Everything you need to know about azelaic acid in skincare

Azelaic acid is a dicarboxylic acid that can be derived from grains like barley, wheat and rye. However, the lab-engineered form is typically used in skincare formulas because of its greater stability and effectiveness.

The ingredient is typically well tolerated by all skin types, even by those with sensitive skin. Azelaic acid is a great treatment for an array of skin concerns.

What skin issues is azelaic acid good for?

• Acne: concentrations of azelaic acid above 10% are useful for the treatment of the acne-causing bacteria propionibacterium acnes and staphylococcus. A study showed that the use of azelaic acid for three months led to remission in 64% of acne patients. If the treatment continues for six months, the acidic efficacy becomes similar to the effect of an antibiotic, benzoyl peroxide and tretinoin, as well as to the influence of tetracycline in daily doses of 0.5-1g/g.

• Rosacea: in one study, the relative efficacy of a 15-week treatment with azelaic acid was compared with the usual treatment regimen used against rosacea. The results indicated that azelaic acid was much more efficient in treating inflammatory response, but less effective in treating erythema. However, participants in this study reported greater satisfaction with the results of treatment with azelaic acid.

• Pigmentation: azelaic acid selectively works on hyperactive melanocytes and does not affect normal pigment, making it a great choice for post-inflammatory hyperpigmentation and melasma. It is clinically proven that azelaic acid in concentrations over 20% inhibits tyrosinase.

Azelaic acid is also useful for neutralising and preventing oxidative damage due to active oxygen species such as superoxide anion radical (-2) and hydroxyl radical (-OH). There are also reports of antiviral and antifungal actions. It can be used in the treatment of ingrowing hairs, folliculitis and keratosis pilaris.

What can azelaic acid be combined with?

It works well alongside vitamin C to treat pigmentation and in its antioxidant approach. Niacinamide is a calming ingredient which also works well with azelaic acid to alleviate inflammation.

Since azelaic acid works so well with other ingredients, at Noon Aesthetics we have created multitasking products. For postinflammatory hyperpigmentation and dark spots there is Double White, which combines 20% azelaic acid with 5% alpha arbutin and 11% stabilised vitamin C. Azelaic Forte 25  is the highest concentration that doesn’t require a prescription, and also contains 5% alpha arbutin. It is safe to use on all skin types due to our DermShield technology.

How can azeliac acid be used in facials?

You would not use azelaic acid in combination with device-led treatments. However, as a supporting ingredient alongside courses such as laser, IPL, peels, needling and waxing, it helps prevent posttreatment pigmentation, boost healing and restore skin function to reduce downtime.

Laura Morgans heads up the UK training team at Noon Aesthetics and is the commercial manager at distributor Advanced Esthetics Solutions.