", IN THIS ARTICLE How does azelaic acid work? Two to three times a week, apply this gentle overnight gel mask to your face to help minimize the appearance of pores and slough off dead skin cells. Second, azelaic acid also has antioxidant properties that help remove free radicals that can contribute to dull skin for a naturally brighter complexion. | Who should use azelaic acid? Speak to the #deciemaddicts in the Facebook Group or search melasma. She explains that azelaic acid is in class B, meaning it's safe to use during pregnancy or while breastfeeding, but it's still not in class A, aka OTC. However, if you’re still interested in testing out an OTC azelaic acid, consider a few of their suggestions along with one of our picks. Significant improvement in Mexameter E mean scores were reported at month one for patients treated with azelaic acid 15 percent gel compared with month six for those treated with hydroquinone. Fifteen of the patients received treatment with azelaic acid 15 percent and another 15 received treatment with hydroquinone 4 percent. Melasma Mask: Azelaic Acid 15%, Kojic Acid 4%, Hydroquinone 8%, Tretinoin 0.1% Melasma is an acquired increase of pigmentation, which occurs exclusively in sun-exposed areas. References for this information: Journal of Cosmetic Dermatology, March 2017, pages 35-42; and September 2016, issue 3, pages 269-282. Tretinoin appears to enhance this effect of azelaic acid. Maiman agrees, and calls azelaic acid “one of few topicals that is safe for use in both pregnancy and breastfeeding, and is always an ingredient I recommend to women who have childbearing in mind.” She adds it’s “very difficult” for pregnant and breastfeeding women to treat acne and melasma because “a vast majority of treatments dermatologists typically use — both topical and oral — are considered unsafe or lack data necessary to conclude there is no risk to a developing fetus and or infant.”. Maiman says morus alba extract found in the serum has oxyreservatrol, an antioxidant similar to azelaic acid because it's also a tyrosinase inhibitor, which prevents hyperpigmentation. When it comes to hyperpigmentation, including melasma, azelaic acid can tackle this tissue by blocking melanocytes from making more melanin, which affects the skin’s pigment. Significant improvement from baseline in PtGAS was reported at months one, four, five and six for patients treated with azelaic acid 15 percent gel compared with months three, four, and five for those treated with hydroquinone. If you purchase something through our links, we may earn a commission. For an optimal experience visit our site on another browser. "If you are using azelaic acid, you definitely should be religious about applying sunscreen. Green tea extract soothes redness since it’s an anti-inflammatory and also full of antioxidants. Paul Jarrod Frank, MD, cosmetic dermatologist and founder of the PFRANKMD, says azelaic acid is a more gentle exfoliant than other alpha hydroxy acids (AHAs), including glycolic, lactic and mandelic acids. It has antimicrobial and anti-inflammatory properties, … Additionally, some find that it helps reduce overall skin sensitivity (when used in appropriate amounts and with sunscreen), thereby decreasing signs of irritation. Azelaic acid may be used alone or paired with other soothing and brightening ingredients like niacinamide, hydroxy acids or antioxidants, says Zeichner. However, Maiman says azelaic acid is "typically the lab-engineered form that is used in skin care products, owing to its being more stable and effective." However, he cautions against becoming lackadaisical about wearing sunscreen. She advises using it as a spot treatment for inflamed or dark areas of the skin, blending the acid out, so it doesn't leave a sharp demarcation. Downie "strongly recommends" azelaic acid for hair bumps, pimples and overall evening of skin tone if you have dark patches on your skin. If they're not, I'm not. Azelaic acid 15 percent gel can be considered a reasonable alternative to hydroquinone for the treatment of melasma, according to results presented in a poster at MauiDerm 2014. Salicylic acid, Vitamin C, retinol and Alpha Hydroxy Acids (AHAs) are a few popular ingredients that have reigned supreme in skin care products. She advises women who are pregnant or breastfeeding check with their OBGYN before incorporating azelaic acid into their skin care routine. Non-hydroquinone-based lighteners rely on azelaic acid or kojic acid. The efficacy of the combination of 20% azelaic acid cream and 0.05% tretinoin cream in the treatment of melasma was compared with that of 20% azelaic acid cream alone in an open-label randomized