

▪️ Anti-keratinizing: Treats and helps prevent clogged pores by clearing away dead skin cells

▪️ Antibacterial: Controls bacteria that can contribute to acne like P. acnes⁹

▪️ Anti-melanogenic: Regulates pigment production to reduce the appearance of dark spots by inhibiting the action of tyrosinase, an enzyme that controls the production of melanin.¹⁰

How azelaic acid works for your skin

So we know the benefits of azelaic acid—but how is it possible it can do so much? We had the same question, so we asked our dermatology providers to explain. Here’s what we learned: 

▪️ Azelaic acid treats acne and helps unclog pores. Azelaic acid helps dead skin cells shed. Without proper regulation, dead skin cells can pile up, blocking pores and leading to breakouts. Azelaic acid keeps things running smoothly,  helping treat different types of acne, such as whiteheads and blackheads.

▪️ Azelaic acid fights bacteria that contribute to breakouts. Azelaic acid helps fight against C. acnes, which plays a role in acne.

▪️ Azelaic acid fights melasma, and other types of hyperpigmentation. Azelaic acid does even more—it helps promote a clear, even complexion by lightening dark spots and reducing excess pigmentation.

▪️ Azelaic acid soothes inflammation. Ever take anti-inflammatories for a swollen knee? Azelaic acid helps reduce redness in the skin, calming the inflammation that contributes to rosacea and breakouts. 

Azelaic acid has anti-inflammatory, antibacterial, and anti-keratinizing properties, helping to treat and prevent clogged pores. It also blocks an enzyme called tyrosinase, which is necessary for the production of melanin (remember: too much melanin causes hyperpigmentation).

We asked one of our licensed dermatology providers Maria Borowiec (NP-BC) about her experience using azelaic acid with patients:

"I prescribe azelaic acid very often with my patients and I see many do so well with it. It can help with multiple skin concerns such as clogged pores, inflammation, and certain types of hyperpigmentation. It is usually well tolerated, making it an alternative option to help with certain skin concerns for those that are unable to tolerate tretinoin or other retinoids."

Interested in experiencing these benefits for yourself? Azelaic acid is one of the possible ingredients in our customizable Future-Proofᴿˣ formula.

How is azelaic acid different from glycolic and salicylic acids?

Azelaic acid, glycolic acid, and salicylic acid are all common skincare ingredients originally derived from plant acids, although they’re more often made in a lab these days. They share many similarities, but they are different in a few ways.

Glycolic acid is an alpha hydroxy acid (AHA) that can help treat hyperpigmentation and increase the production of collagen.¹¹ It’s often used for signs of aging, sun damage, and dark spots—although you can also sometimes find it in acne treatments. 

Salicylic acid, on the other hand, is a beta-hydroxy acid (BHA). You’ll find it most commonly in over-the-counter anti-acne products. There are also prescription-strength products with higher concentrations of salicylic acid, but you’ll need to see a professional for these. 

Azelaic acid isn’t a hydroxy acid like the other two; it’s classified as a dicarboxylic acid. It has been shown to be effective in helping to treat acne, melasma, PIH, and rosacea. Some people may find it gentler on their skin than the other two options.

For all three of these skincare acids, you’ll want to start with lower concentrations used occasionally. This will help prevent the redness and irritation that can happen if you overdo them. If you need to and your skin tolerates it, you can slowly increase the frequency or concentration of the product you use.

How to use azelaic acid in your skincare routine

Skincare is different for everyone—we all have unique skin and skincare goals. That means what works for one person may not work for another. Azelaic acid can be a great choice for people with all skin types, including sensitive skin. 

Even so, it still helps to go slowly when first starting out. Apply azelaic acid no more than once or twice daily to see how your skin responds. You can also do a patch test prior to using azelaic acid if you have any concerns about how your skin may react. 

If you’re new to using azelaic acid in your skincare routine, it may be best to start with a once-a-day application—or even just a few times per week—and under the guidance of a medical professional, like your Curology dermatology provider! 

Azelaic acid isn’t a replacement for good skincare habits. You should still use a cleanser and moisturizer—and don’t forget the sunscreen if you’re going outside.

A step-by-step guide to using azelaic acid

How you use azelaic acid will depend on what type of skincare product you’re using, so follow your product label’s directions. If you’re using a Curology Custom Formulaᴿˣ with azelaic acid, here’s how it’s comonly used, however, you should always follow the instructions from your licensed dermatology provider:  

Step 1: Cleanse with a gentle cleanser and let your face completely dry. 

Step 2: Apply your azelaic acid treatment in a thin layer over your face and neck.

Step 3: Moisturize with a non-comedogenic facial lotion or night cream (if you need the extra hydration boost). 

