If you struggle with acne, several skin care products can help tame, heal and even out acne-prone skin, including face washes, sunscreens and more. What makes these products effective is their active ingredients, which can include everything from retinoids to vitamin C. In addition to more popular acne-fighting and skin-brightening agents, azelaic acid is a more “under the radar” ingredient that’s “frequently overlooked,” explained Dr. Rachel Maiman, a board-certified cosmetic and general dermatologist at Marmur Medical. Azelaic acid not only works to unclog pores and prevent acne, but it also helps to even out your skin tone and lighten dark spots left by acne.
SKIP AHEAD Best azelaic acid products to shop | Who should use azelaic acid?| How to use azelaic acid | How long does azelaic acid take to work?
To determine if azelaic acid is right for you, we consulted dermatologists on how the ingredient works, how you can incorporate it into your skin care routine and who would benefit from using it. We also compiled some highly rated azelaic acid products in line with our experts’ advice as well as a few of their own recommendations.
How does azelaic acid work?
Azelaic acid is a tyrosinase inhibitor, which means it helps to prevent and treat hyperpigmentation on the skin as well as even out your skin tone, according to Dr. Amy Witt, a board-certified dermatologist at Derrow Dermatology. It's an antibacterial antioxidant that works to unclog pores and is more mild than other acne-fighting ingredients like salicylic acid and adapalene, making it more suitable for those sensitive skin, acne and rosacea, said Dr. Lindsey Bordone, a board-certified dermatologist and assistant professor of dermatology at Columbia University Medical Center.
“Azelaic acid can also lighten the brown spots that are left behind from old acne marks, which we see most often in people who have darker skin tones,” Dr. Emmy Graber, a board-certified dermatologist and president of The Dermatology Institute of Boston, previously told us.
Prescription-level azelaic acid is available at 15% and 20% strengths — these have more research to back up their efficacy — but you can also find it over-the-counter at strengths up to 10%. Maiman recommended combining a lower-grade strength OTC azelaic acid with other acne-fighting ingredients, which can be "much more effective than when [azelaic acid is] used alone."
The best azelaic acid products to shop
The dermatologists we consulted said that prescription-strength azelaic acids are better than OTC versions because they have higher concentrations of the ingredient. However, if you’re still interested in testing out an OTC product that contains azelaic acid of 10% strength or lower, we’ve compiled a few of our experts’ suggestions along with some highly rated options that feature azelaic acid paired with other acne-fighting and skin-brightening ingredients like niacinamide.
The Ordinary Azelaic Acid Serum
The Ordinary Azelaic Acid Serum is a favorite among our experts. Graber previously told us she recommends this product to her patients since it can help improve both blemishes and dark spots. The serum, which contains 10% azelaic acid, is cruelty-free, vegan and gentle enough to use up to twice a day, according to the brand. The serum has a 4.2-star average rating from more than 800 reviews at Sephora.
Paula's Choice 10% Azelaic Acid Booster
Dr. Joshua Zeichner, director of cosmetic and clinical research at Mount Sinai Hospital, recommended this 10% azelaic acid face serum, noting that it’s effective at brightening dark spots, evening out skin tone and improving hyperpigmentation caused by breakouts. It’s non-comedogenic, hypoallergenic and can be applied once or twice daily, according to Paula’s Choice. Maiman also recommended the brand’s Niacinamide + Azelaic Acid Duo, a 2-in-1 product that targets acne, minimizes pores, improves dullness and lessens the appearance of uneven skin tone and texture, she said. The booster has a 4.4-star average rating from over 3,000 reviews on Amazon.
Sesderma Azelac Ru Facial Serum
Maiman called this serum one of her "favorites for excessive pigmentation" and noted its benefits go beyond tackling melasma and post-inflammatory hyperpigmentation. The serum is a combination of several active ingredients, including azelaic acid, retinol and vitamin C. The formula also contains tranexamic acid, a topical treatment that “interferes with the interaction of pigment-producing cells and works particularly well for discoloration resulting from UV light," Maiman said. This serum has a 4.5-star average rating from over 1,400 reviews on Amazon.
