Azelaic acid

What does azelaic acid do for skin?

Think of the brown mark a pimple leaves behind on your cheek, the one that lingers for weeks after the bump itself is gone. Azelaic acid is used for exactly that kind of mark, and for uneven tone and redness more generally. It is an acid that occurs naturally in grains such as rye and barley, and it is sold mainly as creams and gels.

It also has the backing of practicing dermatologists. In a 2025 consensus study, 62 dermatologists at 43 centers worked through a long list of skincare ingredients over two rounds of voting. Azelaic acid was one of 23 ingredients they agreed on, recommended for breakouts and dark spots.

How does azelaic acid work?

It slows tyrosinase, the enzyme your pigment cells use to make melanin (the brown pigment in skin). Less tyrosinase activity means less new pigment, which is why it is linked with fading marks rather than removing them overnight. Reviews also describe it as calming and as acting against the bacteria involved in breakouts, and as helping skin shed its surface cells more evenly. Researchers note that its full mechanism is still not entirely understood.

What strength is azelaic acid in skincare?

Products on the market range from 5% to 20%, and the higher strengths are prescription medicines. A 2023 review sums up the market this way: “Commercially available topical formulations with cosmetic and drug status contain 5% to 20% AZA in the form of gels and creams.” This entry covers the cosmetic end of that range only.

What does the evidence at cosmetic strength show?

The clearest human data come from a small 2026 trial, and it tested azelaic acid together with retinal (a form of vitamin A). Researchers at Skinome Research in Stockholm gave 23 people with breakout-prone skin a concentrate of 10% azelaic acid and 0.1% retinal for one side of the face and the same base without the actives for the other, mixed into moisturizer before each use. After 8 weeks, the treated side showed 18.1% less overall redness, 5.6% better texture and a 22.3% better pore measurement than the comparison side. Because the two actives were combined, the study cannot say how much came from azelaic acid alone. Our retinal entry covers the other half of that pairing.

How long until you notice a difference?

Expect weeks, not days. In the 8-week trial above, 65% of participants said they saw a visible improvement within 4 weeks, with measurements taken at week 8.

How do you use azelaic acid?

Apply it to clean, dry skin, then follow with moisturizer, and wear sunscreen in the daytime. Start a few times a week before using it daily, and add it on its own rather than alongside another new active. Our guide to introducing a new skincare product covers the pacing.

Who should be careful with azelaic acid?

Most people tolerate it well; a 2023 review describes side effects as generally mild and short-lived skin irritation. Longer-term use has been linked with itching, burning, stinging and redness in some people, so if your skin is already stinging or peeling, wait until it settles. Patch test first if your skin reacts easily.