It’s typically recommended to apply your Custom Formulaᴿˣ at night and always wear sunscreen during the day. 

Where azelaic acid should fall in your routine

Where azelaic acid falls in your skincare routine will depend on the type of product that you’re using. You’ll generally want to layer your skincare products from thinnest to thickest. This will help them absorb properly before the next product is added. So, a thin serum would be applied before a thicker treatment or moisturizer. 

How often should you use azelaic acid?

Always follow the instructions on the product package or those given to you by your dermatology provider for how often you should use a skincare product. In general, you want to start slowly with azelaic acid until your skin gets used to the effects. Start by using it a few times a week and increase from there as long as you don't experience too much irritation. 

Is azelaic acid suitable for use in the morning and night?

Azelaic acid can generally be used up to twice daily, so you can use it both in the morning and at night. However, if you’re new to the ingredient, you probably don’t want to jump right into using it that often. Azelaic acid may cause skin irritation at first, so it’s best to start by applying it a few times weekly and seeing how your skin reacts before increasing the frequency. 

Should you increase the concentration of azelaic acid?

If your skin tolerates azelaic acid well—without redness or irritation—but you’re not yet seeing the results you want, you can increase the concentration you use. Just be aware that you’ll need to see a dermatology provider for a prescription for the stronger concentrations.

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Get your personalized skincare routine with Curology

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Ingredients to pair with azelaic acid 

These ingredients tend to work well with azelaic acid—and you can find them in products at your local pharmacy: 

▪️ Niacinamide: A multitasking form of vitamin B3 that helps repair signs of sun-damage, reduce the appearance of fine lines and dark spots, and may improve skin elasticity.

▪️ Sulfur: Can help treat both acne and rosacea. It may also decrease redness from inflammation.

▪️ Zinc pyrithione: Can help treat ordinary acne as well as fungal acne. It may also help to reduce oil (aka sebum).

Curology’s Custom Formula mixes azelaic acid with other active ingredients to target your skin concerns. That’s because your formula is prescribed to you by a licensed dermatology provider, so its ingredients are tweaked to meet your needs.

Ingredients to avoid with azelaic acid

Okay, we’re being dramatic—azelaic acid usually plays well with the rest of your skincare routine. That said, there are some ingredients that you may want to temporarily stop using while your skin adjusts to its new azelaic acid treatment: 

• Benzoyl peroxide

• Alpha hydroxy acids or AHAs (like glycolic acid)

• Beta hydroxy acids or BHAs (like salicylic acid)

• Vitamin C

• Retinol

• Rotating brushes

• Face scrubs

• Physical exfoliators

These can sometimes increase your risk of dryness and irritation. The decision to temporarily stop other products may also depend on the strength of the azelaic acid that you are using. That said, some products combine azelaic acid with other ingredients, which can work well! It's important to follow the advice of a dermatology provider if you're unsure how to best incorporate this ingredient into your routine. Feel free to use your judgment when re-introducing these into your routine. When in doubt, keep your skincare routine simple.

What to expect with azelaic acid treatment

If you’ve made the choice to add azelaic acid to your skincare regimen, it’s time to answer the next question—how long does azelaic acid take to work? Well, that sort of depends on what you’re using it for. 

Azelaic acid results

You may notice a difference in hyperpigmentation with azelaic acid by month 2 of your treatment.¹² However, this can depend on the strength that you are using and other components of your routine.

Most dermatology providers say that with a prescription-strength azelaic acid cream, you’ll notice a difference in your skin between six months and a year—although this can vary. Many variables, like skin type and commitment to a skincare routine, can impact how quickly you see results.

For more challenging skin conditions, results can take longer. The good news is most people can tolerate products with azelaic acid, and it can also be combined with other products to increase its effectiveness. 

If, after a few months, you decide you like using azelaic acid, then keep at it!

Potential azelaic acid side effects

Azelaic acid’s side effects are usually mild (when they happen at all). Some side effects of azelaic acid include:¹³

• A burning, stinging sensation

• Itchiness

• Dryness

• Temporary redness

Azelaic acid is generally considered safe to use. Most people experience no significant side effects beyond mild stinging or itching at first. If these sensations are irritating you, let your dermatology provider know.

There’s also a slight risk of something called “skin purging” when you first start azelaic acid. This is when you have increased acne breakouts before your skin starts getting clearer. It’s temporary, but it can be frustrating when you’re just getting started.

It’s possible to have an allergic reaction to azelaic acid. Signs of an allergic reaction may include facial swelling and hives. Let your medical provider know if you experience these side effects—they’re here to help! 

