What is Azelaic Acid?

Azelaic Acid is a naturally occurring acid found in grains such as barley, wheat, and rye.

It helps to regulate and control the production of melanin, a pigment that gives colour to our skin, hair, and eyes. By doing so, Azelaic Acid presents itself as an effective solution to hyperpigmentation and uneven skin tone issues. Furthermore, its anti-inflammatory and anti-bacterial traits make Azelaic Acid beneficial for skin conditions such as acne and rosacea.

How does Azelaic Acid Benefit the skin?

• Fights Acne: Azelaic acid supresses the growth of acne-causing skin bacteria. It also reduces the swelling and redness associated with acne

• Manages Rosacea: It soothes rosacea-associated inflammation effectively due to its anti-inflammatory properties

• Reduces Hyperpigmentation: Azelaic acid's power as a tyrosinase inhibitor can lighten hyperpigmentation and treat conditions like melasma effectively, offering a more even skin tone.

• Antioxidant Properties: Azelaic acid helps neutralize harmful free radicals, helping protect your skin from environmental damage.

• Exfoliates Skin and De-clogs Pores: It has comedolytic properties – meaning it can help prevent the formation of comedones (or blocked pores) which can lead to breakouts.

• Improves the signs of ageing: By increasing cell turnover, evening out skin tone and by combatting oxidative stress, Azelaic acid can help improve the overall signs of ageing

The best ways to use Azelaic Acid in your skincare regime

1.       Finding the Right Product: Azelaic acid is incorporated in various skincare products, from creams and gels to serums and lotions. Depending upon your needs and preferences, you can select the best-suited product for your skin

2.       Start low and go slow: If you're new to Azelaic acid, it's wise to incorporate it slowly into your routine. Starting with a product with a lower concentration (5% - 10%) allows your skin to adapt gently and safely. For skin conditions like acne or rosacea higher strength prescription formulations (15-20%) will be required to see significant benefit. But this may lead to greater irritation which is why it is done under the guidance and supervision of a skin health professional

3.       Eventually build up to daily use: Daily usage of Azelaic acid is what yields optimal results. But as Azelaic acid is an active ingredient, it's essential to keep your skin's response in check.

4.       Application Method: To maximize its benefits, Azelaic Acid should ideally be applied to freshly cleansed, slightly moist skin. After application, allow it to fully absorb before layering other skincare products

5.       Combination with Moisturizer: To minimize initial dryness or irritation, consider pairing Azelaic acid with a hydrator. This approach balances out the drying effect and nourishes your skin

6.       Consistency is Key: For effective results, regular use of Azelaic acid is a must

Can Azelaic Acid be combined with other skin care products?

One of the benefits of Azelaic acid is its versatility and compatibility with a host of other skincare products. While Azelaic acid can be beneficial on its own, it can work wonders when paired with the right skincare ingredients.

Niacinamide, hyaluronic acid, and vitamin C complement Azelaic acid well, enhancing its effectiveness and delivering sumptuous benefits to your skin:

• Niacinamide: When used with Azelaic acid, Niacinamide not only helps to reinforce the skin barrier but also further reduces inflammation and hyper-pigmentation

• Hyaluronic Acid: Known for its hydrating prowess, Hyaluronic acid can counterbalance any potential dryness imparted by Azelaic acid, keeping the skin plump and moisturized   

• Vitamin C: This antioxidant aids in brightening the skin, and when teamed up with Azelaic acid, can boost the lightening of dark spots and enhance overall skin radiance   

• Alpha and Beta Hydroxy Acids (AHAs and BHAs): Using Azelaic acid with AHAs like Glycolic and Lactic acid, or BHAs like Salicylic acid, enhances exfoliation, brightening, and acne-fighting effects. However, combining multiple acids may lead to increased skin sensitivity, so a cautious approach is recommended (more on this below)

• Retinoids: Azelaic acid has proven to work synergistically with retinoids, enhancing the treatment of acne and post-inflammatory hyperpigmentation. Though it can potentially increase skin sensitivity, gradual incorporation and proper moisturization can mitigate this. An easy way to mitigate this is applying your Retinol in the evening and your Azelaic Acid in the morning

• SPF products: As always, this is the crucial, final step in any morning skin care routine, especially when applying actives to your skin

What skin products should you be cautious of when using Azelaic Acid

• Strong Acids or Retinoids: Highly concentrated AHA/BHAs or retinoids can potentially irritate the skin when combined with Azelaic acid. Azelaic acid is a potent exfoliant itself, so pairing it with other strong exfoliation treatments could lead to excess skin dryness or sensitivity. Although in an established skin care routine these agents can work wonders together, when you first introduce Azelaic Acid into your routine, it is best to avoid other strong exfoliants until you ensure that your skin is tolerating the product and then start to re-introduce. Another easy to remember tip is to alternate usage days of these ingredients in the beginning or if you are using them on the same day, to avoid layering and opt to use them at different times of the day.

• Other anti-acne ingredients such as Benzoyl Peroxide: Both may be needed as part of an acne-combatting routine, so just make sure to use them at different times of the day to reap as many of the benefits with as few of the risks.

Let’s talk hyperpigmentation: Why is Azelaic Acid such a good option?

Hyperpigmentation and its various manifestations such as post-inflammatory hyperpigmentation (PIH) can often pose a significant cosmetic concern. Fortunately, Azelaic acid has demonstrated an exceptional ability to treat hyperpigmentation effectively and safely. Either as a standalone product or as a part of a targeted anti-hyperpigmentation routine Azelaic Acid is firmly becoming a strong contender and popular ingredient in this field.

But why is it such a standout? The key to Azelaic acid's power when dealing with hyperpigmentation lies in its role as a tyrosinase inhibitor.

