Azelaic Acid

1 medicine

Azelaic acid is a topical treatment for acne and rosacea whose main risk is local skin irritation, since very little of it is absorbed into the body.

Azelex

Azelaic acid

20%

Azelex is a skin care medication containing Azelaic acid, available as 20% tubes.

from $18.13 / tube View

Key facts

  • Azelaic acid (in creams and gels such as Azelex and Finacea) is a topical treatment for acne and rosacea. It unclogs pores, reduces acne-causing bacteria, and calms redness.
  • It is applied once or twice a day to clean, dry skin; visible improvement usually takes four to eight weeks of steady use.
  • Its main risk is local skin irritation, stinging, redness or dryness, especially in the first weeks. Serious systemic side effects are not expected, because very little azelaic acid passes through the skin into the body.
  • Seek urgent care for severe swelling, blistering, or a rash that spreads well beyond the treated area.

What azelaic acid treats

Azelaic acid treats mild to moderate acne, including whiteheads, blackheads and inflamed pimples, and the facial redness and bumps of rosacea. It can also fade dark marks left behind after a pimple heals. It is not a treatment for severe cystic acne or established scarring.

How azelaic acid works

Applied to the skin, azelaic acid loosens the buildup of dead cells that clog pores, reduces the growth of bacteria linked to acne, and calms the inflammation that drives redness and breakouts. It also blocks tyrosinase, an enzyme overactive pigment cells use, which is why it helps even out dark marks.

Before you take it

  • Avoid applying to broken, sunburned, or eczema-affected skin.
  • Space azelaic acid apart from other strong exfoliating treatments, such as retinoids, glycolic acid or salicylic acid, since combined use increases irritation.
  • Keep it away from your eyes, lips, and the inside of your nose or mouth; rinse with water if accidental contact occurs.
  • Use a daily sunscreen, since treated skin can be more sensitive to sunlight.

Side effects

Common effects include mild stinging, redness, dryness or flaking, and itching in the first days of use, which usually settle with continued treatment.

Stop and seek urgent medical care for any of these:

  • Severe swelling or blistering of the skin.
  • Persistent burning or intense pain that does not improve.
  • A rash that spreads beyond the area you treated.

Safety essentials

  • Local skin irritation is the main safety issue: start with a thin layer once daily and increase frequency only as your skin tolerates it, since serious systemic effects are not expected at typical topical doses.
  • Keep azelaic acid away from your eyes and other mucous membranes, and flush with water if it gets into them.
  • If irritation is severe or a rash spreads, stop use and get medical advice before continuing.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.