TULA Clear It Up Acne Clearing and Tone Correcting Gel
Dr. Hadley King, a board-certified dermatologist in New York City, recommended the TULA Clear It Up gel since it pairs azelaic acid and niacinamide, which experts told us can help brighten the tone and texture of your skin. It contains 2% salicylic acid as well as probiotics to soothe and calm inflammation and hyaluronic acid for hydration, according to the brand. This gel has a 4.5-star average rating from over 1,700 reviews at Target.
Urban Skin Rx Even Tone Cleansing Bar
The Even Tone Cleansing Bar is a 3-in-1 cleanser, mask and exfoliator containing azelaic acid, niacinamide and kojic acid, another tyrosinase inhibitor that can help lighten dark spots on the skin. The brand says you can apply the cleanser on its own or utilize the included exfoliating sponge to massage it onto your skin and leave it on for a few minutes. You can also use it as a brightening mask, leaving it on for 3-5 minutes before rinsing it off with cold water, according to Urban Skin Rx. The cleansing bar has a 4.4-star average rating from over 4,500 reviews on Amazon.
Who should use azelaic acid — and who should avoid it?
The dermatologists we spoke with said azelaic acid is generally well-tolerated. All of the experts we spoke to pointed out that it's a safe and gentle option for children in their early teens as well as those who are pregnant or breastfeeding.
Even though it’s a milder option, people with sensitive skin should still be “very cautious” with this ingredient since they may experience stinging, burning and even hyperpigmentation, according to Dr. Ronda Farah, a board-certified dermatologist at the University of Minnesota Medical School and M Health Fairview. “That's probably the biggest issue because if you get a rash going, it can leave dark spots instead of what you actually intended it to do, which is to lighten and brighten the skin,” Farah explained.
Azelaic acid also likely won’t do much for those with severe cystic acne. “It might help a little bit with the pigment that's left over after an acne lesion clears, but for someone who has deeper cystic acne, [azelaic acid] isn’t going to penetrate that far into the skin,” Bordone said. To combat more severe acne, our experts previously recommended stronger ingredients like benzoyl peroxide that inhibit bacterial growth and retinoid gels like adapalene that reduce clogging.
Azelaic acid can be used 1-2 times per day, but you should start by using it once a day at night, Witt said — if your skin tolerates it well for a few weeks, you can start using it twice a day. And like any other skin care ingredients, azelaic acid should be paired with a gentle cleanser as well as a good moisturizer and sunscreen every morning.
Although azelaic acid doesn’t make you more sensitive to the sun like other acids, Zeichner cautioned against becoming lackadaisical about wearing sunscreen when incorporating the ingredient in your routine. "If you are using azelaic acid, you definitely should be religious about applying sunscreen — even low levels of UV light can promote pigmentation and undo what you have accomplished with your azelaic acid," he said.
Most ingredients are fine to keep using when introducing azelaic acid: The ingredient is safe to use alone or paired with other soothing and brightening ingredients like niacinamide (a natural anti-inflammatory) and hyaluronic acid, which locks in moisture, according to Zeichner. However, our experts generally advised against layering ingredients like beta hydroxy acids (BHAs) — which includes salicylic acid — and alpha hydroxy acids (AHAs) like glycolic acid because it can increase the chances of dryness and irritation.
“I wouldn't put [azelaic acid] on top of something like salicylic acid or glycolic acid because you're going to compound that irritation,” Farah said. “Typically, you want to either remove other irritating things from the regimen or at least separate them, so you can use one thing in the morning and another at nighttime,” she added.
How long does azelaic acid take to work?
Farah told us that you should see some improvement in your skin between six weeks and three months after starting prescription-strength azelaic acid — Witt noted that it can take longer to see improvement with OTC products (about three to four months). When it comes to brightening the skin and lightening any dark spots and hyperpigmentation, the ingredient can be “very slow and very weak — you're looking at probably six months to a year to see a true effect and it would be fairly minimal,” Farah added.
While the mildness of azelaic acid makes it ideal for sensitive skin types, it can also be a drawback. “The biggest issue I hear from patients is that it just doesn't work,” said Dr. Aaron Secrest, a board-certified dermatologist and assistant professor of dermatology at the University of Utah. “It’s one of the weaker acids, which is nice because of fewer side effects or dryness, but it’s also not as helpful at clearing up the skin,” he added.
Catch up on Select's in-depth coverage of personal finance, tech and tools, wellness and more, and follow us on Facebook, Instagram and Twitter to stay up to date.