Azelaic Acid

📋 Quick facts

Description: Azelaic Acid — brightening, anti-inflammatory, acne.

All Functions: brightening, anti-inflammatory, acne

Quick Facts:

• Category: active
• Comedogenic Rating: 0/5

Proven Benefits At A Glance:

• A naturally occurring acid produced by yeast that’s FDA-approved for rosacea
• Works through multiple pathways: antibacterial, anti-inflammatory, and affects melanin production
• More effective than placebo for acne, rosacea, and melasma
• Generally well-tolerated with few adverse events reported
• Only 4% of a topical dose is absorbed into the bloodstream

⚗️ Chemical Overview

Nonanedioic acid is an alpha,-dicarboxylic acid that is heptane substituted at positions 1 and 7 by carboxy groups. It has a role as an antibacterial agent, an antineoplastic agent, a dermatologic drug and a plant metabolite. It is a dicarboxylic fatty acid and an alpha,omega-dicarboxylic acid. It is a conjugate acid of an azelaate and an azelaate(2-). Azelaic acid is a saturated dicarboxylic acid found naturally in wheat, rye, and barley. It is also produced by Malassezia furfur, also known as Pityrosporum ovale, which is a species of fungus that is normally found on human skin. Azelaic acid is effective against a number of skin conditions, such as mild to moderate acne, when applied topically in a cream formulation of 20%. It works in part by stopping the growth of skin bacteria that cause acne, and by keeping skin pores clear. Azelaic acid’s antimicrobial action may be attributable to inhibition of microbial cellular protein synthesis. Azelaic acid is a metabolite found in or produced by Escherichia coli (strain K12, MG1655).

Source(s): ChEBI, E. coli Metabolome Database (ECMDB), DrugBank, via PubChem

📊 Comedogenicity

0/5

🛡️ Safety rating

Safety tier is a starting heuristic from regulatory status and comedogenic rating, not a dermatological verdict — see our Terms for the full disclaimer. Research confidence reflects how many real cited studies back this ingredient, not the strength of their findings.

🤰 Pregnancy Safety Note

Category B. Considered safe during pregnancy. Prescription option for pregnancy acne.

🌍 Regulatory Status

💧 Skin Type Compatibility

Derived from this ingredient’s irritancy potential and comedogenicity rating against the needs of each skin type — e.g. oily and acne-prone skin are marked down for pore-clogging ingredients, sensitive skin for irritants. A starting heuristic, not a dermatological verdict.

⚠️ Don’t Combine With

📚 Research & Evidence

🔬 The Science

Azelaic acid (AZA) is a saturated dicarboxylic acid with nine carbon atoms that’s naturally produced by the yeast Malassezia (Clin Cosmet Investig Dermatol, 2024). It has multiple mechanisms of action that make it useful for different skin conditions. For #1 acne: The ingredient works against acne through several routes. It has antibacterial effects against both aerobic and anaerobic microorganisms, including Propionibacterium acnes (J Am Acad Dermatol, 1987). Research shows azelaic acid is more effective than vehicle (inactive treatment) for improving global assessments and reducing acne severity (J Cosmet Dermatol, 2023). One study found that 20% azelaic acid reduced more lesions than erythromycin gel.

However, when compared head-to-head with other active treatments, the picture is more mixed. According to a Cochrane review covering 49 trials, azelaic acid is probably less effective than benzoyl peroxide, but probably makes little or no difference compared to tretinoin (Cochrane Database Syst Rev, 2020). Comparisons with clindamycin and adapalene showed unclear or very limited evidence. For #2 rosacea: This is where azelaic acid has the strongest evidence. Meta-analyses of 20 rosacea studies showed that erythema (redness) severity, inflammatory lesion counts, overall improvement, and treatment success were significantly improved with azelaic acid compared with vehicle after 12 weeks (J Cosmet Dermatol, 2023).

Notably, azelaic acid was more effective than metronidazole 0.75% for improved erythema severity, overall improvement, and inflammatory lesion counts. The ingredient is FDA-approved specifically for papulopustular rosacea (Clin Cosmet Investig Dermatol, 2024). For #3 melasma and hyperpigmentation: Azelaic acid is a reversible inhibitor of tyrosinase and other enzymes involved in melanin production (J Am Acad Dermatol, 1987). In cell culture, it shows selective toxicity to abnormal melanocytes—meaning it affects pigment-producing cells involved in melasma without damaging normal skin cells at the same concentrations (J Am Acad Dermatol, 1987). Clinical evidence from seven melasma studies showed that 20% azelaic acid was significantly better than vehicle for both severity and global improvement, and demonstrated significantly better results compared with hydroquinone 2% for global improvement (J Cosmet Dermatol, 2023).

Regarding #4 safety and side effects: The research indicates very few significant differences between azelaic acid and comparators were observed for commonly reported adverse events (J Cosmet Dermatol, 2023). Individual application site reactions like scaling have been reported in some studies (Cochrane Database Syst Rev, 2020). Only 4% of a topical dose is absorbed after application, and azelaic acid is a chemical that naturally appears in foods, the bloodstream, and breastmilk (2006 peer-reviewed source). If you’re breastfeeding, it’s considered low risk, though you should avoid applying it directly to the breast or nipple and prevent infant skin contact with treated areas.

One note: No eligible randomized controlled trials were found evaluating azelaic acid’s effectiveness for skin aging, so claims about anti-aging benefits are not supported by the current research (J Cosmet Dermatol, 2023).

📄 Related Research

Matched by search — not necessarily verified support for every statement above.

• Feng X et al. (2024). Azelaic Acid: Mechanisms of Action and Clinical Applications. Clin Cosmet Investig Dermatol.
• Liu H et al. (2020). Topical azelaic acid, salicylic acid, nicotinamide, sulphur, zinc and fruit acid (alpha-hydroxy acid) for acne. Cochrane Database Syst Rev.
• King S et al. (2023). A systematic review to evaluate the efficacy of azelaic acid in the management of acne, rosacea, melasma and skin aging. J Cosmet Dermatol.
• Unknown authors (2006). Azelaic Acid. a peer-reviewed journal.
• Nazzaro-Porro M (1987). Azelaic acid. J Am Acad Dermatol.

📰 Recent News

• Topical PEGylated azelaic acid nanohybrids: A lipid-polymer hydrogel system for sustained dermal delivery in rosacea management (PubMed)
• Best Tranexamic Acid, Alpha Arbutin, Kojic Acid & Azelaic Acid Serums & Creams for Pigmentation (The Derm Review)
• Advanced azelaic acid hyalubilosome-loaded microneedles for potent anti-inflammatory, antioxidant, and antimicrobial for Acne treatment by up-regulation of Nrf2/HO-1 signaling pathway (PubMed)

🧴 Products Containing Azelaic Acid

• The Ordinary www.THEORDINARY.COM
• Typology Acide azélaïque 10% + Extrait de bambou
• Gamma Chemicals Megaduo Gel
• Scalp Relief Tea Tree
• Cosmia Lotion purifiante
• Bioderma Bioderma Pigmentbio Sensitive Areas