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Everything dermatologists want you to know about azelaic acid

Doctors weigh in on the efficacy of azelaic acid for acne, rosacea, melasma and more.
Azelaic acid is an acne-fighting ingredient for those with sensitive skin or people who are pregnant or breastfeeding — but it’ll likely take longer to see results, experts say.
Azelaic acid is an acne-fighting ingredient for those with sensitive skin or people who are pregnant or breastfeeding — but it’ll likely take longer to see results, experts say.Target; The Ordinary; Paula's Choice

If you struggle with acne, you’ve probably shopped around for pimple-fighting face washes, moisturizers and treatments that include active ingredients like benzoyl peroxide and vitamin C. But when it comes to keeping sensitive skin clear, azelaic acid is a more under-the-radar ingredient that helps avoid irritation, according to Dr. Rachel Westbay, a board-certified cosmetic and general dermatologist at Marmur Medical. Azelaic acid not only works to unclog pores and prevent acne, but it also helps lighten dark spots and acne scars for a more even complexion.

We consulted with 8 dermatologists on how azelaic acid works and how you can incorporate it into your skin care routine. We also compiled some azelaic acid products in line with our experts’ guidance.

SKIP AHEAD How we picked the best azelaic acid products | Best azelaic acid products

Selected.Our picks

What is azelaic acid and how does it work?

Azelaic acid is a tyrosinase inhibitor (the enzyme responsible for making melanin), which helps to even out your skin tone and prevent and treat hyperpigmentation due to conditions like melasma, says Westbay. It can also lighten acne scars, dark spots (most often seen on darker skin tones) and red scars (most commonly seen on fair skin tones), according to Westbay.

Azelaic acid is also an antibacterial antioxidant that unclogs pores, reduces inflammation and treats acne. It’s milder than other acne-fighting ingredients like salicylic acid and adapalene, which makes it more suitable for those with sensitive skin, acne and rosacea, says Dr. Lindsey Bordone, a board-certified dermatologist and assistant professor of dermatology at ​Columbia University Medical Center. Plus, it’s one of the only pregnancy-safe acne treatments on the market. 

Prescription-level azelaic acid is available at 15% and 20% strengths, and these have more research to back up their efficacy. However, you can also find over-the-counter options at strengths up to 10%. If your skin can tolerate it, try combining a lower-grade strength OTC option with other acne-fighting ingredients, which can be “much more effective than when [azelaic acid is] used alone,” says Westbay.

How we picked the best azelaic acid products

While shopping for OTC products that contain azelaic acid, our experts recommend considering the following factors:

  • Concentration: While prescription-strength products are usually best because they have higher concentrations of azelaic acid, OTC products that have a 10% strength or lower can still be effective, experts say.
  • Formulation: The formulation you choose depends on your personal preference and how it fits into your skin care routine. Though typically found in serums, you can also find azelaic acid in cleansers, face masks, creams and gels.
  • Additional ingredients: Depending on the specific skin concerns you’re targeting, consider products that pair well with azelaic acid, including skin-brightening ingredients like niacinamide and vitamin C, and hydrating ingredients like hyaluronic acid. Avoid layering this ingredient with harsher acids like alpha hydroxy acids (AHAs) and salicylic acid because it can compound irritation, our experts say.

Best azelaic acid products of 2024

Below, we’ve compiled our experts’ favorite products containing azelaic acid, as well as highly rated options from brands we’ve previously covered.

Best azelaic acid serum

Best overall: The Ordinary Azelaic Acid Serum

This vegan and cruelty-free cream from The Ordinary is a favorite among our experts because it helps improve the appearance of blemishes and dark spots. The serum, which is also one of our favorite acne and melasma treatments, contains 10% azelaic acid, and it’s gentle enough to use up to twice a day, according to the brand.

Best for dark spots: Paula's Choice 10% Azelaic Acid Booster

This 10% azelaic acid face serum is effective at brightening dark spots, evening out skin tone and improving hyperpigmentation caused by breakouts, according to Dr. Joshua Zeichner, director of cosmetic and clinical research at Mount Sinai Hospital. It’s noncomedogenic and hypoallergenic, so it’s safe for sensitive skin. Westbay also recommends the brand’s Niacinamide + Azelaic Acid Duo, a 2-in-1 product that targets acne, minimizes pores, improves dullness and lessens the appearance of uneven skin tone and texture, she says.

