Azelaic Acid

Addresses acne, redness, and hyperpigmentation with anti-inflammatory and antimicrobial properties. Dicarboxylic acid with multiple mechanisms. Inhibits tyrosinase and mitochondrial oxidoreductase in hyperactive melanocytes (selective for abnormal melanocytes, sparing normal skin). Bacteriostatic against C. acnes via inhibition of thioredoxin reductase. Normalizes keratinization in the follicular infundibulum. Anti-inflammatory via inhibition of reactive oxygen species generation by neutrophils.

Safe in pregnancy (FDA Category B). Minimal systemic absorption. Well tolerated; mild transient burning/stinging in ~5-10% of users. Does not cause photosensitivity.

Look for products with 10% (OTC), 15-20% (prescription) for clinical efficacy.

Use Azelaic Acid with AHAs (Glycolic, Lactic, etc.) carefully. Azelaic acid with AHAs can cause irritation for sensitive skin. Both exfoliate through different mechanisms so go slowly.

Use Azelaic Acid with BHAs (Salicylic Acid) carefully. Azelaic acid and BHA together may be too drying for some skin types. Monitor for tightness and scale back if needed.

Use Azelaic Acid with Retinoids carefully. Retinoid with azelaic acid is a potent combo. Both are effective individually. Start with alternating before layering.

Azelaic Acid can be used with Niacinamide. Azelaic acid and niacinamide work synergistically for brightening. Both target hyperpigmentation through different pathways.