study (n = 50).Over the 6-month treatment period both treatments yielded approximately 73% therapeutically meaningful (rated as ‘good’ or ‘excellent’) results. Start on the back of your arm and, if there's no reaction, apply it to your neck and your face last. Disclaimer. "It's anti-inflammatory for the acne and it's anti-pigment because it blocks tyrosinase. Although not registered in New Zealand for other skin disorders, azelaic acid cream may also be useful in the treatment of: Safety and efficacy were measured through adverse event reports and monthly evaluations using Mexameter M & E readings, the Melasma Area & Severity Index (MASI), Physician Global Assessment (PGA), Patient Global Assessment Score (PtGAS), according to the abstract. What is azelaic acid? A group of 60 women diagnosed with melasma were divided into three even, twenty‐person subgroups. Azelaic acid treats sunspots and melasma because it blocks the production of "abnormal pigmentation," he says. It has been recommended as an alternative to hydroquinone. The statistically processed results refer to 39 patients treated for 6 months with 2 applications/die. While it’s targeted towards all skin types, those with oily and acne-prone skin may find this booster works best because it contains salicylic acid, which keeps breakouts at bay and helps decongest clogged pores. It's a combination of "several potent active ingredients" — azelaic acid, retinol and vitamin C. There's also tranexamic acid, a topical treatment, "which interferes with the interaction of pigment-producing cells and works particularly well for discoloration resulting from UV light." Downie adds that she "used it (azelaic acid) all through" her pregnancy 17 years ago. Topical azelaic acid has been used to treat melasma [1 R, 2 C], acne rosacea [3 R], acne vulgaris [4 R, 5 R], and post-inflammatory hyperpigmentation [6 R]. I was told to stop using the HQ for 4 months and then restart using it. Zeichner adds: "Unlike other acids, azelaic acid does not make you sensitive to the sun." The medical experts answer common questions including: How often can you use azelaic acid? Azelaic acid is often recommended for people dealing with acne, rosacea, and pigmentation issues. IE 11 is not supported. Frank, who is also author of “The Pro-Aging Playbook,” likes to pair azelaic acid with hyaluronic acid to provide moisture. Azelaic acid is a compound found in wheat, rye and barley that can help treat acne and rosacea because it soothes inflammation, according to Joshua Zeichner, MD, director of cosmetic and clinical research at Mount Sinai Hospital. Maiman calls this serum one of her "favorites for excessive pigmentation," and notes it's usefulness goes beyond tackling melasma and post-inflammatory hyperpigmentation. All rights reserved. Dermatologists on how to use azelaic acid for acne, rosacea and melasma. In a multicenter, double-blind, randomized study, 88 men and 62 women with acne vulgaris were randomly assigned in equal numbers to azelaic acid 5%, clindamycin 2%, or the combination [ 7 C ]. Objective: To compare the effect of combination therapies of topical 3% tranexamic acid versus topical 20% azelaic acid each combined with oral tranexamic acid in the treatment of melasma. It clears the bumps and swelling caused by rosacea. Zeichner also suggests The Ordinary Azelaic Acid serum because it “can help improve the blemishes as well as dark spots.” Hadley King, MD, board-certified dermatologist, is also a fan of this cruelty-free and vegan serum. It will look like your dark spot is doing a hula hoop — it's gonna look crazy," she says. Wait at least 15 minutes before lying down in bed and sleeping on your back for absorption purposes. There’s also aloe leaf juice to absorb excess oil without stripping the skin of moisture. This prevents the patchy, uneven pigmentation that’s common in people with melasma. All rights reserved. We asked dermatologists how azelaic acid works and what you should know before shopping for it in skin care products. Though Fusco and Gerstner recommend a prescription form of azelaic acid to their patients (either Finacea or Azelex) in a strength of 15 percent to 20 percent respectively, it's also available over the counter in a lower strength of 10 percent or less. I've been using 4% Hydroquinone, vitamin C and 10% AHA cream in AM and 0.05% Retin-A and 4% Hydroquinone again at night. Over the treatment period the azelaic acid cream yielded 65% good or excellent results: no significant treatment differences were observed with regard … This effect also makes azelaic acid one of several effective treatments for removing dark spots left behind by acne breakouts. © 