Best for irritated skin:Peach Slices Redness Relief Azelaic Acid Serum

This serum from Peach Slices — the brand behind some of our favorite pimple patches — has 10% azelaic acid, as well as panthenol, a humectant that helps the skin retain moisture. Effective for both your nighttime and daytime routine, the serum also helps reduce signs of redness and rosacea thanks to ingredients like hydrating green algae and soothing cica, according to the brand.

Best for redness: The Inkey List Azelaic Acid Serum

This azelaic acid serum is recommended by Dr. Erum Ilyas, a board-certified dermatologist at Schweiger Dermatology. It has 10% azelaic acid and you can apply it twice a day, according to the brand. If redness is a major concern, The Inkey List’s serum contains microfine green-colored particles that can help mask redness, as well as 0.3% allantoin, which is a chemical compound that can help soothe the skin, according to The Inkey List.

Best for melasma: Sesderma Azelac Ru Facial Serum

This Sesderma serum is one of Westbay’s favorites for excessive pigmentation on the skin. It can tackle melasma and post-inflammatory hyperpigmentation from acne scars, too, she says. The serum is a combination of several active ingredients, including azelaic acid, retinol and vitamin C. The formula also contains tranexamic acid, a topical treatment that “works particularly well for [treating] discoloration resulting from UV light,” says Westbay.

Best azelaic acid gel and cream

Best with salicylic acid: Tula Clear It Up Acne Clearing and Tone Correcting Gel

This azelaic acid gel pairs its ingredients with niacinamide, which helps brighten your skin’s tone and improve texture, says Dr. Hadley King, a board-certified dermatologist in New York City. It also has 2% salicylic acid that keeps acne at bay, probiotics that soothe and calm inflammation and hyaluronic acid that helps with hydration, according to the brand.

Best for acne-prone skin: Drunk Elephant Bouncy Brightfacial

Best azelaic acid cleansers

Best cleanser: Urban Skin Rx Even Tone Cleansing Bar

This 3-in-1 cleanser, mask and exfoliator contains azelaic acid, niacinamide and kojic acid, another tyrosinase inhibitor that can lighten dark spots. You can apply the cleanser on its own or use the included exfoliating sponge to massage it onto your skin and leave it on for a few minutes, according to the brand. You can also use it as a brightening mask and leave it on for 3-5 minutes before rinsing it off with cold water, according to Urban Skin Rx.

Meet our experts

At NBC Select, we work with experts who have specialized knowledge and authority based on relevant training and/or experience. We also take steps to ensure that all expert advice and recommendations are made independently and with no undisclosed financial conflicts of interest.

  • Dr. Rachel Westbay is a board-certified dermatologist at Marmur Medical in New York City.
  • Dr. Lindsey Bordone is a board-certified dermatologist and assistant professor of dermatology at ​Columbia University Medical Center. She specializes in adult general dermatology, managing all conditions of the skin, hair, and nails.
  • Dr. Joshua Zeichner is the director of cosmetic and clinical research at Mount Sinai Hospital.
  • Dr. Hadley King is a board-certified dermatologist in New York City.
  • Dr. Erum Ilyas is a board-certified dermatologist at Schweiger Dermatology. Dr. Ilyas specializes in adult and pediatric medical dermatology, cosmetic dermatology and skin cancer treatment.
  • Dr. Ronda Farah is a board-certified dermatologist at the University of Minnesota Medical School and M Health Fairview.
  • Dr. Amy Witt is a board-certified dermatologist at Derrow Dermatology in Maitland, Florida.
  • Dr. Aaron Secrest is a board-certified dermatologist and assistant professor of dermatology at the University of Utah. He is the creator of medicalsecrets.com offering practical skin care advice from an expert.

Why trust NBC Select?

Mili Godio is an editor at NBC Select who has written a variety of skin care stories, including treatments for cystic acne, keratosis pilaris and dark under-eye circles. For this article, Godio spoke to eight dermatologists about how azelaic acid works and highlighted their recommendations for the best products to consider.

Catch up on Select’s in-depth coverage of personal financetech and toolswellness and more, and follow us on FacebookInstagramTwitter and TikTok to stay up to date.