Great news: If you’re pregnant or nursing, azelaic acid is generally safe to use.¹⁴ Just chat with your OB-GYN before starting new topical medications to make sure it is safe for you to use.

Azelaic acid alternatives

The alternatives to azelaic acid depend on the skin condition that you’re treating. So, you’ll want to consult a licensed dermatology provider for recommendations. However, some alternative options include:¹⁵

• Topical or oral retinoids

• Benzoyl peroxide

• Topical or oral antibiotics

• Salicylic acid

• Hydroquinone¹⁶

• Ascorbic acid (vitamin C)¹⁷

• Glycolic acid¹⁸

• Kojic acid¹⁹  

• Niacinamide²⁰  

• Tranexamic acid²¹

What does azelaic acid treat?

One of the benefits of azelaic acid is that it has been shown to help treat several common skincare conditions, such as acne, rosacea, melasma, and post-inflammatory hyperpigmentation. Read on for more information about the conditions azelaic acid can help treat.

Azelaic acid for acne treatment

Hyperkeratinization happens when dead skin cells don’t shed as they should, which can result in clogged pores. Azelaic acid’s anti-keratinizing action sheds dead skin cells that clog pores. Its antibacterial properties also fight bacteria that can contribute to pimples. Azelaic acid can be combined with other active ingredients like tretinoin, benzoyl peroxide, or clindamycin for stronger acne-fighting action.²²

Help your skin with a Custom Formula containing azelaic acid.

Help your skin with a Custom Formula containing azelaic acid.

Start your skin quiz

Azelaic acid for rosacea care

Rosacea is a chronic inflammatory skin condition that often affects the cheeks, chin, nose, and central forehead. You may experience flare-ups of redness, burning, papules, and pustules when you have rosacea. Common triggers include temperature changes, heat, cold, exercise, ultraviolet radiation, spicy food, and alcoholic beverages.²³ 

The anti-inflammatory properties of azelaic acid have been shown to help reduce inflammatory lesions (papules and pustules) in rosacea.²⁴

Curology’s Custom Formulaᴿˣ can now be made with ingredients to help treat rosacea flare-ups, including azelaic acid. 

Azelaic acid for melasma

Melasma typically appears as symmetrical hyperpigmentation on the face and has several possible triggers, including sun exposure, hormone treatments (like some types of birth control), and pregnancy. Melasma is sometimes called the “mask of pregnancy,” and while it can resolve a few months after giving birth, it may persist.²⁵

Topical applications of azelaic acid may block the enzyme tyrosinase, which in turn inhibits the production of melanin. This may improve uneven skin tone. It brightens the complexion by targeting hyperpigmented areas of the skin.²⁶ 

Curology’s Custom Formulaᴿˣ can be made with up to 3 active ingredients (including azelaic acid) to help you meet your skincare goals.

Azelaic acid for post-inflammatory hyperpigmentation

Post-inflammatory hyperpigmentation (PIH) appears after an inflammatory event, like acne. Inflammation can trigger an increase in melanin production.²⁷ Melanin is a substance in your body that affects skin color. In post-inflammatory hyperpigmentation, dark spots appear where acne lesions (or other types of inflammation) once were. 

Azelaic acid’s exfoliating properties, combined with its ability to inhibit melanin production, help reduce the appearance of dark spots due to post-inflammatory hyperpigmentation. Its anti-inflammatory and antibacterial properties also work to treat acne, which can help prevent PIH from occurring in the first place.

Where to buy azelaic acid products

Azelaic acid is easily accessible in many over-the-counter and prescription skincare formulations like serums and creams. You’ll also find it combined with other skincare ingredients to enhance and complement its effects.

Over-the-counter options and prescription access

Depending on its strength, you can get azelaic acid over the counter or by prescription. That means you can pick up skincare products with azelaic acid at your local drugstore and at cosmetics stores like Ulta and Sephora. 

Just be sure to use products that are free of potentially pore-clogging or irritating ingredients because those can make conditions like acne and rosacea worse. 

You can also get a Custom Formula by Curology sent to your door. Curology treats skincare concerns related to acne, anti-aging, rosacea, and hyperpigmentation. We’re committed to taking the guesswork out of your skincare routine—licensed dermatology providers work with you to examine your skin, assess your skincare goals, and provide custom treatment options. 

We offer a range of strengths of azelaic acid that we combine with other ingredients, like tretinoin and clindamycin, as part of your personalized prescription formula, picked for you by one of our in-house licensed dermatology providers.

Ready to get started? Start your Curology trial now.

P.S. We did our homework so you don’t have to: 

1. Spaggiari, C., et al. Extraction and Quantification of Azelaic Acid from Different Wheat Samples (Triticum durum Desf.) and Evaluation of Their Antimicrobial and Antioxidant Activities. Molecules. (March 2023).

