Azelaic Acid for Acne: Can it Really Treat and Prevent Breakouts?

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The secret to banishing breakouts in the long-term lies in finding the perfect combination of acne treatments for your skin’s individual needs. This usually requires an element of trial and error, with many immediately flocking to the more well-known acne-fighting ingredients first, such as salicylic acid and benzoyl peroxide.

However, although effective for many, those ingredients won’t work for everyone, requiring you to set your sights a little further afield. Start looking into natural and alternative ways to fight acne and you’ll soon stumble upon azelaic acid. With more and more studies confirming that this ingredient really does hold up as a credible acne treatment, it’s no surprise that it’s becoming increasingly popular. So, if your breakouts have been refusing to budge, don’t despair just yet – azelaic acid could be exactly what you’ve been looking for.


What is Azelaic Acid?

Azelaic acid is a naturally occurring acid found in certain grains, such as barley, wheat, and rye. However, due to how long the extraction process is, as well as the fact that naturally-derived compounds aren’t consistent in terms of potency and stability, the azelaic acid that you’ll find in skin care products will have been created in a lab.

You’re probably already familiar with alpha-hydroxy acids (AHAs), such as glycolic acid and lactic acid, as well as beta-hydroxy acids (BHAs), such as salicylic acid. What sets azelaic acid apart is that it doesn’t fall into either of those two categories. Instead, azelaic acid is technically classed as a dicarboxylic acid. It works in a similar way to hydroxy acids, although not quite as powerfully, but has a number of other unique properties, especially when it comes to fighting acne.

How Does Azelaic Acid Treat Acne?

When it comes to treating acne, azelaic acid works in a few different ways:

Woman with acne applying cream

Destroys Acne-Causing Bacteria

Azelaic acid has powerful antibacterial properties. This allows it to destroy certain bacterial strains, with studies confirming that it’s effective against the p.acnes bacteria, which is the one responsible for breakouts [1].

By eliminating this bacteria from the surface of the skin, azelaic acid is able to prevent breakouts from forming.

Keeps Pores Clear of Blockages

Clogged pores are another precursor to breakouts. These blockages consist of a mixture of dirt, sebum, and dead skin cells. They clump together and become inflamed, resulting in pimples.

Fortunately, azelaic acid deals with this with its comedolytic properties [2]. This means that it keeps the pores clear by loosening up any blockages. This then allows the skin to shed them, rather than holding them in.

Azelaic acid also helps with retention hyperkeratosis. This condition, which is believed to be a major cause of acne, causes the skin to shed its cells at an abnormal rate, which then causes them to collect up in the pores. Azelaic acid regulates this, therefore helping to prevent your pores from becoming clogged in the first place.

Reduces Inflammation

Clogged pores themselves wouldn’t actually be a major issue if it weren’t for the inflammation that subsequently follows. What makes things even worse is that inflammation in the skin not only triggers acne, but also leads to a long list of other skin concerns, from facial redness to premature aging.

So, whether you’re fighting acne or trying to erase wrinkles, anti-inflammatory ingredients are a must. There are plenty to choose from, but azelaic acid is a top contender. Why? Because research shows that this ingredient is far superior to others when it comes to long-term benefits. One study found noticeable improvements in inflammatory lesions after four weeks of regular use, and this only continued to get better up until it plateaued at 15 weeks [3].

Of course, its anti-inflammatory properties mean that azelaic acid can be used to treat other inflammatory skin conditions too. Topical azelaic acid has proven to be particularly effective at treating rosacea [4].

Rosacea symptoms and treatment

Evens Out the Skin Tone

Although not technically related to treating acne itself, those with acne-prone skin often find themselves dealing with scars and an uneven skin tone/skin color, especially after a severe breakout. Certain acne medications can even make post-inflammatory hyperpigmentation worse, leaving your skin dotted with noticeable dark spots.

Azelaic acid works against this in a couple of ways. Firstly, it encourages the cell turnover process, something that naturally declines with age. By stimulating your skin into producing fresh and healthy cells to replace the older, darkened cells, you’ll end up with a clear and even complexion much faster.

Of course, prevention is always better than cure. If you’re using azelaic acid to help treat your acne, then you may not even end up with that hyperpigmentation in the first place. It’s all down to how azelaic acid helps to regulate melanin production in the skin. It prevents the skin from over-producing the pigment, which then means that dark spots simply don’t form. It’s a very effective brightening ingredient, which is why you’ll often find it in skin lightening treatments.

Who Should and Shouldn’t Use Azelaic Acid?

Azelaic acid is particularly beneficial for those with combination or oily skin types. Some people with sensitive skin swear by this ingredient too – many who can’t tolerate some of the more potent acne treatments out there often have no problems with azelaic acid. However, sensitive skin can be finicky, and there are plenty of others who aren’t able to use this ingredient without side effects. To be safe, always perform a patch test before using azelaic acid on your face for the first time, especially if you often deal with sensitivities.

While many skin care ingredients shouldn’t be used during pregnancy and lactation, azelaic acid is considered to be safe. That said, it would still be worth speaking to your doctor before adding the ingredient into your skin care routine.

How to Use Azelaic Acid in Your Skin Care Routine

Azelaic acid is available in both prescription-strength formulas and over-the-counter (OTC) products. While the OTC products won’t be quite as strong, they also don’t bring any side effects, making them a suitable topical treatment no matter your skin type.

Woman touching face and applying cream

Whether you invest in an azelaic acid gel or purchase an azelaic acid cream, the ingredient can be used either day or night, or even twice a day. It plays well with most other skin care ingredients – many like to combine it with hyaluronic acid to give their skin a boost of hydration and prevent dryness.

It can be combined with other acids too, but do this gradually to ensure that your skin can tolerate the mixture.

Azelaic Acid Side Effects

Over-the-counter concentrations of azelaic acid very rarely cause side effects. However, with prescription products being stronger, some people do experience an itching and stinging sensation in their skin, along with dryness, redness, and peeling.

If you notice any side effects after applying azelaic acid to your skin, stop using the ingredient immediately and speak to your doctor for advice on how to proceed.


Pretty blonde applying moisturizing cream on face

Can azelaic acid be used as an acne treatment?

Yes, azelaic acid can be used as an acne treatment, although it’s much more effective when combined with other acne-fighting treatments and medications.

Can azelaic acid make acne worse?

Some people find that azelaic acid makes acne worse to begin with, but this is a process known as purging. It’s common when you first start using ingredients that accelerate cell turnover and should sort itself out in a few weeks, leaving your skin looking clearer than ever!

How long does azelaic acid take to work on acne?

Azelaic acid can work on acne in as little as a week, although you’ll need to use it consistently for a few months to experience its full effects.


Whether you’re looking to improve the efficacy of the acne products that you already use or you’re searching for a new acne treatment altogether, azelaic acid is worth considering. It has a multi-pronged approach to targeting breakouts, which is exactly what makes it so effective. It may cost a little more than some of the other treatments out there, but that’s a small price to pay for clear, pimple-free skin!



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About Alina Jumabhoy

With almost 10 years of experience writing for the skincare industry, Alina brings her unique perspective into all of the in-depth reviews and articles she writes.