2021 MJH Life Sciences™ , Dermatology Times and Multimedia Medical, LLC. Significant improvements in PGA scores were reported at months one, two and four for patients treated with azelaic acid 15 percent gel compared with months three, four and the final visit for those treated with hydroquinone. And if they are, I am," she says. It has been used for treatment of skin pigmentation including melasma and post inflammatory hyperpigmentation, particularly in those with darker skin types. Azelaic acid is beneficial for your skin and increasingly popular but often "overlooked" and "under-the-radar," according to medical experts we consulted. Azelaic acid also helps reduce pigmentation, so it's particularly useful for darker skinned patients whose acne spots leave persistent brown marks (postinflammatory pigmentation) or who have melasma. © 2021 MJH Life Sciences and Dermatology Times and Multimedia Medical, LLC. To learn more about how azelaic acid benefits skin, we consulted six dermatologists across the country for their expert advice. For my patients with more sensitive or rosacea prone skin I generally recommend Azelaic acid in addition to hydroquinone and IPL therapy (depending on skin type). She notes that hyperpigmentation typically occurs when applying azelaic acid to thinner skin areas near the lips or eyes. It’s also gentle enough to use up to twice a day and contains 10 percent of azelaic acid to help brighten your complexion. Our editors independently selected these items because we think you will enjoy them and might like them at these prices. Azelaic acid treats melasma by blocking the effects of tyrosinase, an enzyme that’s responsible for producing the skin pigment melanin. Learn more about Shop TODAY. Significant improvements in Mexameter M mean scores were reported at months five and six for patients treated with azelaic acid 15 percent gel, with month five showing a significant improvement over hydroquinone. Frank doesn’t recommend layering azelaic acid with Beta Hydroxy Acids (BHAs) like salicylic acid as both BHAs and AHAs will increase the chances of dryness and irritation. Azelaic acid is a prescription pharmaceutical active ingredient that is used in creams and gels in concentrations of 15% and 20%. Azelaic acid is an organic compound that is naturally produced by a type of yeast found normally on our skin. Brownish in color, it is exacerbated by sun exposure, pregnancy and oral contraceptives. Glycolic acid According to Maiman, the combination of azelaic acid, niacinamide and salicylic acid are “generally considered safe for both pregnant and lactating women, and work in concert to produce a highly anti-inflammatory combination that is quite effective.” Together, these three ingredients target acne, minimize pores, improve dullness, alleviate redness and lessen the appearance of uneven skin tone and texture. Study design: Interventional comparative study. Nicole Saunders is the associate commerce editor at NBC News Shopping, covering wellness and lifestyle. "It has a different pH than these other acids and doesn't have quite as strong of an exfoliating effect, but it is more effective at helping with … Azelaic acid is available in strengths of 10% or less over-the-counter, and in topical prescription products at concentrations between 15-20%. All other informations on the effects of … Downie says if you have sun damage or if you smoke, you can still use azelaic acid — she recommends you stop smoking because (alongside countless health risks) it can negatively impact your skin. Azelaic acid 15 percent gel can be considered a reasonable alternative to hydroquinone for the treatment of melasma, according to results presented in a poster at MauiDerm 2014. She adds that "much of the research" on topical azelaic acid is for prescription-strength formulas with 15- to 20-percent concentrations. In a double-blind, randomized study, researchers from the Callender Center for Clinical Research enrolled 30 adults with stable moderate-to-severe melasma. Melasma is a chronic condition in which dark areas appear on the forehead, cheeks, and upper lips. Cruelty-free and vegan-friendly, the company says it’s gentle enough for dry and mature skin along with acne-prone, combination and oily skin types. First, it encourages cell turnover to exfoliate the skin and promote new, healthy skin growth. Pricing and availability are accurate as of publish time. When I say no smoking, I mean no smoking, no vaping and no smoking weed," she says. Azelaic acid 15 percent gel can be considered a reasonable alternative to hydroquinone for the treatment of melasma, according to results presented in a poster at MauiDerm 2014.