2. Spaggiari, C., et al. Extraction and Quantification of Azelaic Acid from Different Wheat Samples (Triticum durum Desf.) and Evaluation of Their Antimicrobial and Antioxidant Activities. Molecules. Ibid.

3. Spaggiari, C., et al. Extraction and Quantification of Azelaic Acid from Different Wheat Samples (Triticum durum Desf.) and Evaluation of Their Antimicrobial and Antioxidant Activities. Molecules. Ibid.

4. Passi, S., et al. Mechanism of azelaic acid action in acne. Giornale italiano di dermatologia e venereologia : organo ufficiale, Societa italiana di dermatologia e sifilografia. (October 1989).

5. Spaggiari, C., et al. Extraction and Quantification of Azelaic Acid from Different Wheat Samples (Triticum durum Desf.) and Evaluation of Their Antimicrobial and Antioxidant Activities. Molecules. Ibid.

6. Zaenglein, A.L., et al. Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology. (2016).

7. Schrute, B.C., et al. Azelaic Acid: Evidence-based Update on Mechanism of Action and Clinical Application. Journal of Drugs in Dermatology. (September 2015). 

8. Fitton, A., & Goa, K. L. Azelaic acid. A review of its pharmacological properties and therapeutic efficacy in acne and hyperpigmentary skin disorders. Drugs. (May 1991).

9. Chilicka, K., et al. A comparison of the effectiveness of azelaic and pyruvic acid peels in the treatment of female adult acne: a randomized controlled trial. Scientific reports. (2020).

10. González-Molina, V., et al. Topical Treatments for Melasma and Their Mechanism of Action. The Journal of clinical and aesthetic dermatology. (May 2022).

11. Kim, S J et al. Increased in vivo collagen synthesis and in vitro cell proliferative effect of glycolic acid. Dermatologic surgery: official publication for American Society for Dermatologic Surgery. (1998).

12. Hollinger, J.C., et al. Are natural ingredients effective in the management of hyperpigmentation? A systematic review.The Journal of Clinical and Aesthetic Dermatology. (February 2018). 

13. A. L. Zaenglein, et al. Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology. Ibid.

14. National Center for Biotechnology Information. PubChem Compound Summary for CID 2266, Azelaic Acid. National Library of Medicine. (n.d.).

15. Zaenglein, A.L., et al. Guidelines of care for the management of acne vulgaris. Journal of the American Academy of Dermatology. Ibid.

16. Albzea, W., et al. Azelaic Acid Versus Hydroquinone for Managing Patients With Melasma: Systematic Review and Meta-Analysis of Randomized Controlled Trials. Cureus. (July 2023).

17. González-Molina, V., et al. Topical Treatments for Melasma and Their Mechanism of Action. The Journal of clinical and aesthetic dermatology. (May 2022).

18. González-Molina, V., et al. Topical Treatments for Melasma and Their Mechanism of Action. The Journal of clinical and aesthetic dermatology. Ibid.

19. González-Molina, V., et al. Topical Treatments for Melasma and Their Mechanism of Action. The Journal of clinical and aesthetic dermatology. Ibid

20. González-Molina, V., et al. Topical Treatments for Melasma and Their Mechanism of Action. The Journal of clinical and aesthetic dermatology. Ibid.

21. González-Molina, V., et al. Topical Treatments for Melasma and Their Mechanism of Action. The Journal of clinical and aesthetic dermatology. Ibid.

22. Webster, G. Combination azelaic acid therapy for acne vulgaris.The Journal of the American Academy of Dermatology. (2000, August 1).

23. Farshchian M. & Daveluy S. Rosacea. StatPearls. (2023, August 8).

24. Thiboutot, D., et al. Standard management options for rosacea: The 2019 update by the National Rosacea Society Expert Committee. Journal of the American Academy of Dermatology. (2020).

25. Grimes P. E. Melasma. Etiologic and therapeutic considerations. Archives of dermatology. (1995).

26. Sheth, Vaneeta M., Pandya, Amit G. Melasma: A comprehensive update. Part II.Journal of the American Academy of Dermatology. (2011, October 1).

27. Silpa-archa, Narumol, et al. Postinflammatory hyperpigmentation: A comprehensive overview.Journal of the American Academy of Dermatology. (October 2017).

* Subject to consultation. Subscription is required. Results may vary. ** Restrictions apply. See website for full details and important safety information.

Jessica Lee is a certified Nurse Practitioner at Curology. She received her Master in Nursing from Samuel Merritt University in Oakland, CA.

Written by

Curology Team

Medically reviewed by

Jessica Mefford, NP