How does azelaic acid work? We're going to review a few azelaic acid products that Cassandra recommends and a few azelaic products that Cassandra finds to be the worst.
Firstly, let’s go over the definition and purpose of azelaic acid. Azelaic acid is a dicarboxylic acid, and it is fantastic for rosacea. It is found in prescriptions forrosacea, but it's also in many OTC (over-the-counter/ store-bought) forms. Azelaic acid has been known to help with redness, specifically the redness that accompanies pimples or rosacea pustules.
Furthermore, azelaic acid can help with acne and hyperpigmentation, and as a bonus, it's pregnancy safe. Therefore, if someone is pregnant or breastfeeding, they can use it without concern. The only caveat is that it's hard to incorporate into a formula. It has a powder-like consistency, and likewise, if you put it into a liquid, it can become a bit crusty and crunchy. Given that, azelaic acid has the potential to feel gritty or grainy on the skin. So, for people who are trying to apply products underneath makeup, using azelaic acid can be a struggle.
M Skin Care Azelaic Acid Serum 1 oz -$5.25
For example, this was the cheapest azelaic acid product that Cassandra could find, and it is supposed to help calm irritated skin and prevent breakouts. However, the product is basically water, and after drying, there’s a crunchy feeling on the skin. After using it, there’s not much of an effect on the skin, and you’re left wondering how much azelaic acid is actually in the product. Cassandra does actually have some clinical rosacea, and when she puts this onto her skin, she doesn’t see or feel any changes. This formula includes aloe, glycerin, and azelaic acid, but it’s worth noting that most azelaic acid products usually contain an azelaic acid derivative like potassium azeloyl diglycinate. Potassium azeloyl diglycinate is an OTC derivative of azelaic acid with better solubility meaning it feels less crunchy, and it's easier to dissolve.HoliFrog skincare has this azelaic acid derivative, and it's very good.
REN Clean Skincare Daily AHA Toner - $39
Cassandra wanted to love this product, but Ren is one of those “clean” skincare products that tend to be a little hit or miss. For instance, although citrus is a bit sensitizing for her, Cassandra likes their Ready Steady Glow Daily AHA toner as an AHA product. Conversely, she believes it underperformed as an azelaic acid product. To begin with, this is the only liquid azelaic acid product that Cassandra could find. The toner is exfoliating and has a nice, orange-citrus smell, but otherwise, Cassandra doesn’t believe that it lives up to its claims.
Cassandra didn’t find that it helps with redness, and we want azelaic acid to help with acne, redness, and brightness. Because azelaic acid is a tyrosinase inhibitor, it stops your skin from being able to create as much pigment, and that's why it's sought after as a treatment for hyperpigmentation and dark spots. However, Cassandra did not see that it was effective for any of the above. So ultimately, it’s more of an exfoliating, orange-smelling liquid.
The Ordinary Azelaic Acid 10% -$10
Cassandra loves this product, but it only gets 6th place out of 9 because Cassandra doesn’t care for the formula. She does concede that it’s fantastic for the price though. This is the highest concentration of azelaic acid (10%) that you can get OTC, and it's also the least expensive. This is under $10 whereas almost everything cost more. While this product works great for rosacea, acne-prone skin, and it’s pregnancy-safe, it feels a bit chalky and gritty on the skin. As this product is dimethicone-based, it feels a lot like a makeup primer. Therefore, this is definitely not a comparison to some other gritty azelaic acid products.
If you wear this under makeup, the serum may ball up and peel a little bit. Therefore, it may be difficult to mix this in with your routine. Even though azelaic acid generally works with many skincare ingredients, once again, it balls up easily.
Now, we’ll review some products that cost a couple of dollars more but feel much more elegant on the skin.
Skinfix Acne+ 2% BHA and Azelaic Acid Acne Spot Treatment - $30
If you’re looking for something that spot treats, this is wonderful. Although not the best, it's an effective azelaic OTC treatment. The first ingredient is water, and the second ingredient is azelaic acid. This indicates that the product has a decent amount of azelaic acid. Then, the next ingredient is salicylic acid and kaolin clay.
Although this is a spot treatment, a product you put on pimples, it completely blends into the skin. Given that, Cassandra finds it easier to use under makeup.
You can spot treat or use it all over. If you are someone who gets rosacea in very defined areas, this is a fantastic treatment. Also, if you’re someone who gets periodic breakouts, but you don’t want to use a benzoyl peroxide treatment, this works too.
This one is fragrance-free and similar to The Ordinary, but it applies more elegantly, and Cassandra finds that it doesn’t ball up quite the same. Since it has kaolin clay, Cassandra does like this better as a spot treatment as opposed to something you’d rinse off. You can leave this spot treatment on, and you can put it under other skincare and sunscreen throughout the day.
