Active ingredient
Azelaic Acid
INCIAzelaic Acid
Last reviewed by BIOSAR Scientific Team, PharmD, Cosmetic Chemistry, Pharmacy practice on .
What it is
Azelaic acid is a saturated dicarboxylic acid used in skincare to reduce inflammatory acne, rosacea, and post-inflammatory hyperpigmentation. It works by inhibiting Cutibacterium acnes growth, suppressing tyrosinase activity, and dampening neutrophil-driven inflammation. One of the few actives clinicians actively recommend during pregnancy. Mild additive irritation possible when layered with retinoids.
Pregnancy and breastfeeding
Safe
Considered safe during pregnancy and breastfeeding.
Azelaic acid is recommended by Mother to Baby and ACOG as a first-line topical for acne and melasma during pregnancy and lactation. Systemic absorption is under 4% of the applied dose (Bozzo 2011, Can Fam Physician).
Mechanism in detail
What Azelaic Acid does
Dicarboxylic acid that evens tone and calms visible redness. Well tolerated by sensitive skin.
Evidence
What the research says
- 65%Most patients saw good-to-excellent melasma fadingIn a 24-week double-blind trial, 20% azelaic acid delivered good or excellent results in 65% of patients with melasma, matching prescription 4% hydroquinone. No serious side effects such as ochronosis were seen.Read the study →Int J Dermatol 1991
- −58%Inflammatory blemishes dropped 58% in the trialIn a phase III vehicle-controlled study, 15% azelaic acid gel reduced inflammatory rosacea lesions by 58%, significantly outperforming vehicle at 40%. It was rated an efficacious, well-tolerated topical option.Read the study →J Am Acad Dermatol 2003
Layering guidance
Use Azelaic Acid carefully alongside
These ingredients work well in a routine but are best applied at different times of day or on alternating days to limit irritation.
Where it helps
Concerns Azelaic Acid addresses
Sensitivity
If you have sensitive skin, you have probably been told it is in your head — by a product that says "gentle" on the label, by a friend…
Explore the concernSun Damage
Sun damage is the cumulative photoaging caused by ultraviolet radiation, presenting as solar lentigines, irregular pigmentation, fine…
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