Acne Treatments - Azelaic Acid

What is azelaic acid and how it treats acne |

What is Azelaic Acid?

Azelaic acid is found in wheat, barley, and rye. It has anti-bacterial, anti-inflammatory, and exfoliating properties, making it a great treatment product for acne and rosacea. Since azelaic acid inhibits melanin synthesis, it is also effective against hyperpigmentation and melasma.

You can only get azelaic acid products via prescription in the United States and some Asian countries, but other places offer it as over-the-counter treatments. Prescription products with azelaic acid as the active ingredient include Skinoren, Azelex, AcneDerm, and Finacea. Skinoren, Azelex, and AcneDerm are targeted as acne treatments, while Finacea is more for rosacea.

Skinoren is available in both cream and gel form. The cream version has 20% azelaic acid while the gel form has 15%. I have used both before and prefer the gel because it is lighter, less irritating, and less pore clogging. Azelex is only available in cream form, with 20% azelaic acid. Finally, Finacea contains 15% azelaic acid in a gel base. (Skinoren gel is actually supposed to be the same thing as Finacea because they are both made by Intendis.)

How to Use Azelaic Acid

When you're first starting off with azelaic acid, use it once a day, every other day, and use just enough to cover your entire face (or affected regions) with a very thin layer of the treatment. For me, that's about the size of a large blueberry. You don't want to blob on too much or use it too frequently because you can cause some serious irritation, especially when it's something new to your skin. After your skin adjusts to the azeliac acid treatment, you can then increase the application.

Azelaic acid should be applied onto clean skin (waiting 20 minutes after washing) for better absorption. You can moisturize afterwards if necessary, but I'd wait at least 20 minutes after application to give it time to absorb. Azelaic acid can also be used during the day (under sunscreen) or night, but it's best used at night since it's a chemical exfoliant and will make your skin more sensitive to the sun.

Azelaic acid also works well in conjunction with other prescription products. A lot of times, if you need something stronger, dermatologists will prescribe azelaic acid for the morning and Differin or another retinoid at night. You can even use azelaic acid all over and then use a prescription or over-the-counter product as a spot treatment on pimples.

Azelaic acid is safe to use during pregnancy. So for those who cannot use retinoids, azelaic acid may be a helpful addition to your skin care routine. Those who use retinoids but want something stronger without moving to a stronger retinoid can also consider using azelaic acid.

Side Effects of Azelaic Acid

Like retinoids, azelaic acid has several side effects. For the first few weeks of use, it's common for skin to itch, feel dry, turn red, and peel. Because azelaic acid is an exfoliant, it can also increase sun sensitivity and make your skin purge for a few weeks. However, by introducing this product to your skin slowly, you can minimize most of these irritations.

The itching and redness generally subside after one week of consistent use. If you wait 20 minutes after cleaning your skin and apply the acid onto completely dry skin, it helps the product not itch as much. Noticeable improvement is achieved after approximately 2 months of use.

Note: The cream base for azelaic acid can sometimes give people clogged pores and blackheads. If your skin purges for more than two months, you might want to talk to your dermatologist about switching to a different acne treatment.

My Personal Experience with Azelaic Acid and Acne

I used Skinoren and it super-itched the first week of use. Even though I put it on dry skin, it still itched like crazy. The only way I could prevent myself from scratching my face off was to put it on right before I went to bed, that way I'd be too sleepy to scratch.

I actually purged for two months before my skin started to clear up. I didn't have any cystic acne, but rather tons of whiteheads and clogged pores.

The azelaic acid essentially turned all of my skin-colored bumps and clogged pores into inflamed pimples. And all of the whiteheads turned into very nasty pustules. But, I was like, oh f*ck it. My skin was already shot and another month of breakouts was just another month of breakouts. So, I persisted and things started to improve once the plugs were pushed out of my skin.

However, I found that while azelaic acid seemed to make active acne come to a head faster, it did little to prevent future acne from occurring. I used azelaic acid for a few months, but ultimately stopped using it because it wasn't enough just to make active pimples heal faster. I wanted the acne to stop altogether. Azelaic acid is an effective acne and rosacea treatment for many people though, just not for me.

Like with all acne treatments, azelaic acid takes time to work. It sucks to have to patient and it sucks even more if you have to go through an initial breakout period, but sometimes you'll find that it's worth the wait. For some people, azelaic acid is a safe and effective treatment for acne, rosacea, and hyperpigmentation.

Last updated: October 8, 2012

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