Dermatica Azelaic Acid - $24.99
Prescription azelaic acids are some of Cassandra’s favorites, and if you don’t have insurance or are unable to see a doctor, there are still prescriptions that you can get. These are two prescription formulas that Cassandra loves. One of them is from Dermatica and the other is from Apostrophe. Both are custom blended prescriptions. So, Cassandra is giving a review based on what was specifically prescribed for her skin. Depending on your skin, the prescription will have different amounts of azelaic acid and different supplemental ingredients.
Dermatica offers prescriptions at about $25. Cassandra has had some formulas arrive a bit chalky, and some that have been more hydrating. Overall, the azelaic acid in the Dermatica product does not ball up. Specifically, Cassandra’s current formula has erythromycin in addition to azelaic acid. Erythromycin is an antibacterial agent used for acne and subclinical rosacea. Her formula also includes clindamycin as well as niacinamide. She absolutely loves this one, and Dermatica also has coupons that give you the first two months free.
Apostrophe Azelaic Acid - $75
Apostrophe also has some great options. The one Cassandra has specifically includes spironolactone andtranexamic acid, and this is such a nice formula. Depending on how the formula is concocted, the consistency can vary from gritty to smooth. This works wonderfully from redness or bumps. Moreover, if you arepregnant or breastfeeding, you can get formulas without certain ingredients.
Both Apostrophe and Dermatica are prescribed by medical providers and clinicians. So they’ll actually take a look at your skin and your concerns, and they custom blend a formula for you.
Cassandra loves both of these, but it all depends on your preferences, how much you want to spend, and whether or not you want spironolactone.Dr. Mamina also works with Dermatica, and she’s how Cassandra found out about Dermatica. These are both wonderful prescription options, but there are actually some OTC azelaic products that Cassandra thinks are even better than the prescriptions.
Paula's Choice 10% Azelaic Acid Booster - $38
This formula is potent, stable, and effective, it’s a bit like the Skinfix one. It’s a white paste that you can rub in, and Cassandra thinks this one is even more cosmetically elegant than the Skinfix product. Moreover, it’s a booster. So, you can mix it in with your other products! This is great for giving a moisturizer a boost.
For example,The Inkey List has that peptide moisturizer, and if you put a few drops of azelaic acid in it, the two blend together as a nice, lightweight gel moisturize. It mixes very well with certain moisturizers, but if you try to layer it with a serum, toner, or sunscreen, it can ball up a little. So, keep that in mind, but overall it’s a great one. This formula also has licorice and salicylic acid. Likewise, if you have dark spots and hyperpigmentation, this is one of the best ways to go.
Dr. Sam's Flawless Neutralizing Gel - $38
So, what if you don’t have dark spots or hyperpigmentation, but you have rosacea with little pimples? What if you have adult acne? In this case, Cassandra says that this is one of the best azelaic acid products that she’s ever used. This is from Dr. Sam Bunting, a cosmetic dermatologist from the UK who uses azelaic acid in multiple products. She created theBrightly serum and theNightly serum. Out of all three of them though, the Flawless neutralizing gel is definitely Cassandra’s favorite. Not only does this product have azelaic acid, but it also has salicylic acid, squalane, and bakuchiol. This is the most cosmetically elegant, and it is an awesome choice for someone very particular about how their skincare feels.
Honestly, Cassandra says this is the smoothest azelaic acid product that Cassandra has ever used in her entire life.
Dr. Sam is open about her struggle with rosacea, and greatly considers women who have adult acne and rosacea-prone skin when she makes formulas. Dr. Sam’s is known for being luxurious without costing an arm and a leg. Along with a luxury feel, her products are also formulated in ways that are stable and medically proven to work. Again, the Brightly serum and the Flawless nightly serum are two other azelaic acid products, but Cassandra says the Neutralizing gel is the best if you have adult acne and want a leave-on treatment. While it’s a little bit expensive, it’s worth every penny, and a little goes a long way.
On the other hand, here is another superb option for someone who doesn’t want to spend as much, or perhaps they’re a first-timer with azelaic acid.
Skinfix Acne+ 2% BHA + Azelaic Acid + AHA Cleanser -$35
This is an azelaic cleanser, and yes, it works for rosacea or pityrosporum folliculitis, better known as “fungal acne” or malassezia, a yeast that causes fungal infection. This cleanser comes out as really beautiful pink, and Cassandra has been using it non-stop. She’s currently on her second bottle. This cleanser has a creamy texture that smoothes over the skin. At the same time though, it’s a cleanser, meaning the azelaic acid and BHA won’t sit on your skin.
If you’re just beginning to incorporate azelaic acid into your routine, this is phenomenal, and it’s worth every cent. While it's not going to be as potent as a leave-on product, it’s easy to use and wonderful for first-timers..
Also, please remember to pair your azelaic acid with an SPF because that is essential. Enjoy!