It’s difficult, even for me, to keep up with skin-care trends. It feels like every week there’s a new must-try product or ingredient making the rounds on the internet. Which is why when azelaic acid became the ingredient of the moment in 2021, I understood why folks (including my editor here at the Strategist) were apathetic and unconvinced by the buzz. But as I’ve continued to study, use, and recommend azelaic acid to friends and clients, my interest in the ingredient and its wide range of benefits has only grown. That’s truer now than ever, since azelaic acid just fixed my friend’s rosacea weeks before her wedding.
Two months ago, my friend called me frantic. The stress of wedding planning had caused her skin to erupt in persistent hormonal acne that wasn’t going away. And to make matters worse, all the acne-fighting products she’d purchased — like salicylic-acid serums and retinol gels — were triggering her rosacea. Red blotchy patches popped up all over her skin. As someone with severe eczema and acne, I’d been in a similar position before and could understand the frustration that comes with trying to manage two temperamental and seemingly conflicting skin conditions at once. But I remembered learning about azelaic acid’s benefits on rosacea-prone skin in esthetician school and knew from my own experience that it was an incredible ingredient for reducing swelling and inflammation caused by acne. About a year ago, I was dealing with some stubborn hormonal breakouts after coming off of birth control, and Naturium’s azelaic acid helped clear it up without irritation.
I knew the stakes were high, so before I made any recommendations, I reached out to Dr. Loretta Ciraldo, a board-certified dermatologist based in Miami, to ask about how azelaic acid might function on acne-prone, rosacea-prone skin. According to Dr. Loretta, it’s a naturally occurring acid that comes from barley, rye, and wheat. It helps treat acne because it has antibacterial and anti-keratinizing properties. That means it kills bacteria and breaks up the dead-cell plugs that cause pimples. And while these acne-fighting abilities inherently have anti-inflammatory benefits, she explained that the reason why azelaic acid is so good for rosacea-prone skin is that it is a tyrosinase inhibitor, which means it actively works to block the formation of excess pigment in the skin, reducing the redness that comes with rosacea flare-ups. When I asked Dr. Loretta if there were any potentially negative side effects, she said that while pretty much any skin-care product could trigger sensitivity, azelaic acid is rather mild. And over-the-counter products are less likely to cause reactions in general.
What’s so great about azelaic acid is that it works in conjunction with other ingredients. It can be paired with AHAs, BHAs, or retinoids, so you won’t have to rearrange your routine to include it. I felt confident recommending a few options to my friend and waited with bated breath to hear how it worked out. Thankfully, a few weeks later, I received a fresh-faced selfie from my pal. Her rosacea was calmed, and she had significantly shrunken zits. She even told me that the products had helped her brighten up the dark marks left behind from acne scarring. Sweet relief. And confirmation for me that azelaic acid is much more than an “ingredient of the moment.”
Here are three affordable and effective azelaic-acid serums (including the miracle worker that helped my friend).
A basic azelaic acid
Dr. Loretta often recommends this azelaic acid to clients interested in trying out the ingredient. It’s a suspension formula, which means it’s more on the creamy side, so if you’re integrating it into your routine, you should apply it after any water-based serums (like a hyaluronic-acid serum) and before your moisturizer.
An azelaic acid to mix into your moisturizer
As this is a “booster,” it was formulated to be used on its own as a standard serum or mixed into your favorite moisturizer. If you’re someone who doesn’t like the fuss of multiple products and are trying to keep your routine as simple as possible, this is a great option, since you can mix it in with your moisturizer and keep your skin-care steps to a minimum.
An antioxidant-boosted azelaic acid
This is the serum that sorted out my friend’s pre-wedding flare-up. It’s not only azelaic acid but includes niacinamide, oat, squalane, and allantoin, which all work together to help reduce redness, inflammation, and swelling.
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