Tyrosinase is an enzyme that stimulates the production of melanin. In situations of hyperpigmentation and PIH, tyrosinase production is often overactive resulting in concentrated, darker patches of skin than can linger for months or years and can be very difficult to shift. Azelaic acid is able to limit this turbo-charged tyrosinase activity, hence disrupting the production of excess melanin. This regulation ensures a more even spread of pigmentation across the skin, gradually restoring uniformity in the skin tone.

Moreover, Azelaic acid's mild exfoliating action aids in shedding the upper layers of the skin, effectively speeding up the skin cell turnover. This process accelerates the fading of hyperpigmentation and emergence of new, brighter skin, promising an even and revitalized complexion over time.

In essence, the dual action of Azelaic acid in tackling hyperpigmentation, through pigment inhibition and accelerated skin renewal, makes it a very effective tool in the fight against irregular skin tone.

And how does Azelaic Acid help to calm down Rosacea?

Rosacea as a condition exists across a wide spectrum of severity and can be debilitating for some. Thankfully, Azelaic acid proves to be a faithful ally by calming and treating rosacea-prone skin, achieving its goal in two significant ways.

Primarily, Azelaic acid is a potent anti-inflammatory agent, an attribute that makes it highly effective in managing the redness and inflammation associated with rosacea. When applied to the skin, it helps to reduce the swelling and calm the skin, significantly reducing the visible signs of rosacea over continuous use.

Secondarily, Azelaic acid inhibits the growth of certain types of bacteria on the skin. Some studies suggest that patients with rosacea have a higher than usual concentration of a particular skin bacteria (see acne section below). By reducing the count of these bacteria, Azelaic Acid indirectly helps manage rosacea by targeting potential microbial triggers.

Additionally, since rosacea-prone skin can often be sensitive, a positive aspect of Azelaic acid is its generally low irritant profile compared to other acne or rosacea treatments. This means that it can usually be used safely and effectively without causing additional skin irritation or exacerbating rosacea symptoms.

In a nutshell, Azelaic acid’s perfect blend of anti-inflammatory and anti-bacterial actions contribute to its effectiveness against rosacea.

That being recognized, let’s now touch on its mechanism of action when dealing with acne…

Azelaic Acid and its role in Acne

One of the hallmarks of Azelaic acid's effectiveness in skincare lies in its potent anti-inflammatory capabilities. Numerous clinical studies showcase its role in reducing inflammation, particularly in treating conditions such as acne and rosacea.

Azelaic acid acts on the inflammatory process at a cellular level. Specifically, it decreases the production and release of inflammatory chemicals known as cytokines. High levels of cytokines can lead to inflammation and often exacerbate skin disorders like acne. Besides, Azelaic acid also helps tame follicular keratinization - a process whereby skin cells overproduce keratin leading to clogged hair follicles. This clogging is a significant contributory factor towards the development of inflamed acne lesions. Moreover, the acid works as an efficient antioxidant by neutralizing harmful free radicals that can damage skin cells and trigger inflammation.

Acne is often associated with an overgrowth of the bacterium Propionibacterium acnes (P. acnes) within skin pores. Here's where Azelaic acid brings out its powerful anti-bacterial side. By penetrating deep into the skin, Azelaic acid demonstrates strong bacteriostatic effects, particularly against P. acnes. Its antibacterial action reduces the population of these bacteria, thereby reducing the skin inflammation that they provoke. Unlike antibiotics, Azelaic acid doesn't lead to bacterial resistance, making it a safe and effective long-term treatment option for acne.

Interestingly, the acid’s antibacterial activity isn't confined solely to P. acnes. Studies suggest that Azelaic acid can help moderate other types of skin bacteria that are associated with rosacea and folliculitis.

The Side Effects and Precautions of Using Azelaic Acid

While Azelaic acid is generally well-tolerated, some users may experience certain side effects during the initial application periods. Like all skincare products, it is essential to use it responsibly and prudently. Here are some potential side effects and precautions to bear in mind.

• Skin Irritation: Redness, burning, dryness, or itching might occur, particularly during the initial applications

• Contact with Eyes or Mucous Membranes: Azelaic acid can cause irritation or discomfort if it gets into your eyes, mouth or nose. So, always apply it carefully to avoid these areas.

• Use During Pregnancy or Breastfeeding: Azelaic acid appears to be safe for use during pregnancy or breastfeeding. However, it is always best to consult your doctor or dermatologist before using any new skincare product during these life stages.

In Conclusion…

Incorporating Azelaic Acid into your skincare routine is likely to result in a string of benefits that help to fight off some truly troublesome skin conditions. Azelaic acid, once an unassuming component found in grains, has remarkably transcended to be an indispensable star player in skincare. With its exceptional benefits, such as tackling hyperpigmentation, reducing acne, soothing rosacea, and offering gentle exfoliation, Azelaic acid for skin care is a undeniable gem we shouldn't overlook.

Also, the fact that this ingredient is well tolerated by most, makes it a great addition to your toolbox and a great compliment to a whole host of other ingredients.

However, as with all hero skin care ingredients the trick is consistency and patience and using it in the right way for your individual skin needs and skin type. Also it is important as always to listen to your skin and introduce any nw agents safely and gradually.

At Skin Health by Dr. Jenny, we prioritize your skin's health and well-being. We are here to answer any questions and guide you on your journey to beautiful, radiant skin. You can trust in our commitment to science, ethical practices, and providing you with the most innovative and effective skincare solutions available.

If you want to know more, then why not book in a personalized skin consultation with Dr. Jenny to create a bespoke and safe skin care plan for your individual skin type and individual skin concerns.

Stay tuned to our blog for more exciting updates, skincare tips, and scientific insights into the world of skin health